How Hospitalists spend their time: Insights on efficiency and safety
How Hospitalists spend their time: Insights on efficiency and safety
复制标题
DOI：
10.1002/jhm.88
复制
发表时间：
2006-03-01
影响因子：
2.6
通讯作者：
Baker, David W.
中科院分区：
文献类型：
--
作者：
O'Leary, Kevin J.;Liebovitz, David M.;Baker, David W.
背景：尽管住院医师的数量急剧增长，但没有研究评估住院医师从事的活动的类型和频率。为了评估住院医师在日常工作中进行的活动的类型和频率，我们进行了一项时间运动研究的住院医师在我们institution.DESIGN：一个研究助理阴影住院医师3- 5小时的时间。观察期的分布是为了采样一个典型的一天的住院医生，包括入院和非入院期间的所有部分。以1分钟间隔将活动记录在标准化数据收集表上。传入的网页记录，以及。结果：10名住院医生的阴影由一个单一的研究助理，共4467分钟。医院医生将1.8%的时间用于直接患者护理，69%用于间接患者护理，4%用于个人活动，3%用于专业发展，教育和旅行。通信占总分钟数的24%。多任务处理，即同时进行多项活动，占21%。Hospitalists收到平均3.4 +/- 1.5页每hours.CONCLUSIONS：Hospitalists花了他们的大部分时间在间接的病人护理活动和相对较少的时间在直接的病人护理。医院医生在沟通上花费了大量的时间，强调了医院医生需要具备出色的沟通技巧和支持有效沟通的系统。多任务处理和寻呼中断是常见的。由中断和多任务处理引起的固有分心是导致医疗错误的潜在因素，值得进一步研究。
BACKGROUND: Despite the dramatic growth of hospitalists, no studies have evaluated the type and frequency of activities that hospitalists perform. To evaluate the types and frequency of activities that hospitalists perform during routine work, we conducted a time-motion study of hospitalist physicians at our institution.DESIGN: A research assistant shadowed hospitalist physicians for 3- to 5-hour periods. Observation periods were distributed in order to sample all parts of a typical day of a hospitalist, including both admitting and nonadmitting periods. Activities were recorded on a standardized data collection form in I-minute intervals. Incoming pages were recorded as well.RESULTS: Ten hospitalists were shadowed by a single research assistant for a total of 4467 minutes. Hospitalists spent 1.8% of their time on direct patient care, 69% on indirect patient care, 4% on personal activities, and 3% each on professional development, education, and travel. Communication accounted for 24% of the total minutes. Multitasking, performing more than one activity at the same time, was done 21% of the time. Hospitalists received an average of 3.4 +/- 1.5 pages per hour.CONCLUSIONS: Hospitalists spent most of their time on indirect patient care activities and relatively little time on direct patient care. Hospitalists spent a large amount of time on communication, underscoring the need for hospitalists to have outstanding communication skills and systems that support efficient communication. Multitasking and paging interruptions were common. The inherent distraction caused by interruptions and multitasking is a potential contributor to medical error and warrants further study.