• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利:CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验

卡塔尔哈马德总医院普通内科的医疗查房活动时间、行走距离和时间动作研究

Time Spent on Medical Round Activities, Distance Walked, and Time-Motion in the General Medicine Department at Hamad General Hospital in Qatar.

作者信息

Al Halabi Anas, Habas Elmukhtar, Farfar Khalifa L, Ghazouani Hafedh, Alfitori Gamal, Abdulla Moza A, Borham Abdelsalam M, Khan Fahmi Y

机构信息

Quality and Patient Safety, Hamad Medical Corporation, Doha, QAT.

Internal Medicine, Hamad General Hospital, Doha, QAT.

出版信息

Cureus. 2023 Apr 21;15(4):e37935. doi: 10.7759/cureus.37935. eCollection 2023 Apr.

DOI:10.7759/cureus.37935
PMID:37220459
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10200253/
Abstract

Background The daily morning round is a routine activity performed by medical teams. During the morning round, updates on the patient's clinical condition, new laboratory results, and other test results are reviewed and discussed between team members, the patient, and at times the family. Completing these tasks takes time. The design of the patient location differs between hospitals, and significant distance between patients can considerably affect round times. This study assesses physicians' time spent on clinical activities, the distance traveled, and the time they spend walking between patients during daily morning rounds to identify better reorganization methods to reduce wasted time. Methodology The survey was self-administered and had no intervention needing ethical approval. The research team's leader engaged two observers (a general practitioner from another department and a general internal medicine department case manager) to collect the data. The general practitioner was a medical graduate doctor, while the bed manager was not a medical college graduate. They observed 10 rounds over 10 non-consecutive days from July 1 to July 30, 2022. They recorded daily activities during the daily morning round, including time spent with patients, family conversations, bedside education, medication, social issues, and the time and distance required to move from patient to patient and from one location to location. The informal conversations about age, work history, and other small talk were recorded and converted into quantitative data. In each round, records were given to a statistician for rechecking. Subsequently, the records were imported into a Microsoft Excel spreadsheet for further statistical analysis. For continuous variables, the data were summarized as mean, median, and standard deviation. For categorical variables, the data were summarized as counts or proportions. Results On average, the duration of the daily morning round was 161.7 ± 17.3 minutes. The average number of patients seen by the general internal medicine round team was 14. The median patient encounter time per patient was 14 minutes (11-19 minutes), with an average of 12 minutes. An average of 8.6 employees participated in the 10-day rounds. The physician spent 41.2% of the time in direct contact with the patient during the morning round, 11.4% in maintaining electronic medical records, and 18.20% in bedside teaching. Additionally, 7.1% of the round time was spent because of interruptions by clinical and non-clinical staff other than team members or family members who were not in the room. Furthermore, a team member walked an average of 763 ± 54.5 m (667-872 m) per round, costing 35.7 minutes (22.1%) of the total round time. Conclusions The daily morning round time was significantly longer compared with the reported round times. Relocating patient beds to a common location reduced the rounding time by 22.30%. Disruption, teaching, and medical instruction must also be considered and shortened to reduce the morning round time.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53c1/10200253/643d222f81c7/cureus-0015-00000037935-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53c1/10200253/655bd4ee5851/cureus-0015-00000037935-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53c1/10200253/e18b3b622569/cureus-0015-00000037935-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53c1/10200253/3e5fd175113f/cureus-0015-00000037935-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53c1/10200253/643d222f81c7/cureus-0015-00000037935-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53c1/10200253/655bd4ee5851/cureus-0015-00000037935-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53c1/10200253/e18b3b622569/cureus-0015-00000037935-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53c1/10200253/3e5fd175113f/cureus-0015-00000037935-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53c1/10200253/643d222f81c7/cureus-0015-00000037935-i04.jpg
摘要

背景 每日晨间查房是医疗团队的一项常规活动。在晨间查房期间,团队成员、患者以及有时患者家属会对患者的临床状况更新、新的实验室检查结果和其他检查结果进行回顾和讨论。完成这些任务需要时间。不同医院患者所在位置的设计有所不同,患者之间的距离较远会显著影响查房时间。本研究评估医生在每日晨间查房期间用于临床活动的时间、行走距离以及在患者之间行走所花费的时间,以确定更好的重组方法来减少浪费的时间。

方法 该调查采用自行填写的方式,且无需伦理批准的干预措施。研究团队负责人聘请了两名观察员(来自另一个科室的全科医生和一名普通内科科室的病例管理员)来收集数据。全科医生是一名医学博士毕业生,而床位管理员不是医学院毕业生。他们在2022年7月1日至7月30日的10个非连续日中观察了10次查房。他们记录了每日晨间查房期间的日常活动,包括与患者相处的时间、与家属的谈话、床边教育、用药情况、社会问题以及在患者之间和从一个地点到另一个地点移动所需的时间和距离。关于年龄、工作经历和其他闲聊的非正式谈话被记录下来并转化为定量数据。在每次查房中,记录会交给一名统计学家进行复查。随后,记录被导入到Microsoft Excel电子表格中进行进一步的统计分析。对于连续变量,数据总结为均值、中位数和标准差。对于分类变量,数据总结为计数或比例。

结果 平均而言,每日晨间查房的时长为161.7 ± 17.3分钟。普通内科查房团队平均查房的患者数量为14名。每位患者的中位查房时间为14分钟(11 - 19分钟),平均为12分钟。在为期10天的查房中,平均有8.6名员工参与。医生在晨间查房期间有41.2%的时间与患者直接接触,11.4%的时间用于维护电子病历,18.20%的时间用于床边教学。此外,7.1%的查房时间是由于非团队成员或不在房间内的家属以外的临床和非临床工作人员的干扰而花费的。此外,团队成员每次查房平均行走763 ± 54.5米(667 - 872米),占总查房时间的35.7分钟(22.1%)。

结论 与报告的查房时间相比,每日晨间查房时间明显更长。将患者床位迁至一个共同位置可使查房时间减少22.30%。还必须考虑并缩短干扰、教学和医疗指导时间,以减少晨间查房时间。

相似文献

1
Time Spent on Medical Round Activities, Distance Walked, and Time-Motion in the General Medicine Department at Hamad General Hospital in Qatar.卡塔尔哈马德总医院普通内科的医疗查房活动时间、行走距离和时间动作研究
Cureus. 2023 Apr 21;15(4):e37935. doi: 10.7759/cureus.37935. eCollection 2023 Apr.
2
Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas.在流行地区,服用抗叶酸抗疟药物的人群中,叶酸补充剂与疟疾易感性和严重程度的关系。
Cochrane Database Syst Rev. 2022 Feb 1;2(2022):CD014217. doi: 10.1002/14651858.CD014217.
3
Patient-centered interprofessional collaborative care: factors associated with bedside interprofessional rounds.以患者为中心的跨专业协作护理:与床边跨专业查房相关的因素。
J Gen Intern Med. 2014 Jul;29(7):1040-7. doi: 10.1007/s11606-014-2817-x. Epub 2014 Mar 11.
4
Relationships of the location and content of rounds to specialty, institution, patient-census, and team size.轮班地点和内容与专业、机构、患者人数和团队规模的关系。
PLoS One. 2010 Jun 21;5(6):e11246. doi: 10.1371/journal.pone.0011246.
5
All Together Now: Impact of a Regionalization and Bedside Rounding Initiative on the Efficiency and Inclusiveness of Clinical Rounds.现在齐心协力:区域化和床边查房倡议对临床查房效率和包容性的影响。
J Hosp Med. 2017 Mar;12(3):150-156. doi: 10.12788/jhm.2696.
6
An Observational Time Study of Neonatal Intensive Care Unit Multidisciplinary Rounds.一项关于新生儿重症监护病房多学科查房的观察时间研究。
Am J Perinatol. 2024 May;41(S 01):e689-e693. doi: 10.1055/a-1933-7137. Epub 2022 Aug 30.
7
Patient-Centered Structured Interdisciplinary Bedside Rounds in the Medical ICU.医学重症监护病房中以患者为中心的结构化跨学科床边查房
Crit Care Med. 2018 Jan;46(1):85-92. doi: 10.1097/CCM.0000000000002807.
8
A real-time locating system observes physician time-motion patterns during walk-rounds: a pilot study.实时定位系统观察巡房过程中医务人员的时间-动作模式:一项试点研究。
BMC Med Educ. 2014 Feb 25;14:37. doi: 10.1186/1472-6920-14-37.
9
Use of a Real-Time Locating System to Assess Internal Medicine Resident Location and Movement in the Hospital.使用实时定位系统评估内科住院医师在医院内的位置和移动情况。
JAMA Netw Open. 2022 Jun 1;5(6):e2215885. doi: 10.1001/jamanetworkopen.2022.15885.
10
The return of bedside rounds: an educational intervention.床边查房的回归:一项教育干预措施。
J Gen Intern Med. 2010 Aug;25(8):792-8. doi: 10.1007/s11606-010-1344-7. Epub 2010 Apr 13.

引用本文的文献

1
Rounds Redesign: Our Experience In Splitting Interdisciplinary Rounds.查房重新设计:我们在拆分跨学科查房方面的经验
J Brown Hosp Med. 2024 Apr 1;3(2):115837. doi: 10.56305/001c.115837. eCollection 2024.
2
Making clinical teaching visible-A time and motion study of hospital rounds in undergraduate medical teaching.让临床教学可视化——本科医学教学中查房的时间与动作研究
Front Med (Lausanne). 2024 Aug 21;11:1377903. doi: 10.3389/fmed.2024.1377903. eCollection 2024.
3
"Time wasted by health professionals is time not invested in patients": time management practice and associated factors among health professionals at public hospitals in Bahir Dar, Ethiopia: a multicenter mixed method study.

本文引用的文献

1
Scenarios to Improve the Patient Experience Time in a Tertiary Academic Hospital Using Simulation.利用模拟技术改善三级学术医院患者体验时间的方案。
Cureus. 2022 Oct 27;14(10):e30751. doi: 10.7759/cureus.30751. eCollection 2022 Oct.
2
Interruptions to Attending Physician Rounds and Their Effect on Resident Education.主治医师查房的中断及其对住院医师教育的影响。
J Grad Med Educ. 2021 Apr;13(2):266-275. doi: 10.4300/JGME-D-20-00698.1. Epub 2021 Apr 16.
3
What works to promote walking at the population level? A systematic review.
“卫生专业人员浪费的时间就是没有投入到患者身上的时间”:在埃塞俄比亚巴赫达尔公立医院的卫生专业人员中的时间管理实践和相关因素:一项多中心混合方法研究。
Front Public Health. 2023 Jul 21;11:1159275. doi: 10.3389/fpubh.2023.1159275. eCollection 2023.
促进人群水平步行的有效措施有哪些?系统评价。
Br J Sports Med. 2018 Jun;52(12):807-812. doi: 10.1136/bjsports-2017-098953.
4
Patient participation in inpatient ward rounds on acute inpatient medical wards: a descriptive study.患者参与急性住院内科病房的住院查房:一项描述性研究。
BMJ Qual Saf. 2019 Jan;28(1):15-23. doi: 10.1136/bmjqs-2017-007292. Epub 2018 Feb 23.
5
Patient-Centered Structured Interdisciplinary Bedside Rounds in the Medical ICU.医学重症监护病房中以患者为中心的结构化跨学科床边查房
Crit Care Med. 2018 Jan;46(1):85-92. doi: 10.1097/CCM.0000000000002807.
6
The clinical effectiveness of hourly rounding on fall-related incidents involving adult patients in an acute care setting: a systematic review.
JBI Libr Syst Rev. 2012;10(56 Suppl):1-12. doi: 10.11124/01938924-201210561-00010.
7
Development of Electronic Medical Record-Based "Rounds Report" Results in Improved Resident Efficiency, More Time for Direct Patient Care and Education, and Less Resident Duty Hour Violations.基于电子病历的“查房报告”的开发提高了住院医师的效率,增加了直接护理和教育患者的时间,并减少了住院医师违反值班时间规定的情况。
Am Surg. 2016 Sep;82(9):853-9.
8
Interprofessional collaborative care characteristics and the occurrence of bedside interprofessional rounds: a cross-sectional analysis.跨专业协作护理特征与床边跨专业查房的发生情况:一项横断面分析
BMC Health Serv Res. 2016 Sep 1;16(1):459. doi: 10.1186/s12913-016-1714-x.
9
Physician experience and outcomes among patients admitted to general internal medicine teaching wards.普通内科教学病房收治患者的医生经验与治疗结果
CMAJ. 2015 Oct 6;187(14):1041-1048. doi: 10.1503/cmaj.150316. Epub 2015 Aug 17.
10
Challenges of the ward round teaching based on the experiences of medical clinical teachers.基于医学临床教师经验的查房教学挑战
J Res Med Sci. 2015 Mar;20(3):273-80.