Title: Changes in the hospital care following European Working Time Directive with special reference to the craft specialties

Authors: Alfred Cuschieri, Giuseppe Turchetti

Addresses: Istituto di Management, Scuola Superiore Sant'Anna, Piazza Martiri della Liberta, 33, 56127 Pisa, Italy. ' Istituto di Management, Scuola Superiore Sant'Anna, Piazza Martiri della Liberta, 33, 56127 Pisa, Italy

Abstract: The revised European Working Time Directive (EWTD) for doctors has changed hospital care delivery from the on call to the shift or rota system. Despite its potential benefits, it has major staff resource and cost implications and requires drastic changes in training of all hospital specialists, but especially those in the craft specialties. Inevitably, training of specialists has changed from being apprentice-based to competence-based. The impact of this change is crucial in the craft specialties such as surgery, where proficiency in execution of operations is crucial to patient outcome. Hence, several changes are needed to address this problem: more flexible curriculum, expansion in consultant numbers (consultant driven health service), improvement of the quality of training including establishment of dedicated training operating lists, supplemented by the establishment of skills laboratories in all training hospitals or regional training centres with ready access by trainees for both component and procedure-related skills.

Keywords: European Working Time Directive; EWDT; competence-based training; training curricula; craft specialties; organisational implications; hospital care; healthcare delivery; shifts; rota systems; surgery; healthcare training; healthcare education; staff resources; hospital specialists.

DOI: 10.1504/IJHTM.2011.040476

International Journal of Healthcare Technology and Management, 2011 Vol.12 No.3/4, pp.215 - 229

Published online: 28 Mar 2015 *

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