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时间至关重要：一项关于内科住院医师值班期间的观察性时间动作研究。

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

作者信息

Leafloor Cameron W, Liu Erin Yiran, Code Catherine C, Lochnan Heather A, Keely Erin, Rothwell Deanna M, Forster Alan J, Huang Allen R

机构信息

Faculty of Medicine, University of Ottawa, Ontario, Canada.

Quality and Performance Measurement, Ottawa Hospital, Ontario, Canada.

出版信息

Can Med Educ J. 2017 Jun 30;8(3):e49-e70. eCollection 2017 Jun.

PMID:29098048
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5661738/
Abstract

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 .

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.

摘要

背景

住院医师值班时间变化的影响需要是可衡量的。这项时间动作研究旨在记录内科住院医师值班时的工作流程，并确定使用移动电子工具获取详细数据的可行性。

方法

由一名观察员对初级和高级住院医师进行为期六小时的跟踪观察，涵盖所有七天。活动实时记录。确定了分为九类的89项活动。

结果

共记录了17714个事件，观察时长为516小时。时间分配如下：直接患者护理（22%）、沟通（19%）、个人任务（15%）、文件记录（14%）、教育（13%）、间接护理（11%）、转运（6%）、行政管理（0.6%）和非医师任务（0.4%）。19%的教育时间用于自主学习活动。值班总时间中只有9%用于与患者相处。65%的沟通时间用于信息传递。共记录了968次中断，每次中断平均处理时间为93.5秒。

结论

详细记录住院医师的工作流程是可行的，现在可以对未来住院医师培训变化的影响进行衡量。教育活动占值班时间的13%。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d888/5661738/a8d809042a25/cmej-08-49f3.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d888/5661738/62e8329a5b31/cmej-08-49f10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d888/5661738/8d2b5e967c76/cmej-08-49f11.jpg
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