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Shedding light on junior doctors' work practices after hours.
Intern Med J. 2013 Jun 26;
Authors: Arabadzhiyska PN, Baysari MT, Walter S, Day RO, Westbrook JI
Abstract
BACKGROUND: It is imperative to understand the current work practices of hospital personnel to inform efforts and secure resources towards the improvement of hospital systems. Research examining doctors' work during night-shifts is limited.
AIM: To describe and quantify the night-shift work-practices of junior doctors.
METHODS: An observational time and motion study was conducted. Eight resident doctors in four general wards were observed for 96 hours during night-shifts (Monday-Friday, 2200-0800).
RESULTS: Doctors spent the highest proportion (28%; 95%CI 21-35) of their time performing social/personal tasks (e.g. sleeping, eating) and indirect care (24%; 95%CI 22-25) (e.g. reviewing notes, ordering tests). Work-related discussion comprised 15% (95%CI 13-17) and most took place at the beginning of the night. Medication-related tasks consumed a small proportion of time (4%; 95%CI 3-4) but attracted a higher level of multi-tasking and interruptions than most other tasks. On average, two hours of every shift were spent at a computer and 1.3 hours with patient notes. Doctors spent 72% of the night-shift alone, multi-tasked 6.4% of the time and were interrupted, on average, once every 46 minutes.
CONCLUSIONS: This study provides new data about junior doctors' work at night. Relative to doctors during the day, greater proportions of time were devoted to social/personal tasks including sleep and indirect care, but a similar proportion to direct care. Multi-tasking and interruptions were minimal. Computer activities were an integral part of work. Handovers were observed at the beginning but not the completion of the night-shift which may have implications for patient safety.
PMID: 23800071 [PubMed - as supplied by publisher]