Time is of the essence: an observational time-motion study of internal medicine residents while they are on duty.

Autor:	Leafloor CW; Faculty of Medicine, University of Ottawa, Ontario, Canada., Liu EY; Quality and Performance Measurement, Ottawa Hospital, Ontario, Canada., Code CC; Faculty of Medicine, University of Ottawa, Ontario, Canada.; Division of General Internal Medicine, The Ottawa Hospital, Ontario, Canada., Lochnan HA; Faculty of Medicine, University of Ottawa, Ontario, Canada.; Division of Endocrinology and Metabolism, The Ottawa Hospital, Ontario, Canada.; The Ottawa Hospital Research Institute, The Ottawa Hospital, Ontario, Canada., Keely E; Faculty of Medicine, University of Ottawa, Ontario, Canada.; Division of Endocrinology and Metabolism, The Ottawa Hospital, Ontario, Canada.; The Ottawa Hospital Research Institute, The Ottawa Hospital, Ontario, Canada., Rothwell DM; Quality and Performance Measurement, Ottawa Hospital, Ontario, Canada., Forster AJ; Faculty of Medicine, University of Ottawa, Ontario, Canada.; Quality and Performance Measurement, Ottawa Hospital, Ontario, Canada.; Division of General Internal Medicine, The Ottawa Hospital, Ontario, Canada.; The Ottawa Hospital Research Institute, The Ottawa Hospital, Ontario, Canada., Huang AR; Faculty of Medicine, University of Ottawa, Ontario, Canada.; The Ottawa Hospital Research Institute, The Ottawa Hospital, Ontario, Canada.; Division of Geriatric Medicine, The Ottawa Hospital, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	Canadian medical education journal [Can Med Educ J] 2017 Jun 30; Vol. 8 (3), pp. e49-e70. Date of Electronic Publication: 2017 Jun 30 (Print Publication: 2017).
Abstrakt:	Background: The effects of changes to resident physician duty hours need to be measureable. This time-motion study was done to record internal medicine residents' workflow while on duty and to determine the feasibility of capturing detailed data using a mobile electronic tool. Methods: Junior and senior residents were shadowed by a single observer during six-hour blocks of time, covering all seven days. Activities were recorded in real-time. Eighty-nine activities grouped into nine categories were determined a priori . Results: A total of 17,714 events were recorded, encompassing 516 hours of observation. Time was apportioned in the following categories: Direct Patient Care (22%), Communication (19%), Personal tasks (15%), Documentation (14%), Education (13%), Indirect care (11%), Transit (6%), Administration (0.6%), and Non-physician tasks (0.4%). Nineteen percent of the education time was spent in self-directed learning activities. Only 9% of the total on duty time was spent in the presence of patients. Sixty-five percent of communication time was devoted to information transfer. A total of 968 interruptions were recorded which took on average 93.5 seconds each to service. Conclusion: Detailed recording of residents' workflow is feasible and can now lead to the measurement of the effects of future changes to residency training. Education activities accounted for 13% of on-duty time. Competing Interests: Conflicts of interest: All authors report no conflicts of interest.
Databáze:	MEDLINE
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