Department of Anesthesiology and Intensive Care, University Hospital Leipzig, Liebigstr, 20, Leipzig 04103, Germany.
BMC Anesthesiol. 2013 Oct 4;13(1):29. doi: 10.1186/1471-2253-13-29.
If one party has more or better information than the other, an information asymmetry can be assumed. The aim of the study was to identify the origin of incomplete patient-related preoperative information, which led to disruptions and losses of time during pre-anaesthetic patient briefing. We hypothesized that lower employees' educational level increases the amount of disruptive factors.
A prospective observational study design was used. Patient selection was depending on the current patient flow in the area of the clinic for pre-anesthetic patient briefing. Data were collected over a period of 8 weeks. A stopwatch was used to record the time of disruptive factors. Various causes of time losses were grouped to facilitate statistical evaluation, which was performed by using the U-test of Mann and Whitney, Chi-square test or the Welch-t-test, as required.
Out of 221 patients, 130 patient briefings (58.8%) had been disrupted. Residents were affected more often than consultants (66% vs. 47%, p = 0.008). Duration of disruptions was independent of the level of training and lasted about 2,5 minutes and 10% of the total time of patient briefing. Most time-consuming disruptive factors were missing study results, incomplete case histories, and limited patient compliance.
Disruptions during pre-anesthetic patient briefings that were caused by patient-related information asymmetry are common and account for a significant loss of time. The resultant costs justify investments in appropriate personnel allocation.
如果一方拥有更多或更好的信息,就可以假定存在信息不对称。本研究的目的是确定导致麻醉前患者介绍期间出现中断和时间损失的不完整患者相关术前信息的来源。我们假设较低的员工教育水平会增加干扰因素的数量。
采用前瞻性观察研究设计。患者选择取决于麻醉前患者介绍区域的当前患者流量。数据收集时间为 8 周。使用秒表记录干扰因素的时间。将各种时间损失的原因分组,以便于统计评估,使用 Mann 和 Whitney 的 U 检验、卡方检验或 Welch 检验(视需要而定)进行统计评估。
在 221 名患者中,有 130 名患者(58.8%)的介绍被打断。住院医师比顾问更容易受到影响(66%比 47%,p=0.008)。干扰的持续时间与培训水平无关,持续约 2.5 分钟,占患者介绍总时间的 10%。最耗时的干扰因素是研究结果缺失、病史不完整和患者配合有限。
麻醉前患者介绍期间由患者相关信息不对称引起的中断很常见,并且会导致大量时间损失。由此产生的成本证明了在适当的人员配置方面进行投资是合理的。