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T
he standard of out-of-hours care is a huge area of concern
for the health service. Studies demonstrate drops in
healthcare quality at night and on weekends, including
significant increases in mortality. The demands of out-of-hours
working lower quality of life for staff and impact the costs of care
through absenteeism and over-reliance on locums. Despite well
documented effects, out-of-hours care remains under-studied, due
in part to practicalities of large scale manual studies in complex,
geographically dispersed, and sensitive working environments.
Dr Dominic Shaw is a clinical academic and leads out-of-hours care
at Nottingham City Hospital. He summarises the problem: “Providing
care 24 hours a day 7 days a week is a hugely complicated,
costly and specialist task. Understanding the relationship between
workload and work place will help our understanding of this vital
area.”
The Horizon Wayward project investigates the collection and analysis
of data concerning out-of-hours care in secondary care institutions.
Dr Michael Brown, a researcher on the project, comments: “As it
stands little is known about how doctors deliver out-of-hours care
in hospitals and even less about whether they are doing it right. This
is a problem Wayward is addressing head on though novel methods
and technologies.”
Wayward builds upon technology and procedures developed by
the team in order to identify best practice for out-of-hours training,
management and care delivery and make nationally relevant
recommendations. They utilise the relationship between activity
and location to record the type, timing and location of tasks being
undertaken by medical doctors without the need for traditional direct
observation methods.
In collaboration with three NHS Trusts (Nottingham University
Hospitals, Aintree Hospital and Blackpool Victoria Hospital) and
Liverpool School of Tropical Medicine the team has recently been
awarded funding from the Health Foundation for the uptake and
spread of the project team’s ground breaking data collection
technologies across NHS hospitals. “It will allow the expansion of our
studies over multiple sites in order to demonstrate that the methods
are scalable, cost effective and unobtrusive for staff and patients,”
Dr Shaw says. “It will enable evidence based improvements to safety,
efficiency, and efficacy in service provision for this understudied and
important aspect of secondary care.”
For further information, please contact:
Dr Michael Brown
:
michael.brown@nottingham.ac.ukWayward: Informing best practice in out-of-hours secondary care