Defining and measuring the effort needed for inpatient medicine work

Abstract

BACKGROUND:Current metrics for assessing physician workload are inadequate. Understanding the effort associated with work tasks could make workload assessments more robust.OBJECTIVE:To assess the physical, mental, and psychological effort needed for the tasks performed by internal medicine doctors while admitting a patient to the hospital.DESIGN:Cross‐sectional survey.SETTING:A single Midwest academic institution.SUBJECTS:Internal medicine housestaff, hospitalists, and nonhospitalist internal medicine faculty.MEASUREMENTS:Subjects rated 99 tasks across 3 domains: physical, mental, and psychological effort using a scale of 1–7 (1 = least effort, 7 = most effort). A composite effort score was calculated for each task and for each of 6 task categories: direct patient care, indirect patient care, searching for/finding things, educational/academic activities, personal/downtime activities, and other.RESULTS:Overall, the most difficult task was going to codes, which was also the most difficult psychological task. The most difficult physical task was placing a central line, and the most difficult mental task was transferring an unstable patient to the intensive care unit. The easiest task was using the Internet. That was also the easiest physical, mental, and psychological task. Direct patient care was more difficult than indirect patient care overall (3.58 vs 3.21; P < 0.001).CONCLUSION:We began the process of describing the workload of inpatient doctors by measuring the difficulty of the tasks they perform while admitting patients. To assess the relationship between workload and other outcomes (such as physician burnout and patient safety), it is essential that we be able to accurately measure workload. Journal of Hospital Medicine 2012. © 2012 Society of Hospital Medicine

The Composition of Intern Work While on Call

“…The RA operated a data-logging laptop computer that ran custom data collection software, which has been refined over the last 14 years and has been demonstrated to be effective at measuring the effects of a variety of performance shaping factors. [10][11][12][13] This software contained all possible tasks performed by the intern, based on a pilot study 14 (task list available online). The observer recorded each of the intern's tasks by clicking on the appropriate task button on the computer display ( Fig.…”

The Burden of Burnout

“…This suggests that increased burnout on specific rotations is likely related to other factors such as the density of work, patient load, and acuity of illness, consistent with prior literature. 10,12,16 Variable amounts of ancillary support and logistical challenges specific to various practice locations also may contribute to burnout.…”

Developing an Integrated Evaluation Model for Physician Comprehensive Workload Tethered to Outpatient Practice: An Empirical Study From China

“…In our previous study, we decomposed and further classified all work activities physicians performed during outpatient encounters into the two large groups based on a time-motion task analysis on 32 Chinese physicians from public tertiary hospitals: physician-patient communication work tasks (comprising six categories of work tasks) characterized by direct patient interaction, and non-physician-patient communication work tasks (comprising seven categories of work tasks) characterized by paperwork ( 27 ). Research indicated that gaining insight into the effort associated with work tasks could make workload assessments more robust, since task analysis might facilitate workload measurement by the individual work components or subtasks to be measured ( 28 ). The definition of the detailed work tasks performed by physicians in outpatient practice can provide a solid foundation for the present study to further seek to comprehensively assess physician workload with the consideration of the content and nature of work tasks tethered to outpatient practice.…”