主治醫師排班原則之探討

Attending Physicians' Preferences for Shift-Scheduling

劉玲伶(Ling-Ling Liu) ； 王震宇(Jenn-Yue Wang)

《北市醫學雜誌》 2卷2期 (2005/02) Pp. 193-202

https://doi.org/10.6200/TCMJ.2005.2.2.09

摘要

目的：傳統的醫師值班是以住院醫師為第一線的值班人員，主治醫師的職責是第二線的監督工作。近年來，由於住院醫師的人力不足，主治醫師也須分擔值班的工作。由於主治醫師的年齡，體能狀況，與工作情形不同於住院醫師，因此排班的考量可能也有所差異，然而目前並無主治醫師值班的相關研究。本研究的目的在於瞭解主治醫師對於排班原則的偏好，以作為同儕主治醫師排班的參考。方法：18名內科主治醫師參與研究，以問卷方式進行調查。問卷的內容設計經由綜合相關文獻，內部醫師會議討論的共識，與深入訪談部分醫師意見的方式而成；內容包括對於排班規則、排班政策、各種班別的偏好、與被排班者的屬性等資料與理想班表的看法。結果：問卷結果以「符合預約班表」、「假日班公平」與「不同班別應該點數不同」為三個最重要的排班原則；由於會影響正常睡眠時間，所以大家對「急診大夜班」最不喜歡；值班優惠則是「優惠總點數」與「依年齡優惠」較合適。

關鍵字

排班 ； 醫師排班 ； 排班原則

並列摘要

Background: In the traditional medical care system, residents are the personnel on duty for the care of patients. Attending physicians only supervise. Due to an insufficiency of residents, attending physicians have been sharing the duty of residents in recent years. The age, the physical conditions, and the workload of attending physicians are quite different from those of residents. The rules for the scheduling of their shifts are supposed to be different. There has been no study that considers the viewpoints of the attending physicians. Purpose: The purpose of this study is to survey the preferences of the attending physicians with respect to the rules for the scheduling of the shifts. Method: A questionnaire was submitted to eighteen doctors of the Internal Medicine Department of a district hospital in Taipei city for their opinions about the rules used to schedule shifts. The questionnaire was designed by referring to the research literature, through discussions with doctors and after in-depth interviews with them. It includes the rules for scheduling, the policy for scheduling, preferences for different types of shifts, personal factors and their ideal schedules. Result: The questionnaire showed that shifts reserved by attending physicians, equal sharing of weekend shifts, and different scores for different types of shifts, were the three major concerns of the attending physicians. The overnight shift in the Emergency Department is generally considered the most unfavorable due to interruptions to the physicians' regular sleeping rhythm. Adjustment of shifts on the basis of the age of the attending physician rather than rank, and by changing to a score based system rather than the present total number of shifts system, is preferred.

並列關鍵字

scheduling ； physician scheduling ； rules for scheduling