Authors: (including presenting author): :
Shih YN(1), LEUNG MPS(1), LAI PY(1), CHAN KY(1), LUI TW(1)
Affiliation: :
(1) Accident and Emergency Department (AED), Princess Margaret Hospital (PMH)
Keyword 1: :
Five-day week
Keyword 3: :
Staff happiness
Keyword 4: :
Staff wellness
Keyword 5: :
Work schedule change
Keyword 6: :
Employee retention
Introduction: :
PMH A&E previously operated on a 5.5 day workweek for Patient Care Assistants (PCAs) and nursing staff, using 8 hour shifts totaling 44 hours weekly. In June 2025, a new shift model was introduced that maintains the 44 hour workload but transitioned staff to a 5 day workweek by extending each shift to 8 hours and 48 minutes. The new arrangement provides two fixed days off per week and incorporates overlapping shifts to better balance operational needs and staff welfare. The shift redesign aims to improve work life balance, support personal and family commitments, and strengthen team cohesion and morale. The intentional overlap between shifts enhances communication, handover quality, and staff learning opportunities, without significantly increasing workload. Preparatory work began in November 2024, including setting new shift hours and conducting a staff attitude survey, which showed strong support among PCAs and nurses.
Objectives: :
The primary objective was to transition from a 5.5 day to a 5 day workweek while maintaining the same total weekly hours, thereby improving staff welfare and operational efficiency. Specific goals included: - Providing two days off per week to enhance work life balance - Strengthening communication and collaboration through overlapping shifts - Improving staff morale and retention by better accommodating personal and family needs - Ensuring adequate manpower coverage across all shifts without increasing workload or compromising patient care - Collecting staff feedback to gauge acceptance before full implementation - Demonstrating the feasibility of a 5 day workweek model within a high demand A&E
Methodology: :
Implementation began with an analysis of existing shift patterns and staffing levels. An Excel-based scheduling matrix was created, with columns representing 15 minute time intervals and rows representing headcount. This ensured sufficient manpower at all times after accounting for meal breaks. The target was a minimum of 10 staff per hour (excluding night shifts) to maintain adequate coverage. A staff attitude survey conducted in late 2024 indicated strong support for the proposed changes. A pilot schedule was launched on June 16, 2025, followed by close monitoring and feedback collection. Based on staff input, adjustments to day (D) and night (N) shifts were implemented on September 8, 2025. After the pilot demonstrated positive outcomes, a formal departmental application was submitted and approved by HR in November 2025.
Result & Outcome: :
The pilot implementation of the 5 day workweek in PMH A&E was successful and well received. Staff benefited from having two days off each week, leading to better work life balance and improved alignment with personal and family needs. Overlapping shifts strengthened communication, streamlined handovers, and increased opportunities for learning and team interaction, contributing to higher morale. These improvements were achieved without significant increases in workload or staffing gaps during peak periods. Positive feedback from nursing and PCA staff affirmed broad acceptance of the new model. Subsequent refinements to shift hours further enhanced operational efficiency. HR approval in November 2025 formally established the new work system, which is expected to support long term staff welfare and retention while maintaining high-quality patient care.
