The improvement of the working system of doctors in ER and its safety management

Abstract

Recently, the number of patients coming to ER is increasing in number. Moreover, advanced and precise medical care is required. This causes many problems to doctors and safety management. When our new ER named “ER-Yokkaichi” was opened, the work shift system of doctors has been changed. The detail of our system is reported here.
Previous system: One 1st-year resident and one 2nd-year resident were at work in the ER, backed up by one internist and one surgeon. All four doctors were on duty the next day. All patients were diagnosed by the residents first. The two senior doctors were called when the patients were judged serious. New system: One 1st-year resident, one 2nd-year resident, one emergency doctor (3rd or 4th-year resident), one internist and one surgeon are on duty everyday. The three younger doctors are off duty the next day. All patients are diagnosed by the residents first, and then double-checked by the emergency doctor. The senior doctors are called when the patient needs hospital stay. Our approach is considered to be one of the methods to improve the quality and safety management level of ER.