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World J Crit Care Med. May 4, 2017; 6(2): 91-98
Published online May 4, 2017. doi: 10.5492/wjccm.v6.i2.91
Generalizable items of quantitative and qualitative cornerstones for personnel requirement of physicians in anesthesia
Manfred Weiss, Rolf Rossaint, Thomas Iber
Manfred Weiss, Department of Anesthesiology, University Hospital Ulm, 89081 Ulm, Germany
Rolf Rossaint, Department of Anesthesia and Pain Medicine, University Hospital Aachen, 52074 Aachen, Germany
Thomas Iber, Department of Anesthesia and Intensive Care, Klinikum Mittelbaden Baden-Baden/Bühl, 76532 Baden-Baden, Germany
Author contributions: Weiss M, Rossaint R and Iber T wrote the paper on behalf of the “Forum quality management and economics” of the German Association of Anaesthesiologists (BDA) and the German Society of Anaesthesiology and Intensive Care Medicine (DGAI); Weiss M, Rossaint R and Iber T were leading in the previous versions and the update and publications in German language of the calculation base for the personnel requirement of physicians in anesthesia including an Excel calculation sheet by the “Forum quality management and economics” focusing on quantitative and qualitative cornerstones for personnel requirement of physicians in anesthesia.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Manfred Weiss, MD, MBA, Department of Anesthesiology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany. manfred.weiss@uni-ulm.de
Telephone: +49-731-50060226 Fax: +49-731-50060008
Received: July 31, 2016
Peer-review started: August 1, 2016
First decision: October 20, 2016
Revised: January 2, 2017
Accepted: February 8, 2017
Article in press: February 9, 2017
Published online: May 4, 2017
Processing time: 275 Days and 12.1 Hours
Abstract

Anesthesiologists perform a broad spectrum of tasks. However, in many countries, there is no legal basis for personnel staffing of physicians in anesthesia. Also, the German diagnosis related groups system for refunding does not deliver such a basis. Thus, in 2006 a new calculation base for the personnel requirement that included an Excel calculation sheet was introduced by the German Board of Anesthesiologists (BDA) and the German Society of Anesthesiology and Intensive Care Medicine (DGAI), and updated in 2009 and 2015. Oriented primarily to organizational needs, in 2015, BDA/DGAI defined quantitative and qualitative cornerstones for personnel requirement of physicians in anesthesia, especially reflecting recent laws governing physician’s working conditions and competence in the field of anesthesia, as well as demands of strengthened legal rights of patients, patient care and safety. We present a workload-oriented model, integrating core working hours, shift work or standby duty, quality of care, efficiency of processes, legal, educational, controlling, local, organizational and economic aspects for calculating personnel demands. Auxiliary tables enable physicians to calculate personnel demands due to differing employee workload, non-patient oriented tasks and reimbursement of full-equivalents due to parental leave, prohibition of employment, or long-term illness. After 10 years of experience with the first calculation tool, we report the generalizable key aspects and items of a necessary calculation tool which may help physicians to justify realistic workload-oriented personnel staffing demands in anesthesia. A modular, flexible nature of a calculation tool should allow adaption to the respective legal and organizational demands of different countries.

Keywords: Anesthesia; Service time; Organization; Personnel requirement; Working time directive; Continuing medical education; Patient rights; Patient safety

Core tip: After 10 years of experience with the first calculation tool, generalizable key aspects and items of an updated calculation tool are presented to help physicians to justify realistic workload-oriented personnel staffing demands in anesthesia. A modular, flexible nature of a calculation tool allows adaption to the respective legal and organizational demands of different countries. A workload-oriented model is presented, integrating core working hours, shift work or standby duty, quality of care, efficiency of processes, legal, educational, controlling, local, organizational and economic aspects. Auxiliary tables reflect differing employee workload, non-patient oriented tasks, parental leave, prohibition of employment, or long-term illness.