Senior clinicians working the nightshift

5 April 2017

Lyell McEwin Hospital patients will receive better round-the-clock care thanks to an
initiative that will see senior doctors and nurses working in the wards overnight.

Over the past few decades, there has been a growing tendency to put our most experienced night shift doctors closer to the ‘front line’ in the Emergency Department or on remote call from home.

This has made it increasingly difficult for our most junior ward doctors to access support from their more experienced colleagues overnight.

However, in recent years, with an increased focus on patient-centred care, hospitals such as the Lyell McEwin are recognising the gap that has appeared and are working on ways to support overnight staff better again.

Therefore, according to Head of Anaesthesia Dr Simon Jenkins, the Lyell McEwin Hospital was an obvious choice by SA Health to trial an after-hours senior clinical cover initiative.

Dr Jenkins, who is chairing the implementation group for the pilot, said trialling a model of care for after-hours senior clinical cover was a natural progression.

“We’ve been going down this path for some time now,” Dr Jenkins said.

“The Department of Medicine at the Lyell McEwin has been working very hard on supporting its junior staff at night and has made some great progress. Our nurses have also gone down this path ahead of us and provide senior clinical support for the wards up until midnight or later. We hope that some of the resources provided by running
this pilot will help them do even better.

“The Lyell McEwin Hospital has always been a place where we embrace change so it’s a fantastic site for testing new ways to do things.”

Some of the expected benefits of the pilot include improved communication between doctors and nurses, more readily available support for junior clinical staff overnight and, ultimately, better patient care.

“Patients won’t be waiting until morning for a decision to be made about their care,” Dr Jenkins said.

“We will be able to actively manage their problems as they arise. If treatment is progressed, rather than simply maintained overnight, patients will get better more quickly. This has the additional benefit of freeing up bed space within the hospital so that patients requiring admission are not held up.”

Introduction of an electronic clinical activity task board that chronicles a patient’s care in real time will enable senior clinicians to see what jobs each staff member is attending to, which assists in the allocation of work.

“The clinical activity task board should reduce the regular interruptions coming from pagers, because medical staff will be able to see at a glance where they are needed on the wards,” Dr Jenkins said.

“And the leadership team will be able to see when staff need them and can step in to help them out.”

The clinical activity task board was introduced in February and recruiting for the senior clinician positions is expected to be completed during March.

“This pilot is expected to result in faster and more positive outcomes for patients,” Dr Jenkins said.