Inter-hospital comparison of working time allocation among internal medicine residents using time-motion observations: an innovative benchmarking tool

ObjectivesThe vast majority of residents’ working time is spent away from patients. In hospital practice, many factors may influence the resident’s working day structure.Using an innovative method, we aimed to compare working time allocation among internal medicine residents using time-motion observ...

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Published in:BMJ open 2020-02, Vol.10 (2), p.e033021-e033021
Main Authors: Frey, Simon Martin, Méan, Marie, Garnier, Antoine, Castioni, Julien, Wenger, Nathalie, Egloff, Michael, Marques-Vidal, Pedro, Beer, Juerg-Hans
Format: Article
Language:English
Subjects:
Adult
Benchmarking - methods
Emergency medical care
Female
Hospitals
Hospitals, Community
Hospitals, University
Humans
Internal medicine
Internal Medicine - education
Internship and Residency - statistics & numerical data
Male
Medical Education and Training
Medical records
Medicine
Patient Care - statistics & numerical data
Patients
Physicians
Time and Motion Studies
Working hours
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cited_by cdi_FETCH-LOGICAL-b538t-8a3ff627b7b6fa338abf806f4cbb4bc49e4692b0d4a786534a44ee4d565946643
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container_title BMJ open
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creator Frey, Simon Martin
Méan, Marie
Garnier, Antoine
Castioni, Julien
Wenger, Nathalie
Egloff, Michael
Marques-Vidal, Pedro
Beer, Juerg-Hans
description ObjectivesThe vast majority of residents’ working time is spent away from patients. In hospital practice, many factors may influence the resident’s working day structure.Using an innovative method, we aimed to compare working time allocation among internal medicine residents using time-motion observations. The first study goal was to describe how the method could be used for inter-hospital comparison. The secondary goal was to learn about specific differences in the resident’s working day structure in university and non-university hospital settings.DesignTwo separate time-motion studies. Trained peer-observers followed the residents during weekday day shifts with a tablet, able to record 22 different activities and corresponding context (with patient, phone, colleague or computer).SettingInternal medicine residencies at a university (May–July 2015) and a non-university (September–October 2016) community hospital.Participants28 residents (mean age: 29 years, average postgraduate training: 30 months) at university hospital, 21 residents (mean age: 30 years, average postgraduate training: 17 months) at non-university hospital.OutcomesTime spent with patients and time dedicated to activities directly related to patients; description of main differences of time allocation between hospitals.ResultsCumulatively 1051 hours of observation (566 (university hospital)+486 (non-university hospital)) and 92 day shifts (49+43) were evaluated. Daily working time was 11.5 versus 11.3 hours. A median daily period of 195 min (IQR 179–211, 27.9%) and 116 min (IQR 98–134, 17.2%) (p
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In hospital practice, many factors may influence the resident’s working day structure.Using an innovative method, we aimed to compare working time allocation among internal medicine residents using time-motion observations. The first study goal was to describe how the method could be used for inter-hospital comparison. The secondary goal was to learn about specific differences in the resident’s working day structure in university and non-university hospital settings.DesignTwo separate time-motion studies. Trained peer-observers followed the residents during weekday day shifts with a tablet, able to record 22 different activities and corresponding context (with patient, phone, colleague or computer).SettingInternal medicine residencies at a university (May–July 2015) and a non-university (September–October 2016) community hospital.Participants28 residents (mean age: 29 years, average postgraduate training: 30 months) at university hospital, 21 residents (mean age: 30 years, average postgraduate training: 17 months) at non-university hospital.OutcomesTime spent with patients and time dedicated to activities directly related to patients; description of main differences of time allocation between hospitals.ResultsCumulatively 1051 hours of observation (566 (university hospital)+486 (non-university hospital)) and 92 day shifts (49+43) were evaluated. Daily working time was 11.5 versus 11.3 hours. A median daily period of 195 min (IQR 179–211, 27.9%) and 116 min (IQR 98–134, 17.2%) (p&lt;0.001) was dedicated to direct patient care, respectively.ConclusionsWe successfully identified differences potentially related to each hospital structure and organisation. Inter-hospital comparisons could help set up interventions aiming to improve workday structure and experience of residents.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2019-033021</identifier><identifier>PMID: 32066604</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adult ; Benchmarking - methods ; Emergency medical care ; Female ; Hospitals ; Hospitals, Community ; Hospitals, University ; Humans ; Internal medicine ; Internal Medicine - education ; Internship and Residency - statistics &amp; numerical data ; Male ; Medical Education and Training ; Medical records ; Medicine ; Patient Care - statistics &amp; numerical data ; Patients ; Physicians ; Time and Motion Studies ; Working hours</subject><ispartof>BMJ open, 2020-02, Vol.10 (2), p.e033021-e033021</ispartof><rights>Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2020 Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b538t-8a3ff627b7b6fa338abf806f4cbb4bc49e4692b0d4a786534a44ee4d565946643</citedby><cites>FETCH-LOGICAL-b538t-8a3ff627b7b6fa338abf806f4cbb4bc49e4692b0d4a786534a44ee4d565946643</cites><orcidid>0000-0002-6786-7931 ; 0000-0001-8361-2210</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2356400240/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2356400240?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>112,113,230,314,727,780,784,885,3194,25753,27549,27550,27924,27925,37012,37013,44590,53791,53793,75126,77594,77595,77601,77632</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32066604$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Frey, Simon Martin</creatorcontrib><creatorcontrib>Méan, Marie</creatorcontrib><creatorcontrib>Garnier, Antoine</creatorcontrib><creatorcontrib>Castioni, Julien</creatorcontrib><creatorcontrib>Wenger, Nathalie</creatorcontrib><creatorcontrib>Egloff, Michael</creatorcontrib><creatorcontrib>Marques-Vidal, Pedro</creatorcontrib><creatorcontrib>Beer, Juerg-Hans</creatorcontrib><title>Inter-hospital comparison of working time allocation among internal medicine residents using time-motion observations: an innovative benchmarking tool</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><description>ObjectivesThe vast majority of residents’ working time is spent away from patients. In hospital practice, many factors may influence the resident’s working day structure.Using an innovative method, we aimed to compare working time allocation among internal medicine residents using time-motion observations. The first study goal was to describe how the method could be used for inter-hospital comparison. The secondary goal was to learn about specific differences in the resident’s working day structure in university and non-university hospital settings.DesignTwo separate time-motion studies. Trained peer-observers followed the residents during weekday day shifts with a tablet, able to record 22 different activities and corresponding context (with patient, phone, colleague or computer).SettingInternal medicine residencies at a university (May–July 2015) and a non-university (September–October 2016) community hospital.Participants28 residents (mean age: 29 years, average postgraduate training: 30 months) at university hospital, 21 residents (mean age: 30 years, average postgraduate training: 17 months) at non-university hospital.OutcomesTime spent with patients and time dedicated to activities directly related to patients; description of main differences of time allocation between hospitals.ResultsCumulatively 1051 hours of observation (566 (university hospital)+486 (non-university hospital)) and 92 day shifts (49+43) were evaluated. Daily working time was 11.5 versus 11.3 hours. A median daily period of 195 min (IQR 179–211, 27.9%) and 116 min (IQR 98–134, 17.2%) (p&lt;0.001) was dedicated to direct patient care, respectively.ConclusionsWe successfully identified differences potentially related to each hospital structure and organisation. 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Méan, Marie ; Garnier, Antoine ; Castioni, Julien ; Wenger, Nathalie ; Egloff, Michael ; Marques-Vidal, Pedro ; Beer, Juerg-Hans</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b538t-8a3ff627b7b6fa338abf806f4cbb4bc49e4692b0d4a786534a44ee4d565946643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Benchmarking - methods</topic><topic>Emergency medical care</topic><topic>Female</topic><topic>Hospitals</topic><topic>Hospitals, Community</topic><topic>Hospitals, University</topic><topic>Humans</topic><topic>Internal medicine</topic><topic>Internal Medicine - education</topic><topic>Internship and Residency - statistics &amp; numerical data</topic><topic>Male</topic><topic>Medical Education and Training</topic><topic>Medical records</topic><topic>Medicine</topic><topic>Patient Care - statistics &amp; numerical data</topic><topic>Patients</topic><topic>Physicians</topic><topic>Time and Motion Studies</topic><topic>Working hours</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Frey, Simon Martin</creatorcontrib><creatorcontrib>Méan, Marie</creatorcontrib><creatorcontrib>Garnier, Antoine</creatorcontrib><creatorcontrib>Castioni, Julien</creatorcontrib><creatorcontrib>Wenger, Nathalie</creatorcontrib><creatorcontrib>Egloff, Michael</creatorcontrib><creatorcontrib>Marques-Vidal, Pedro</creatorcontrib><creatorcontrib>Beer, Juerg-Hans</creatorcontrib><collection>British Medical Journal Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing &amp; 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In hospital practice, many factors may influence the resident’s working day structure.Using an innovative method, we aimed to compare working time allocation among internal medicine residents using time-motion observations. The first study goal was to describe how the method could be used for inter-hospital comparison. The secondary goal was to learn about specific differences in the resident’s working day structure in university and non-university hospital settings.DesignTwo separate time-motion studies. Trained peer-observers followed the residents during weekday day shifts with a tablet, able to record 22 different activities and corresponding context (with patient, phone, colleague or computer).SettingInternal medicine residencies at a university (May–July 2015) and a non-university (September–October 2016) community hospital.Participants28 residents (mean age: 29 years, average postgraduate training: 30 months) at university hospital, 21 residents (mean age: 30 years, average postgraduate training: 17 months) at non-university hospital.OutcomesTime spent with patients and time dedicated to activities directly related to patients; description of main differences of time allocation between hospitals.ResultsCumulatively 1051 hours of observation (566 (university hospital)+486 (non-university hospital)) and 92 day shifts (49+43) were evaluated. Daily working time was 11.5 versus 11.3 hours. A median daily period of 195 min (IQR 179–211, 27.9%) and 116 min (IQR 98–134, 17.2%) (p&lt;0.001) was dedicated to direct patient care, respectively.ConclusionsWe successfully identified differences potentially related to each hospital structure and organisation. Inter-hospital comparisons could help set up interventions aiming to improve workday structure and experience of residents.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>32066604</pmid><doi>10.1136/bmjopen-2019-033021</doi><orcidid>https://orcid.org/0000-0002-6786-7931</orcidid><orcidid>https://orcid.org/0000-0001-8361-2210</orcidid><oa>free_for_read</oa></addata></record>
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subjects Adult
Benchmarking - methods
Emergency medical care
Female
Hospitals
Hospitals, Community
Hospitals, University
Humans
Internal medicine
Internal Medicine - education
Internship and Residency - statistics & numerical data
Male
Medical Education and Training
Medical records
Medicine
Patient Care - statistics & numerical data
Patients
Physicians
Time and Motion Studies
Working hours
title Inter-hospital comparison of working time allocation among internal medicine residents using time-motion observations: an innovative benchmarking tool
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