令和元年度厚生労働省委託

医療勤務環境改善マネジメントシステムに基づく医療機関の取組に対する支援の充実を図るための調査･研究事業報告書

2020（令和 2）年 3 月

医療勤務環境改善マネジメントシステムに基づく医療機関の取組に対する支援の充実を図るための検討委員会

目次
Ⅰ 事業の概要 ............................................................................................. 1
１．目的.......................................................................................................................................................................... 2
２．実施概要................................................................................................................................................................ 2３．実施体制................................................................................................................................................................ 7
Ⅱ 提言～勤務環境改善の更なる推進のために～ .................................................. 11
Ⅲ 令和元年度実態調査 ...............................................................................23
Ⅲ－１．病院調査 ..................................................................................... 25
Ⅲ－１－１．病院調査 サマリー ..................................................................... 26
Ⅲ－１－２．病院調査 調査結果 .................................................................. 31
１．属性........................................................................................................................................................................31
２．職員数と定着状況 ...........................................................................................................................................36
３．フルタイム勤務正規職員の労働時間 .....................................................................................................38
４．フルタイム勤務正規職員の働き方 ...........................................................................................................43
５．休日・休暇 ...........................................................................................................................................................48
６．勤務環境改善の取組状況 ...........................................................................................................................49
７．「いきサポ」の認知と利用状況 ...................................................................................................................62
８．「医療勤務環境改善センター」の認知と利用状況 .............................................................................64
９．その他の取組状況 ..........................................................................................................................................66
Ⅲ－２．有床診療所調査............................................................................. 67
Ⅲ－２－１．有床診療所調査 サマリー ............................................................ 68
Ⅲ－２－２．有床診療所調査 調査結果.......................................................... 72
１．属性........................................................................................................................................................................72
２．職員数と定着状況 ...........................................................................................................................................75
３．フルタイム勤務正規職員の労働時間 .....................................................................................................76
４．フルタイム勤務正規職員の働き方 ...........................................................................................................79
５．休日・休暇 ...........................................................................................................................................................82
６．勤務環境改善の取組状況 ...........................................................................................................................83
７．「いきサポ」の認知と利用状況 ...................................................................................................................90
８．「医療勤務環境改善センター」の認知と利用状況 .............................................................................92
９．その他の取組状況 ..........................................................................................................................................93
Ⅲ－３．病院勤務医調査............................................................................. 95
Ⅲ－３－１．病院勤務医調査 サマリー ............................................................ 96
Ⅲ－３－２．病院勤務医調査 調査結果........................................................ 103
１．属性..................................................................................................................................................................... 103
２．労働時間........................................................................................................................................................... 111

３．休日・休暇 ........................................................................................................................................................ 130
４．夜間の働き方や拘束時間......................................................................................................................... 135
５．健康について .................................................................................................................................................. 145
６．勤務環境改善の取組と効果 .................................................................................................................... 149
７．満足度................................................................................................................................................................ 156
Ⅲ－４．有床診療所勤務医調査 .................................................................. 159
Ⅲ－４－１．有床診療所勤務医調査 サマリー .................................................. 160
Ⅲ－４－２．有床診療所勤務医調査 調査結果 ............................................... 167
１．属性..................................................................................................................................................................... 167
２．労働時間........................................................................................................................................................... 172
３．休日・休暇 ........................................................................................................................................................ 181
４．夜間の働き方や拘束時間......................................................................................................................... 184
５．健康について .................................................................................................................................................. 189
６．勤務環境改善の取組と効果 .................................................................................................................... 191
７．満足度................................................................................................................................................................ 196
Ⅲ－５．病院勤務看護職調査 ..................................................................... 199
Ⅲ－５－１．病院勤務看護職調査 サマリー..................................................... 200
Ⅲ－５－２．病院勤務看護職調査 調査結果 .................................................. 206
１．属性..................................................................................................................................................................... 206
２．労働時間........................................................................................................................................................... 212
３．休日・休暇 ........................................................................................................................................................ 221
４．夜間の働き方や拘束時間......................................................................................................................... 224
５．健康について .................................................................................................................................................. 232
６．勤務環境改善の取組と効果 .................................................................................................................... 235
７．満足度................................................................................................................................................................ 240
Ⅲ－６．有床診療所勤務看護職調査 ............................................................ 241
Ⅲ－６－１．有床診療所看護職調査 サマリー .................................................. 242
Ⅲ－６－２．有床診療所看護職調査 調査結果 ............................................... 247
１．属性..................................................................................................................................................................... 247
２．労働時間........................................................................................................................................................... 252
３．休日・休暇 ........................................................................................................................................................ 258
４．夜間の働き方や拘束時間......................................................................................................................... 260
５．健康について .................................................................................................................................................. 267
６．勤務環境改善の取組と効果 .................................................................................................................... 269
７．満足度................................................................................................................................................................ 273
Ⅲ－７．病院勤務コメディカル調査 ................................................................. 275
Ⅲ－７－１．病院勤務コメディカル調査 サマリー ................................................. 276
Ⅲ－７－２．病院勤務コメディカル調査 調査結果 .............................................. 280

１．属性..................................................................................................................................................................... 280
２．労働時間........................................................................................................................................................... 286
３．休日・休暇 ........................................................................................................................................................ 296
４．夜間の働き方や拘束時間......................................................................................................................... 299
５．健康について .................................................................................................................................................. 302
６．勤務環境改善の取組と効果 .................................................................................................................... 304
７．満足度................................................................................................................................................................ 309
Ⅳ モデル事業 .......................................................................................... 311
１．モデル事業の実施内容.............................................................................................................................. 312
２．モデル事業個別事例................................................................................................................................... 313
A 医療法人財団佐野メディカルセンター 佐野市民病院............................................................ 313
B 医療法人博俊会 春江病院................................................................................................................. 321
Ｃ 医療法人穂仁会 大滝病院 ................................................................................................................ 328
Ｄ 医療法人菊野会 菊野病院 ................................................................................................................ 334
Ｅ 医療法人社団大岩外科医院 大岩外科胃腸科医院（有床診療所） ................................. 338
３．フォローアップについて .............................................................................................................................. 343
Ⅴ 取組事例 ........................................................................................... 349
１．調査概要........................................................................................................................................................... 350
２．事例収集の視点と事例収集方法........................................................................................................... 350
３．事例収集結果から見た先進事例の特徴............................................................................................ 350
４．ヒアリング項目................................................................................................................................................ 351
５．収集した事例 .................................................................................................................................................. 352
６．事例個票........................................................................................................................................................... 353
参考資料：調査票 ..................................................................................... 371