Need for recovery amongst emergency physicians in the UK and Ireland: a cross-sectional survey. Issue 11 (2nd November 2020)

• Record Type: Journal Article
• Authors: Cottey, Laura; Roberts, Tom; Graham, Blair; Horner, Daniel; Stevens, Kara Nicola; Enki, Doyo; Lyttle, Mark David; Latour, Jos
• Other Names: author non-byline.; Kane L author non-byline.; Richter S author non-byline.; Selway J author non-byline.; Rimmer C author non-byline.; Ayres M author non-byline.; Ponami C author non-byline.; Quartermain A author non-byline.; Kaur K author non-byline.; Hartshorn S author non-byline.; McGregor K author non-byline.; Gardner G author non-byline.; Clingo T author non-byline.; Stewart R author non-byline.; Mullen N author non-byline.; Mirza K author non-byline.; Hussan T author non-byline.; Cuthbert P author non-byline.; Alex M author non-byline.; Barham F author non-byline.; Bayston A author non-byline.; Veeramuthu K author non-byline.; Macfarlane R author non-byline.; Criddle J author non-byline.; Lipton G author non-byline.; New K author non-byline.; Jee Poh Hock M author non-byline.; Umana E author non-byline.; Ward C author non-byline.; Agosti V author non-byline.; Connelly M author non-byline.; Weegenaar C author non-byline.; Kerr J author non-byline.; Dhutia SJ author non-byline.; 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• Is Part Of: BMJ open. Volume 10:Issue 11(2020)
• Publication Date: 2020-11-02
• Subjects: accident & emergency medicine -- health services administration & management -- human resource management -- organisation of health services -- occupational & industrial medicine; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2020-041485
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: To determine the need for recovery (NFR) among emergency physicians and to identify demographic and occupational characteristics associated with higher NFR scores. Design: Cross-sectional electronic survey. Setting: Emergency departments (EDs) (n=112) in the UK and Ireland. Participants: Emergency physicians, defined as any registered physician working principally within the ED, responding between June and July 2019. Main outcome measure: NFR Scale, an 11-item self-administered questionnaire that assesses how work demands affect intershift recovery. Results: The median NFR Score for all 4247 eligible, consented participants with a valid NFR Score was 70.0 (95% CI: 65.5 to 74.5), with an IQR of 45.5–90.0. A linear regression model indicated statistically significant associations between gender, health conditions, type of ED, clinical grade, access to annual and study leave, and time spent working out-of-hours. Groups including male physicians, consultants, general practitioners (GPs) within the ED, those working in paediatric EDs and those with no long-term health condition or disability had a lower NFR Score. After adjusting for these characteristics, the NFR Score increased by 3.7 (95% CI: 0.3 to 7.1) and 6.43 (95% CI: 2.0 to 10.8) for those with difficulty accessing annual and study leave, respectively. Increased percentage of out-of-hours work increased NFR Score almost linearly: 26%–50% out-of-hours work=5.7 (95% CI: 3.1 to 8.4); 51%–75% out-of-hours work=10.3 (95% CI: 7.6 to 13.0); 76%–100% out-of-hours work=14.5 (95% CI: 11.0 to 17.9). Conclusion: Higher NFR scores were observed among emergency physicians than reported in any other profession or population to date. While out-of-hours working is unavoidable, the linear relationship observed suggests that any reduction may result in NFR improvement. Evidence-based strategies to improve well-being such as proportional out-of-hours working and improved access to annual and study leave should be carefully considered and implemented where feasible.