title: Hip fracture documentation-the impact of shift systems.
abstract: The recent reduction in junior doctors' hours has lead to a change in working patterns. The aim of this study was to assess the effect of this change on documentation in orthopaedic surgery. Over a 6-week period, 25 patients were admitted to our unit with hip fractures. During this period, all junior doctors worked on a 'full-shift' working pattern. For comparison a control group was formed comprising of 29 patients admitted with hip fractures over an earlier 6 weeks when all junior doctors worked on a traditional 'on-call' system. The medical records of each patient were assessed for the quality of medical documentation using a published scoring system. The on-call group scored higher for the standard of documentation compared with the shift system group (mean 24.8 versus mean 21.3), p<0.05. The on-call group also had fewer weekdays without any documented entries in the medical records compared to the shift system group (mean 3.2 days versus mean 4.0 days), p<0.05. A change in the working pattern for junior doctors has lead to a reduction in the quality of medical documentation. With more personnel working fewer hours, maintaining a high standard of documentation is essential for the good clinical care of patients.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Queen Elizabeth Hospital, Gayton Road, King's Lynn, Norfolk, UK. jrcrawford@doctors.org.uk
authors.forename: John R
authors.initials: JR
authors.lastname: Crawford
authors.forename: Douglas
authors.initials: D
authors.lastname: Hay
authors.forename: Nigel
authors.initials: N
authors.lastname: Coleman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004282:Documentation / Q000592:standards; D004739:England; D005260:Female; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008499:Medical Records / Q000592:standards*; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data*; D008875:Middle Aged; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data; D014940:Work Schedule Tolerance; D016526:Workload / Q000706:statistics & numerical data*