Coping with pressures in acute medicine--the second RCP consultant questionnaire survey.

H M Mather, H Connor
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Abstract

The second questionnaire survey of consultant physicians involved in acute unselected takes in 1999 achieved a 76% response rate, and the results have been compared with those from the first survey of 1997. The proportion of consultants whose trainees worked partial shifts had increased from 42% to 61%, although these patterns of duty were adjudged to have detrimental effects on the quality and continuity of care, and on junior staff education and training. The benefits of ward-based systems were counterbalanced by their disadvantages, but introductions of admission wards and assessment units were considered a resounding success. The number of hospitals with 'physician of the week' schemes had increased from 12 to 23, but opinion of their value was sharply divided. The provision and competence of all grades of locums was identified as an increasing problem. Seventy per cent of respondents stated that they would never participate in 'hands-on' emergency care, although 86% thought that future consultants might have to do so. Seventy-nine per cent reported increases in the pressures of their posts and in their working hours, and the tensions between general and specialist duties were highlighted. Most consultants considered that the only long-term solution to the staffing crisis was a marked expansion in the numbers of all grades of medical staff.

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应对急症医学压力——第二次RCP咨询师问卷调查。
1999年对参与急性非选择性手术的会诊医师进行了第二次问卷调查,回复率为76%,并与1997年第一次调查的结果进行了比较。受训人员轮班工作的顾问比例从42%增加到61%,尽管这些工作模式被认为对护理的质量和连续性以及对初级工作人员的教育和培训有不利影响。以病房为基础的系统的好处被其缺点所抵消,但入院病房和评估单位的引入被认为是一个巨大的成功。实行"每周医生"计划的医院从12家增加到23家,但对其价值的看法却存在严重分歧。所有职等培训师的提供和胜任能力被认为是一个日益严重的问题。70%的受访者表示,他们永远不会参与“亲自动手”的紧急护理,尽管86%的人认为未来的顾问可能不得不这样做。79%的人报告说,他们的职位和工作时间的压力有所增加,一般职责和专门职责之间的紧张关系也很突出。大多数顾问认为,解决人员配备危机的唯一长期办法是显著增加各级医务人员的人数。
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