A scoping review of work patterns of junior medical officer tasks in hospital out of hours

Background

The role of Junior Medical Officers (JMOs) is pivotal in ensuring the delivery of patient care in hospitals. The challenges of providing medical care for patients out of hours (OOH) fall disproportionately to the JMO group, with implications for supervision and well-being.

Aim

The aim was to identify and map the available evidence on the work patterns of hospital JMOs OOH, including tools for measuring tasks and workload; barriers to JMO well-being; factors which impact on the safety of care and strategies to reduce JMO workload OOH.

Methods

A scoping review following Arksey and O'Malley and the Joanna Briggs Institute framework was performed. A total of 2446 articles were identified, and 49 individual articles were included.

Results

Work performed during non-standard working hours (evenings, nights and weekends) has impacts on both patient safety (morbidity, mortality, intensive care unit readmission, procedural complications). The OOH period is associated with reduced training quality and diminished JMO well-being.

Conclusions

Strategies to reduce workload and maximise supervision are key to improving OOH care and JMO experience. A more detailed account of JMO work OOH is needed. Tools for studying workload should include direct observation.