Time is of the essence: an observational time-motion study of internal medicine residents while they are on duty

Authors

  • Cameron Leafloor University of Ottawa
  • Erin (Yiran) Liu McGill University
  • Cathy Code University of Ottawa
  • Heather Lochnan University of Ottawa
  • Erin Keely University of Ottawa
  • Deanna Rothwell The Ottawa Hospital Research Institute
  • Alan Forster University of Ottawa
  • Allen Huang University of Ottawa http://orcid.org/0000-0003-2680-7657

DOI:

https://doi.org/10.36834/cmej.36948

Keywords:

time-motion, duty hours, workflow, measurement

Abstract

Background: The effects of changes to resident physician duty hours need to be measureable. This time-motion study was done to record internal medicine residents’ workflow while on duty and to determine the feasibility of capturing detailed data using a mobile electronic tool.

Methods: Junior and senior residents were shadowed by a single observer during six-hour blocks of time, covering all seven days. Activities were recorded in real-time. Eighty-nine activities grouped into nine categories were determined a priori.

Results: A total of 17,714 events were recorded, encompassing 516 hours of observation. Time was apportioned in the following categories: Direct Patient Care (22%), Communication (19%), Personal tasks (15%), Documentation (14%), Education (13%), Indirect care (11%), Transit (6%), Administration (0.6%), and Non-physician tasks (0.4%). Nineteen percent of the education time was spent in self-directed learning activities. Only 9% of the total on duty time was spent in the presence of patients. Sixty-five percent of communication time was devoted to information transfer. A total of 968 interruptions were recorded which took on average 93.5 seconds each to service.

Conclusion: Detailed recording of residents’ workflow is feasible and can now lead to the measurement of the effects of future changes to residency training. Education activities accounted for 13% of on-duty time. 

Author Biographies

Cameron Leafloor, University of Ottawa

Medical Student

Erin (Yiran) Liu, McGill University

Department of Clinical Epidemiology and Biostatistics

Cathy Code, University of Ottawa

Department of Medicine

Division of General Internal Medicine

Heather Lochnan, University of Ottawa

Department of Medicine

Division of Endocrinology and Metabolism

Erin Keely, University of Ottawa

Department of Medicine

Division of Endocrinology and Metabolism

Deanna Rothwell, The Ottawa Hospital Research Institute

Quality and Performance Measurement, The Ottawa Hospital

Alan Forster, University of Ottawa

Department of Medicine

Division of General Internal Medicine

Quality and Performance Measurement, The Ottawa Hospital

Allen Huang, University of Ottawa

Head, Division of Geriatric Medicine

Department of Medicine

University of Ottawa

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Published

2017-07-04

How to Cite

1.
Leafloor C, Liu E (Yiran), Code C, Lochnan H, Keely E, Rothwell D, Forster A, Huang A. Time is of the essence: an observational time-motion study of internal medicine residents while they are on duty. Can. Med. Ed. J [Internet]. 2017 Jul. 4 [cited 2023 Jan. 28];8(3):e49-70. Available from: https://journalhosting.ucalgary.ca/index.php/cmej/article/view/36948

Issue

Section

Original Research