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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.

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.

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53c1/10200253/655bd4ee5851/cureus-0015-00000037935-i01.jpg

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本文引用的文献

1
Scenarios to Improve the Patient Experience Time in a Tertiary Academic Hospital Using Simulation.
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.
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.
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.
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.
Crit Care Med. 2018 Jan;46(1):85-92. doi: 10.1097/CCM.0000000000002807.
9
Physician experience and outcomes among patients admitted to general internal medicine teaching wards.
CMAJ. 2015 Oct 6;187(14):1041-1048. doi: 10.1503/cmaj.150316. Epub 2015 Aug 17.

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