Time and motion studies have been conducted to address system failures within an organisation,1 but never before as a course development needs analysis process.
Simulation is increasingly used to teach human factors and strategies to cope with pressures on a busy ward.
This study can provide real time data of junior doctors’ work schedule, to increase the realism of simulation to reflect accurately work conditions on a busy ward, and help identify training needs and design courses to target specific learning strategies to improve efficiency.
Methodology Following cg approval and signed consent, two observers shadowed individually fourteen doctors during their shift in the acute assessment unit, for 5 h each, recording and timing all tasks performed. Statistics were carried out to identify times spent in different tasks, individually and categorised. The different levels of doctors were then compared by using a x2 test.
Results Nearly 1/3 of time was spent in communication, 1/3 on direct patient tasks. Training time was only 8%, and lots of time was ‘’wasted’’ in admin tasks. A detailed breakdown of the associations between groups will be presented.
Reccommendations We propose a comprehensive plan of improving training oppurtunities while increasing efficiency on the wards by:
Reducing the time spent in administrative tasks and increasing the effectiveness of communication through one day simulation course on time management and prioritisation for junior doctors working in an acute medicine.
Increasing the time spent on procedures other than cannulation, (provide repeated small group simulation based procedural courses, and simultaneously appoint nurse practitioners for cannulation tasks).
A limitation is that this study applies particularly to acute medicine. However, we believe that the results are reproducible, as proven by similar studies abroad.2,3 Our protocol can be followed in other medical units around the country and wider results can be obtained.
Patton WM Jr. ‘’Developing tima and motion study for a lean healthcare environment’’, 2011, University of Kentucky Master’s Thesis, paper 163
Westbrook JI, Ampt A, Kearney L, Rob MI. ‘’All in a day’s work: an observational study to quantify how and with whom doctors on hospital wards spend their time’’, MJA 2008;188:506–509
Ammenwerth E, ‘’The time needed for clinical documentation versus direct care’’. Methods Int Medicine 2009;48:84–91
- Category: Course or curriculum evaluation/innovation/integration
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