Managing Fatigue For Doctors in your Healthcare Staff Rotas

In the UK we work with a number of NHS & other healthcare practices and are familiar with the the junior doctor contract and working time directives set our for those professionals. And while they do set some hard rules to prevent the worst instances of rota-caused doctor fatigue, we often hear that they do not provide enough guidance to schedule-makers to determine when a combination of different schedule factors can leave doctors overtired and patients at risk.

The Australian Medical Association National Code of Practice defines a risk score that can be used to assess every seven days of a rota [2]. The risk score was validated and the factors were found to be associated with excessive sleepiness [3].

Here at Rotageek we decided to help our healthcare teams plan better schedules by implementing the AMA risk score into our schedule analysis tools. It can be used in real time while making a schedule to warn when a particular doctor passes a threshold risk score or when the group of doctors on shift have an average risk score above some threshold. It can also be used to look across an entire rota period to spot trends in risk score to identify problem spots (see below image).

[1] West CP, Tan AD, Habermann TM, Sloan JA, Shanafelt TD. Association of Resident Fatigue and Distress With Perceived Medical Errors. JAMA. 2009;302(12):1294–1300. doi:10.1001/jama.2009.1389

[2] https://ama.com.au/system/tdf/documents/FINAL_NCP_%20Hours_of_work_2016.pdf?file=1&type=node&id=37826

[3] Gander P, Purnell H, Garden A, Woodward A. Work patterns and fatigue-related risk among junior doctors. Occup Environ Med. 2007;64(11):733–738. doi:10.1136/oem.2006.030916