Inter-hospital comparison of working time allocation among internal medicine residents using time-motion observations: an innovative benchmarking tool.
health economics
internal medicine
medical education & training
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
16 02 2020
16 02 2020
Historique:
entrez:
19
2
2020
pubmed:
19
2
2020
medline:
20
2
2021
Statut:
epublish
Résumé
The vast majority of residents' working time is spent away from patients. In hospital practice, many factors may influence the resident's working day structure.Using an innovative method, we aimed to compare working time allocation among internal medicine residents using time-motion observations. The first study goal was to describe how the method could be used for inter-hospital comparison. The secondary goal was to learn about specific differences in the resident's working day structure in university and non-university hospital settings. Two separate time-motion studies. Trained peer-observers followed the residents during weekday day shifts with a tablet, able to record 22 different activities and corresponding context (with patient, phone, colleague or computer). Internal medicine residencies at a university (May-July 2015) and a non-university (September-October 2016) community hospital. 28 residents (mean age: 29 years, average postgraduate training: 30 months) at university hospital, 21 residents (mean age: 30 years, average postgraduate training: 17 months) at non-university hospital. Time spent with patients and time dedicated to activities directly related to patients; description of main differences of time allocation between hospitals. Cumulatively 1051 hours of observation (566 (university hospital)+486 (non-university hospital)) and 92 day shifts (49+43) were evaluated. Daily working time was 11.5 versus 11.3 hours. A median daily period of 195 min (IQR 179-211, 27.9%) and 116 min (IQR 98-134, 17.2%) (p<0.001) was dedicated to direct patient care, respectively. We successfully identified differences potentially related to each hospital structure and organisation. Inter-hospital comparisons could help set up interventions aiming to improve workday structure and experience of residents.
Identifiants
pubmed: 32066604
pii: bmjopen-2019-033021
doi: 10.1136/bmjopen-2019-033021
pmc: PMC7044966
doi:
Types de publication
Comparative Study
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e033021Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: J-HB received financial support from the Swiss National Science Foundation and the Kardio Foundation.
Références
Methods Inf Med. 2009;48(1):84-91
pubmed: 19151888
JAMA Intern Med. 2019 Jun 1;179(6):760-767
pubmed: 30985861
J Am Med Inform Assoc. 2005 Sep-Oct;12(5):505-16
pubmed: 15905487
JAMA. 2016 Sep 6;316(9):923-4
pubmed: 27532804
Health Informatics J. 2016 Sep;22(3):768-78
pubmed: 26187989
J Gen Intern Med. 2013 Aug;28(8):1042-7
pubmed: 23595927
Ann Intern Med. 2017 Apr 18;166(8):579-586
pubmed: 28135724
Ann Intern Med. 2016 Dec 6;165(11):753-760
pubmed: 27595430
Clinicoecon Outcomes Res. 2013 Aug 09;5:399-406
pubmed: 23966799
PLoS One. 2017 Feb 24;12(2):e0172878
pubmed: 28235078
Med J Aust. 2008 May 5;188(9):506-9
pubmed: 18459920
Ochsner J. 2014 Winter;14(4):545-50
pubmed: 25598719
Neuropsychiatr Dis Treat. 2015 Dec 10;11:3023-9
pubmed: 26677329
Acad Med. 2016 Jun;91(6):827-32
pubmed: 27028026
JAMA. 2014 Dec 10;312(22):2331-2
pubmed: 25490318
N Engl J Med. 2018 Apr 19;378(16):1494-1508
pubmed: 29557719
J Gen Intern Med. 2012 Nov;27(11):1432-7
pubmed: 22865015
Science. 2010 Apr 16;328(5976):360-3
pubmed: 20395509