Pediatricians' working conditions in German hospitals: a real-time task analysis.

Surveys of pediatricians in Germany report low levels of job satisfaction. Preferably, such subjective reports should be corroborated by objective data regarding physicians' working conditions. However, such data in the field of pediatrics could not be found in the scientific literature. The aim of the present observational field study was to collect exact data about pediatricians' workflow in different pediatric hospital departments to evaluate and to optimize work routines. Data of 697 working hours were collected by using Tablet PCs during weekday shifts at three urban German hospitals. Twenty-five pediatricians were observed separately. A pediatrician's workday lasted on average 9 h and 18 min (SD = 0:53:44 h). The following amount of time was spent on various job tasks within this period: 29.80% (SD = 8.25 %) on meetings, 17.54% (SD = 6.51%) on documentation duties, 12.65% (SD = 3.73%) on indirect patient care, 9.22 % (SD = 5.74%) on hospital admissions and ward rounds and 4.03% (SD = 2.49%) on direct patient care. This is the first objective task analysis of physicians' workflow in pediatric hospital wards. Some of the physicians' self-reported problems were verified. Improvements in work organization and a new allocation of responsibilities among the medical staff may prove helpful in improving the quality of patient care by reducing the burden on pediatricians.