Allocation of Internai Medicine Resident Time in a Swiss Hospital: A Time and Motion Study , the Médical Day (MeDay) Study


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PhD thesis: a PhD thesis.
Allocation of Internai Medicine Resident Time in a Swiss Hospital: A Time and Motion Study , the Médical Day (MeDay) Study
Wenger Nathalie
Waeber Gérard
Marques-Vidal Pedro
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Université de Lausanne, Faculté de biologie et médecine
Faculté de biologie et de médecine
Université de Lausanne
CH-1015 Lausanne

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Background: Little current evidence documents how internal medicine residents spend their time at work, particularly with regard to the proportions of time spent in direct patient care versus using computers.
Objective: To describe how residents allocate their time during day and evening hospital shifts.
Design: Time and motion study.
Setting: Internal medicine residency at a university hospital in Switzerland, May to July 2015.
Participants: 36 internal medicine residents with an average of 29 months of postgraduate training.
Measurements: Trained observers recorded the residents' activities using a tablet-based application. Twenty-two activities were categorized as directly related to patients, indirectly related to patients, communication, academic, nonmedical tasks, and transition. In addition, the presence of a patient or colleague and use of a computer or telephone during each activity was recorded.
Results: Residents were observed for a total of 696.7 hours. Day shifts lasted 11.6 hours (1.6 hours more than scheduled). During these shifts, activities indirectly related to patients accounted for 52.4% of the time, and activities directly related to patients accounted for 28.0%. Residents spent an average of 1.7 hours with patients, 5.2 hours using computers, and 13 minutes doing both. Time spent using a computer was scattered throughout the day, with the heaviest use after 6:00 p.m.
Limitation: The study involved a small sample from 1 institution.
Conclusion: At this Swiss teaching hospital, internal medicine residents spent more time at work than scheduled. Activities indirectly related to patients predominated, and about half the workday was spent using a computer.
Primary Funding Source: Information Technology Depart- ment and Department of Internal Medicine of Lausanne University Hospital.
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31/08/2017 9:55
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20/08/2019 13:42
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