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Author Eva-Maria Carman, Giulia Miles, Steve Cantellow & Patrick Waterson |
| Abstract Healthcare needs to provide services 24 hours a day, seven days a week, 365 days a year. This includes out-of-hours from 17:00 to 09:00 weekdays, weekends and Bank Holidays. To provide this care, which has been estimated to be about 75% of the working week, dedicated out-of-hours teams have developed within the healthcare system. At one large NHS Hospital Trust, the focus of this study, the out-of-hours care is provided by the Hospital 24 service, a small team with limited resources covering a wide range of medical and surgical specialities across two large and complex hospital sites. In light of the increasing demand on this service, changes in available technology and with the numerous changes as a result of the COVID-19 pandemic, the Out-of-Hours Review aims to capture the current state of this service to determine the potential requirements for the future. This component of the Out-of-Hours Review aims to provide a high-level description of the system elements of the Hospital 24 Service. The systems analysis was compiled from three different data sources, namely a survey, data from the task management system and observation sessions. Using the SEIPS 2.0 model, high-level descriptions of the different work system components and a preliminary list of the barriers staff encounter, and facilitators staff use in this work system were generated. This analysis also identified the perspectives, system components and interactions that need to be explored in more detail in the next phase of this review. |
