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Titolo:
ANALYZING THE TIME AND VALUE OF HOUSESTAFF INPATIENT WORK
Autore:
DRESSELHAUS TR; LUCK J; WRIGHT BC; SPRAGG RG; LEE ML; BOZZETTE SA;
Indirizzi:
VET ADM MED CTR,MED SERV,MAIL CODE 111 SAN DIEGO CA 92161
Titolo Testata:
Journal of general internal medicine
fascicolo: 8, volume: 13, anno: 1998,
pagine: 534 - 540
SICI:
0884-8734(1998)13:8<534:ATTAVO>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTERNAL-MEDICINE; SYSTEM; STAFF; CALL;
Keywords:
WORK SAMPLING; TIME STUDY; HOUSESTAFF; COMPUTER;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
21
Recensione:
Indirizzi per estratti:
Citazione:
T.R. Dresselhaus et al., "ANALYZING THE TIME AND VALUE OF HOUSESTAFF INPATIENT WORK", Journal of general internal medicine, 13(8), 1998, pp. 534-540

Abstract

OBJECTIVE: determine time allocation and the perceived value to education and patient care of the weekday activities of internal medicine housestaff on inpatient rotations and to compare the work activities ofinterns and residents. DESIGN: An observational study. We classified activities along five dimensions (association, location, activity, time, aad value), developed a computer-assisted self-interview survey, sued demonstrated its face and content validity, internal consistency, and interrater reliability. Subjects were assigned survey computers for5 consecutive weekdays over a 24-week period, into which they entereddata when prompted several times a day. SETTING: The medical service of a university-affiliated Veterans Administration Medical center. PARTICIPANTS: Sixty housestaff (36 interns, 24 residents) rotating on theinpatient wards. MEASUREMENTS AND MAIN RESULTS: We analyzed activities according to content (direct patient care, indirect patient care, education), association, and location. Likert-scale ratings of perceivedvalue to education and patient care were also obtained. Housestaff provided complete responses to 3,812 (95%) of 3,992 prompts by a median of 11 seconds: 93% of responses were logically consistent across the measured dimensions. Housestaff spent more time in indirect patient care (56%) than in direct patient care (14%) or educational activities (45%). Formal educational activities had the highest educational value (66 on 0-100 scale), and direct care had the highest value to patient care (81). Over 30% of time was spent in administrative activities, which had low educational value (40). Compared with residents, interns allocated significantly less time to educational activities (38% vs 57%)and more time to lower-value activities such as documentation (19% vs12%). CONCLUSIONS: Improved data collection methods demonstrate that housestaff in our program, particularly interns, spend much of their workday in activities that are Pow in educational and patient care value. Selective elimination or delegation of such activities would preserve higher-value experiences during reductions in overall impatient training time, planners can use automated random sampling to guide the rational redesign of housestaff work.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/10/20 alle ore 00:50:27