配备PGY-1住院医师的住院医疗团队中的抄写员：对有意义工作时间的影响。
Scribes with PGY-1 Residents on Inpatient Medicine Teams: Effect on Time Spent in Meaningful Work.
作者信息
Hartman-Hall Heather, Kanwal Arjun, Jory Lindsay, Maharaj Anil, Prasad Ruchi, Desale Sameer, Henricus Marsiyana, Jones Lyn C, Detterline Stephanie
机构信息
Department of Medicine, MedStar Union Memorial Hospital, Baltimore, MD, USA.
MedStar Health Research Institute, Hyattsville, MD, USA.
出版信息
J Community Hosp Intern Med Perspect. 2023 Jan 10;13(1):25-29. doi: 10.55729/2000-9666.1137. eCollection 2023.
BACKGROUND
The high documentation demands and limited time in direct patient care in the first year of internal medicine residency represent concerns for burnout and low job satisfaction in this important year of training.
OBJECTIVE
To assess the effect of scribes on the time PGY-1 residents spent on various work tasks.
METHODS
Participants were 24 PGY-1 internal medicine residents on two inpatient medicine teams at one site for 6 months (September 2019-February 2020). Residents were assigned a scribe during the first or second 2 weeks of a 4-week rotation and had no scribe for the other 2 weeks. Time study observers documented resident work activities. Residents ranked the meaningfulness of work activities via survey at the end of each 2-week period.
RESULTS
Of 24 residents, 18 (75%) completed the survey at both time points. Residents ranked patient care as the most meaningful and EHR work as the least meaningful work activity. EHR work claimed the largest percentage of time, with or without a scribe (mean, 33.2% and 39%, respectively). With a scribe, residents spent significantly less time (-5.8%, P < 0.0001) in EHR work and significantly more time (1.3%, P = 0.0267) in direct patient care and coordinating patient care (3.0%, P < 0.0001).
CONCLUSIONS
The presence of a scribe with PGY-1 internal medicine residents on inpatient teams resulted in a significantly greater percentage of total work time spent in work they considered most meaningful and a significantly lower percentage of total work time in work they considered least meaningful.
背景
内科住院医师培训的第一年，直接患者护理工作中的高文档记录要求和有限时间引发了对这一重要培训年份中职业倦怠和低工作满意度的担忧。
目的
评估速记员对第一年住院医师（PGY-1）在各项工作任务上所花费时间的影响。
方法
参与者为在一个地点的两个内科住院团队中的24名第一年内科住院医师（PGY-1），为期6个月（2019年9月至2020年2月）。住院医师在为期4周的轮班的第一或第二个2周期间被分配一名速记员，另外2周则没有速记员。时间研究观察员记录住院医师的工作活动。住院医师在每个2周周期结束时通过调查对工作活动的意义进行排名。
结果
24名住院医师中，18名（75%）在两个时间点都完成了调查。住院医师将患者护理列为最有意义的工作，而电子病历工作列为最无意义的工作活动。无论有无速记员，电子病历工作占用的时间百分比最大（平均分别为33.2%和39%）。有速记员时，住院医师在电子病历工作上花费的时间显著减少（-5.8%，P<0.0001），在直接患者护理和协调患者护理上花费的时间显著增加（1.3%，P = 0.0267）和（3.0%，P<0.0001）。
结论
在内科住院团队中，为第一年住院医师（PGY-1）配备速记员，使得他们在认为最有意义的工作上花费的总工作时间百分比显著增加，而在认为最无意义的工作上花费的总工作时间百分比显著降低。
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