Medical residents at a Swiss teaching hospital spend almost half of their workday on the computer, which is approximately three times the amount of time they spend with patients, according to a study published online today in the Annals of Internal Medicine.
On average, residents spend 1.7 hours per day with patients, compared with 5.2 hours using computers, and 13 minutes doing both.
The findings, reported by Nathalie Wenger, MD, from the Department of Internal Medicine at Lausanne University Hospital in Switzerland, and colleagues mirror patterns seen among internal medicine residents in the United States.
“That so much of residents’ time is spent on the computer, rather than on direct patient care and interaction, suggests we need to rethink how residents’ time is allocated to achieve a more reasonable balance,” Dr Wegner said in an interview, noting that resident burnout and dissatisfaction are unacceptable costs of increased technology.
To estimate how much time residents spend on the computer and with patients, Dr Wegner and colleagues conducted an observational time-and-motion study between May and July 2015 in the Internal Medicine Department of Lausanne University Hospital. The study focused on the activity of 36 residents (23 women and 13 men) during day (8:00 a.m. – 6:00 p.m.) and evening (4:30 – 11:30 pm) shifts.
Trained observers recorded the residents’ activities in real time, using a tablet, based on 22 predefined activities across six categories: directly related to the patient, communication, indirectly related to the patient, academic, nonmedical, and transition. For each activity, the observers recorded whether a patient or colleague was present and whether the resident was using a telephone or computer.
During the course of the study, observers collected data for nearly 700 hours of residents’ time from 66 shifts (49 day, 17 evening) and determined that day shifts lasted an average of 11.6 hours (95% confidence interval, 11.2 – 12.0 hours), and evening shifts lasted an average of 7.6 hours (confidence interval, 7.0 – 8.2 hours), indicating that most residents needed more time than their scheduled shift to fulfil their duties, the authors report. After-hours activities consisted mostly of writing in the EMR, they observe.
For the day shifts, 28.0% of residents’ time was spent on tasks that were directly patient related, including clinical procedures, admissions, and rounds, whereas 52.4% of their time was spent on tasks indirectly related to patient care, including writing in the electronic medical record (EMR), looking for information, and handoffs.
“Two of the longest activities (>1 hour) were daily patient rounds and writing in the EMR,” the authors note. The amount of time residents spent per patient per day on direct care was approximately 14.6 minutes, they write.
The remainder of the residents’ time was spread across academic (6.3%), nonmedical (6.1%), transition (5.1%), and communication (2.3%) activities, the authors report.
The time allocation was similar for evening shifts for all categories except academic activities, which accounted for almost none of the residents’ time.
[Source:-Medscape]
