Annu Int Conf IEEE Eng Med Biol Soc. 2021 Nov;2021:2386-2391. doi: 10.1109/EMBC46164.2021.9630597.
Clinicians and staff who work in intense hospital settings such as the emergency department (ED) are under an extended amount of mental and physical pressure every day. They may spend hours in active physical pressure to serve patients with severe injuries or stay in front of a computer to review patients' clinical history and update the patients' electronic health records (EHR). Nurses on the other hand may stay for multiple consecutive days of 9-12 working hours. The amount of pressure is so much that they usually end up taking days off to recover the lost energy. Both of these extreme cases of low and high physical activities are shown to affect the physical and mental health of clinicians and may even lead to fatigue and burnout.In this study Real-Time location systems (RTLS) are used for the first time, to study the amount of physical activity exerted by clinicians. RTLS systems have traditionally been used in hospital settings for locating staff and equipment, whereas our proposed method combines both time and location information together to estimate the duration, length, and speed of movements within hospital wards such as the ED. It is also our first step towards utilizing non-wearable devices to measure sedentary behavior inside the ED. This information helps to assess the workload on the care team and identify means to reduce the risk of performance compromise, fatigue, and burnout.We used one year worth of raw RFID data that covers movement records of 38 physicians, 13 residents, 163 nurses, 33 staff in the ED. We defined a walking path as the continuous sequences of movements and stops and identified separate walking paths for each individual on each day. Walking duration, distance, and speed, along with the number of steps and the duration of sedentary behavior, are then estimated for each walking path. We compared our results to the values reported in the literature and showed despite the low spatial resolution of RTLS, our non-invasive estimations are closely comparable to the ones measured by Fitbit or other wearable pedometers.Clinical Relevance- Adequate assessment of workload in a dynamic care delivery space plays an important role in ensuring safe and optimal care delivery [7]. Systems capable of measuring physical activities on a continuous basis during daily work can provide precious information for a variety of purposes including automated assessment of sedentary behaviors and early detection of work pressure. Such systems could help facilitate targeted changes in the number of staff, duration of their working shifts leading to a safer and healthier environment for both clinicians and patients.
在急诊室（ED）等紧张的医院环境中工作的临床医生和工作人员每天都承受着大量的身心压力。他们可能会花费数小时积极应对身体压力，为严重受伤的患者提供服务，或者在电脑前查看患者的临床病史并更新患者的电子健康记录（EHR）。另一方面，护士可能会连续多日工作 9-12 小时。压力如此之大，以至于他们通常需要休假几天来恢复失去的能量。这两种极端的低体力活动和高体力活动都被证明会影响临床医生的身心健康，甚至可能导致疲劳和倦怠。
在这项研究中，首次使用实时定位系统（RTLS）来研究临床医生所承受的体力活动量。RTLS 系统传统上用于医院环境中的人员和设备定位，而我们提出的方法将时间和位置信息结合在一起，以估计 ED 等医院病房内的运动持续时间、长度和速度。这也是我们利用非穿戴设备测量 ED 内久坐行为的第一步。这些信息有助于评估护理团队的工作量，并确定减少绩效受损、疲劳和倦怠风险的方法。
我们使用了一年的原始 RFID 数据，涵盖了 38 名医生、13 名住院医师、163 名护士和 33 名 ED 工作人员的运动记录。我们将行走路径定义为连续的运动和停止序列，并为每个人在每一天确定了单独的行走路径。然后，为每个行走路径估计行走持续时间、距离和速度，以及步数和久坐行为持续时间。我们将我们的结果与文献中的报告值进行了比较，并表明尽管 RTLS 的空间分辨率较低，但我们的非侵入性估计与 Fitbit 或其他可穿戴计步器测量的值非常接近。
临床相关性-在动态护理提供空间中对工作量进行充分评估对于确保安全和优化护理提供起着重要作用[7]。能够在日常工作中连续测量体力活动的系统可以为各种目的提供宝贵信息，包括自动评估久坐行为和早期检测工作压力。这些系统可以帮助有针对性地改变员工人数和工作轮班时间，为临床医生和患者创造更安全、更健康的环境。
