医院的医生和护士认为什么浪费了他们的时间？

What do hospital doctors and nurses think wastes their time?

作者信息

Bagheri Lankarani Kamran, Ghahramani Sulmaz, Roozitalab Marjan, Zakeri Mohammadreza, Honarvar Behnam, Kasraei Hengameh

机构信息

Health Policy Research Center, Institute of Health, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Clinical Affairs, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

SAGE Open Med. 2019 May 5;7:2050312118813680. doi: 10.1177/2050312118813680. eCollection 2019.

DOI:10.1177/2050312118813680

PMID:31105937

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6503588/

Abstract

OBJECTIVE

With regard to limitation in national budget, the relevant authorities of healthcare and treatment throughout the globe are seeking the use of available resources in a way that no wastage of money or time-which is, of course, convertible to money-is acceptable. This study sought the opinions of hospital doctors and nurses on those activities at work that wasted their time.

METHODS

A questionnaire designed to identify activities that waste time during hospital care was completed based on the review of previous studies and including hospital wastes items. The authors designed a questionnaire, which was filled out by 209 nurses and 30 doctors in the surgery wards in hospitals affiliated to Shiraz University of Medical Sciences (SUMS). The items for time wasting activities were extracted from previous studies, and the reliability of the questionnaire was more than 0.785 using Cronbach's alpha. The response rate was more than 60%.

RESULTS

The mean age of the participating nurses and doctors was 30.24 ± 6.85 and 32.77 ± 7.05 years. In all aspects, more time was wasted during the morning and evening shifts in comparison with the night shifts. The activity that was thought to waste time in hospital care the most was paper-based documentation. Preventable wasted time during the shift was 16%-30% in the nurses' view and 18%-34% in the doctors' view. For both nurses and doctors, the highest-rated preventable wasted time was related to time spent waiting in ward for lab data responses, transfer of patients, or delivery of care.

CONCLUSION

Hospital working environment is complex, and opportunities for improvement of the efficiency of the nurses' and doctors' workload should be analyzed, case by case, in each hospital and work group. Process change (for the decrease in the wasted time for waiting in wards), simple innovative ways (for the decrease in the wasted time for searching the needed equipment), using hospital information system technology for documentation, communication, and the better design of the wards (to decrease the wasted time due to transfer between the ward and restroom) could be helpful for improving efficiency and for a safer and acceptable delivery of care.

摘要

目的

鉴于国家预算有限，全球医疗保健和治疗的相关部门都在寻求以一种不浪费金钱或时间（当然，时间可转化为金钱）的方式来利用现有资源。本研究旨在征求医院医生和护士对工作中那些浪费他们时间的活动的看法。

方法

在回顾以往研究并纳入医院浪费项目的基础上，设计了一份旨在识别医院护理期间浪费时间的活动的问卷。作者设计了一份问卷，由设拉子医科大学（SUMS）附属医院外科病房的209名护士和30名医生填写。浪费时间活动的项目从以往研究中提取，使用克朗巴赫α系数，问卷的信度超过0.785。回复率超过60%。

结果

参与研究的护士和医生的平均年龄分别为30.24±6.85岁和32.77±7.05岁。在所有方面，与夜班相比，早班和晚班浪费的时间更多。医院护理中被认为最浪费时间的活动是纸质文档记录。护士认为轮班期间可预防的浪费时间为16%-30%，医生认为为18%-34%。对于护士和医生来说，可预防浪费时间评分最高的是在病房等待实验室数据回复、患者转运或护理交付所花费的时间。

结论

医院工作环境复杂，应针对每家医院和每个工作小组逐一分析提高护士和医生工作效率的机会。流程变革（减少在病房等待的浪费时间）、简单的创新方法（减少寻找所需设备所浪费的时间）、利用医院信息系统技术进行文档记录、沟通以及更好地设计病房（减少因病房与卫生间之间的转移而浪费的时间）可能有助于提高效率，并实现更安全、可接受的护理交付。