Guarisco S, Oddone E, Simel D
Division of Gastroenterology, Duke University Medical Center, Durham, NC.
J Gen Intern Med. 1994 May;9(5):272-7. doi: 10.1007/BF02599655.
To describe a novel method of time analysis for health care settings by quantifying internal medicine housestaff's work activities and contacts.
Observational work sampling study based on random sampling technique.
General medicine service in a university hospital.
All housestaff (18 interns, 18 residents) rotating through the general medicine service during a 12-week period.
Proportion of time spent doing 22 work activities and proportion of time spent with 13 work contacts, reported separately for interns and residents and for on-call days and off-call days.
The authors sampled 6,599 unique time observations (3,533 from on-call days, 3,066 from off-call days) during 193 housestaff workdays. The housestaff spent a majority of their time engaged in direct patient care activities (81% of the interns' workdays, and 64.5% of the residents' workdays), primarily in patient evaluation and follow-up (48% of the interns' and 39% of the residents' workdays). Compared with the interns, the residents spent relatively more time in direct educational activities (conferences, reading, teaching): 27% of the residents' workdays versus 10% of the interns' workdays. Analysis of work contacts showed that the housestaff spent a large portion of the workday alone: 27% of the residents' and 34% of the interns' workdays. The housestaff also spent a large portion of the workday with attending physicians: 23% of the residents' and 11% of the interns' workdays. This translates into 21 hours/week of attending supervision for the residents and 10 hours/week for the interns.
Using random work sampling, the authors found that the vast majority of the houseofficer's workday was spent in direct patient care. This method of time analysis may be used to describe housestaff training and supervision, as well as to evaluate administrative interventions designed to change housestaff work experience.
通过量化内科住院医师的工作活动和接触情况，描述一种适用于医疗保健机构的新型时间分析方法。
基于随机抽样技术的观察性工作抽样研究。
一所大学医院的普通内科服务科室。
在12周期间轮转至普通内科服务科室的所有住院医师（18名实习生、18名住院医生）。
分别报告实习生和住院医生在进行22项工作活动时所花费时间的比例，以及与13个工作联系人接触所花费时间的比例，分为值班日和非值班日。
作者在193个住院医师工作日期间抽取了6599个独特的时间观察样本（3533个来自值班日，3066个来自非值班日）。住院医师大部分时间用于直接的患者护理活动（实习生工作日的81%，住院医生工作日的64.5%），主要是患者评估和随访（实习生工作日的48%，住院医生工作日的39%）。与实习生相比，住院医生在直接教育活动（会议、阅读、教学）上花费的时间相对较多：住院医生工作日的27%，而实习生工作日的10%。工作接触分析表明，住院医师工作日的很大一部分时间是独自度过的：住院医生工作日的27%，实习生工作日的34%。住院医师工作日的很大一部分时间也与主治医师在一起：住院医生工作日的23%，实习生工作日的11%。这相当于住院医生每周有21小时的主治医师监督时间，实习生每周有10小时。
通过随机工作抽样，作者发现住院医师工作日的绝大部分时间用于直接的患者护理。这种时间分析方法可用于描述住院医师培训和监督情况，也可用于评估旨在改变住院医师工作体验的行政干预措施。
