Emergency Medicine CMOs and General Practitioners, Mudgee NSW

Scenario

Historically, the Mudgee Hospital Emergency Department was run as a GP VMO facility, wherein GPs from the local practice were rostered on to cover the ED, being called by nursing staff as and when patients presented. Due to increased presentation numbers, it became unviable for local GPs to continue to juggling patient consults in the clinic with on-call responsibilities for emergency department presentations. 

Local GPs opted to withdraw coverage from the hospital. This left the hospital in a predicament as until this point, the hospital had never needed to recruit directly for medical staff.  

Recruitment efforts were unrewarding, and the hospital ended up relying on short-term FIFO locums to provide medical cover for the facility. The locums were rostered on for 24 hours, being on-site during the day and on-call overnight. The presentation numbers continued to rise, and it became increasingly difficult to find locums willing to accept shifts, due to the long hours and heavy workload. The cost to the hospital was very high, there was no guarantee of rosters being covered and there was an increased administrative burden due to the high number of medical staff rotating through the shifts.  

The Director of Medical of Services contacted Medical Directions for assistance with providing a workforce solution.

Our Approach

• Create an improved model to stabilise the medical workforce in the region 
• A strategic market mapping, networking and advertising campaign was executed to encourage and identify suitable doctors
• A two-shift model was implemented and worked for many years
•  Eventually, as ED presentations continued to increase and with feedback from doctors, the model was amended to include an additional day shift during weekends

Outcome

•  Since 2013 Medical Directions has recruited and managed a permanent and locum workforce for the Emergency Department, covering 4200 shifts at a 92% fill rate
• There was keen interest and participation from doctors outside the local area to provide coverage in the ED so they could maintain their ED skills. Locally based doctors agreed to share the night cover. Medical Directions were flexible in supporting this change to ensure local doctors were being prioritised
• Mudgee Hospital now enjoys a roster filled with a cohort of local doctors which both the community and facility benefit from
• Ownership of the roster has been returned to the local management team with Medical Directions retaining a roster line one week in two for night shifts