Objective  To understand the status of human resource allocation of medical staff in emergency department of top(3A)hospitals in Zhangjiakou City and their leaving willingness, so as to provide suggestions for optimizing medical human resource allocation in this city.

  Methods  Referring to the annual statistical reports of 2 top (3A) hospitals in Zhangjiakou, the data related to emergency department operation and medical human resource allocation during 2017 to 2019 was collected. The questionnaires were used to survey leaving willingness of medical staff and possible affecting factors. The emergency workload, medical human resource allocation and basic situation of emergency medical care in these 3 years were analyzed. Multivariate logistic regression analysis was performed to screen the factors influencing leaving willingness.

  Results  The daily average workloads of emergency department in these 2 top three hospitals from 2017 to 2019 showed an increasing trend(P < 0.05). The proportions of both doctors and nurses with permanent employment increased also in these 3 years. Most emergency doctors worked in their position for more than 3 years, but had clinical training for less than 2 years. The working time of clinical nurses showed a decreasing gradually year by year(P < 0.05). The ration of bed-to-doctor in emergency department was basically met the governmental requirements, but there still existed a shortage of medical beds. Though more than 80% of medical doctors had bachelor's degree or higher and 90% senior nurses had bachelor's degree and/or college education, the proportion of medical staff with intermediate and/or senior titles was lower than 40%, and 70% of the medical staff worked for less 5 years. There was no statistically significant difference of medical staff's age, gender, title, educational level, and working time during these 3 years (P > 0.05). From 2017 to 2019, the proportion of resigned staff in emergency department was 31.08%, 40.66% and 39.81%, respectively. Among current employed medical staff, 24.07%(26/108) had the intention to leave. The results of logistic regression analysis showed that the leaving willingness possibility of medical staff in emergency department were affected by higher work stress and the severer psychological symptoms (OR=1.533, 1.874, P < 0.05).

  Conclusions  There was insufficient allocation of medical staff, shortage of senior of professionals, insufficient work experience and poor personnel stability in emergency department of top (3A)hospitals in Zhangjiakou City. It is necessary to further improve medical human resource allocation in emergency departments.