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15 Jul 2017

Since the AMA embarked on its safe working hours campaign in the mid-1990s, there has been a significant reduction in the number of doctors whose working hours expose them to higher risks of fatigue. However the results of the 2016 AMA Safe Hours Audit shows there has been little improvement since the last AMA Safe Hours Audit conducted in 2011.

The report shows that:

  • One in two doctors (53 per cent) are still working rosters that put them at significant and higher risk of fatigue to the extent that it could impact on performance, effect the health of the doctor and the safety of the patient. This number has not changed since 2011. 
  • Registrars appear to be at particular risk with 59 per cent working rosters that place them at significant and higher risk of fatigue compared to 49 per cent of Interns/RMOs and 47 per cent of CMO/Consultants. 
  • The number of Interns/RMOs working in the higher risk category has also increased by 11 per cent in 2016 compared with the 2011 report.

 The 2016 Audit confirms that doctors at higher risk of fatigue typically work longer hours, longer shifts, have more days on call, less days off and are more likely to skip a meal break. These are red flags that public hospitals need to urgently address in their rostering arrangements.

Safe rostering practices are a critical part of ensuring a safe work environment. Public hospitals in conjunction with medical colleges need to urgently review training and service requirements and implement rostering arrangements that create safe work environments and provide for high quality patient care. This includes implementing and supporting safe rostering practices and staffing levels, providing appropriate access to rest and leave provisions, and for clinicians, protected teaching and training time, organised within working hours.

The AMA National Code of Practice - Hours of Work, Shiftwork and Rostering for Hospital Doctors (the Code) responds to ongoing concerns about working hours and safe practice. It acknowledges the special characteristics of the hospital sector as well as managing the risks associated with shiftwork and extended hours for hospital doctors and doctors in training. This Code has been revised in 2016 and provides practical guidance on how to manage fatigue and eliminate or minimise the risks associated with shiftwork and extended working hours.

The AMA National Code of Practice – Flexible work and training practices is another useful tool to assist employers, training providers, doctors and doctors in training to implement and access best practice flexible work and training arrangements. 

The AMA Fatigue Risk Assessment Tool can help doctors determine whether they are at risk of fatigue. Doctors who use the assessment tool will receive an on-line assessment of the fatigue risks of their roster. Doctors who are assessed as being at risk are encouraged to raise this with hospital management.

 

 


Published: 15 Jul 2017