Ling Li1, Isla Hains2, Toni Hordern3, David Milliss4, Ray Raper5, Johanna Westbrook2. 1. Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia. ling.li@mq.edu.au. 2. Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia. 3. National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia. 4. Intensive Care Services, Concord Hospital, Sydney, NSW, Australia. 5. Intensive Care Unit, Royal North Shore Hospital, Sydney, NSW, Australia.
Abstract
OBJECTIVE: To quantify the time that intensive care unit registrars spend on different work tasks with other health professionals and patients and using information resources, and to compare them with those of clinicians in general wards and the emergency department (ED). DESIGN, SETTING AND PARTICIPANTS: A prospective, observational time-and-motion study of two ICUs with a total of 71 beds at two major teaching hospitals in Sydney. Twenty-six registrars were observed between 08:00 and 18:00 on weekdays for a total of 160.52 hours. MAIN OUTCOME MEASURES: Proportions of time spent on different tasks, using specific information resources, working with other health professionals and patients, and rates of multitasking and interruptions. RESULTS: A total of 12 043 distinct tasks were observed. Registrars spent 69.2% of time working at patients' bedsides, 49.6% in professional communication and 39.0% accessing information resources. Half of their time (53.8%) was spent with other ICU doctors and 29.2% with nurses. Compared with doctors and nurses on general wards, and doctors in the ED, ICU registrars were more likely to multitask (40.1 times/hour [24.4% of their time]). ICU registrars had a higher interruption rate than ward clinicians, (4.2 times/hour), but a lower rate than ED doctors. CONCLUSIONS: Face-to-face communication and information seeking consume a vast proportion of ICU registrars' time. Multitasking and handling frequent interruptions characterise their work, and such behaviours may create an increased risk of task errors. Electronic clinical information systems may be particularly beneficial in this information-rich environment.
OBJECTIVE: To quantify the time that intensive care unit registrars spend on different work tasks with other health professionals and patients and using information resources, and to compare them with those of clinicians in general wards and the emergency department (ED). DESIGN, SETTING AND PARTICIPANTS: A prospective, observational time-and-motion study of two ICUs with a total of 71 beds at two major teaching hospitals in Sydney. Twenty-six registrars were observed between 08:00 and 18:00 on weekdays for a total of 160.52 hours. MAIN OUTCOME MEASURES: Proportions of time spent on different tasks, using specific information resources, working with other health professionals and patients, and rates of multitasking and interruptions. RESULTS: A total of 12 043 distinct tasks were observed. Registrars spent 69.2% of time working at patients' bedsides, 49.6% in professional communication and 39.0% accessing information resources. Half of their time (53.8%) was spent with other ICU doctors and 29.2% with nurses. Compared with doctors and nurses on general wards, and doctors in the ED, ICU registrars were more likely to multitask (40.1 times/hour [24.4% of their time]). ICU registrars had a higher interruption rate than ward clinicians, (4.2 times/hour), but a lower rate than ED doctors. CONCLUSIONS: Face-to-face communication and information seeking consume a vast proportion of ICU registrars' time. Multitasking and handling frequent interruptions characterise their work, and such behaviours may create an increased risk of task errors. Electronic clinical information systems may be particularly beneficial in this information-rich environment.
Authors: Hannah H Leslie; Denisse Laos; Cesar Cárcamo; Ricardo Pérez-Cuevas; Patricia J García Journal: BMC Health Serv Res Date: 2021-02-06 Impact factor: 2.655
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Authors: Vincent Compère; Emmanuel Besnier; Thomas Clavier; Nicolas Byhet; Florent Lefranc; Frederic Jegou; Nicolas Sturzenegger; Jean Baptiste Hardy; Bertrand Dureuil; Thomas Elie Journal: Front Med (Lausanne) Date: 2022-01-17