Time Spent on Medical Round Activities, Distance Walked, and Time-Motion in the General Medicine Department at Hamad General Hospital in Qatar

Abstract

BackgroundThe daily morning round is a routine activity performed by medical teams. During the morning round, updates on the patient's clinical condition, new laboratory results, and other test results are reviewed and discussed between team members, the patient, and at times the family. Completing these tasks takes time. The design of the patient location differs between hospitals, and significant distance between patients can considerably affect round times. This study assesses physicians' time spent on clinical activities, the distance traveled, and the time they spend walking between patients during daily morning rounds to identify better reorganization methods to reduce wasted time. MethodologyThe survey was self-administered and had no intervention needing ethical approval. The research team's leader engaged two observers (a general practitioner from another department and a general internal medicine department case manager) to collect the data. The general practitioner was a medical graduate doctor, while the bed manager was not a medical college graduate. They observed 10 rounds over 10 nonconsecutive days from July 1 to July 30, 2022. They recorded daily activities during the daily morning round, including time spent with patients, family conversations, bedside education, medication, social issues, and the time and distance required to move from patient to patient and from one location to location. The informal conversations about age, work history, and other small talk were recorded and converted into quantitative data. In each round, records were given to a statistician for rechecking. Subsequently, the records were imported into a Microsoft Excel spreadsheet for further statistical analysis. For continuous variables, the data were summarized as mean, median, and standard deviation. For categorical variables, the data were summarized as counts or proportions. ResultsOn average, the duration of the daily morning round was 161.7 ± 17.3 minutes. The average number of patients seen by the general internal medicine round team was 14. The median patient encounter time per patient was 14 minutes (11-19 minutes), with an average of 12 minutes. An average of 8.6 employees participated in the 10-day rounds. The physician spent 41.2% of the time in direct contact with the patient during the morning round, 11.4% in maintaining electronic medical records, and 18.20% in bedside teaching. Additionally, 7.1% of the round time was spent because of interruptions by clinical and nonclinical staff other than team members or family members who were not in the room. Furthermore, a team member walked an average of 763 ± 54.5 m (667-872 m) per round, costing 35.7 minutes (22.1%) of the total round time. ConclusionsThe daily morning round time was significantly longer compared with the reported round times. Relocating patient beds to a common location reduced the rounding time by 22.30%. Disruption, teaching, and medical instruction must also be considered and shortened to reduce the morning round time.

Rounds Redesign: Our Experience In Splitting Interdisciplinary Rounds

“…Al Halabi et al indicated that physicians, managing an average of 14 patients, spend a median of 14 minutes per patient encounter in the inpatient setting in their 11-hour work day. 13 Furthermore, physicians dedicate approximately 3.8 hours (±2) daily, constituting about 37% (±17%) of total work hours, to electronic health record (EHR) activities. 14 Nurses face similar challenges, with greater time allocated to indirect care than direct patient interaction.…”

“Time wasted by health professionals is time not invested in patients”: time management practice and associated factors among health professionals at public hospitals in Bahir Dar, Ethiopia: a multicenter mixed method study

“…In healthcare facilities, time management is critical since time wasted by healthcare workers is time not spent with patients, and this has a detrimental impact on the quality of treatment provided to patients (9,36). Therefore, this study was aimed at assessing time management and factors affecting it among health professionals at public hospitals in Bahir Dar, Ethiopia.…”