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In the Wake of the 2003 and 2011 Duty Hours Regulations, How Do Internal Medicine Interns Spend Their Time?

Journal of general internal medicine : JGIM, 2013-08, Vol.28 (8), p.1042-1047 [Peer Reviewed Journal]

Society of General Internal Medicine 2013 ;ISSN: 0884-8734 ;EISSN: 1525-1497 ;DOI: 10.1007/s11606-013-2376-6 ;PMID: 23595927

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  • Title:
    In the Wake of the 2003 and 2011 Duty Hours Regulations, How Do Internal Medicine Interns Spend Their Time?
  • Author: Block, Lauren ; Habicht, Robert ; Wu, Albert W. ; Desai, Sanjay V. ; Wang, Kevin ; Silva, Kathryn Novello ; Niessen, Timothy ; Oliver, Nora ; Feldman, Leonard
  • Subjects: Health education ; Humans ; Internal Medicine ; Internal Medicine - methods ; Internal Medicine - standards ; Internship and Residency - methods ; Internship and Residency - standards ; Medical residencies ; Medicine ; Medicine & Public Health ; Original Research ; Patient Care - methods ; Patient Care - standards ; Personnel Staffing and Scheduling - standards ; Regulation ; Time and Motion Studies ; Time Management - methods ; Work Schedule Tolerance ; Working hours ; Workload - standards
  • Is Part Of: Journal of general internal medicine : JGIM, 2013-08, Vol.28 (8), p.1042-1047
  • Description: ABSTRACT BACKGROUND The 2003 and 2011 Accreditation Council for Graduate Medical Education (ACGME) common program requirements compress busy inpatient schedules and increase intern supervision. At the same time, interns wrestle with the effects of electronic medical record systems, including documentation needs and availability of an ever-increasing amount of stored patient data. OBJECTIVE In light of these changes, we conducted a time motion study to determine how internal medicine interns spend their time in the hospital. DESIGN Descriptive, observational study on inpatient ward rotations at two internal medicine residency programs at large academic medical centers in Baltimore, MD during January, 2012. PARTICIPANTS Twenty-nine interns at the two residency programs. MAIN MEASURES The primary outcome was percent of time spent in direct patient care (talking with and examining patients). Secondary outcomes included percent of time spent in indirect patient care, education, and miscellaneous activities (eating, sleeping, and walking). Results were analyzed using multilevel regression analysis adjusted for clustering at the observer and intern levels. KEY RESULTS Interns were observed for a total of 873 hours. Interns spent 12 % of their time in direct patient care, 64 % in indirect patient care, 15 % in educational activities, and 9 % in miscellaneous activities. Computer use occupied 40 % of interns’ time. There was no significant difference in time spent in these activities between the two sites. CONCLUSIONS Interns today spend a minority of their time directly caring for patients. Compared with interns in time motion studies prior to 2003, interns in our study spent less time in direct patient care and sleeping, and more time talking with other providers and documenting. Reduced work hours in the setting of increasing complexity of medical inpatients, growing volume of patient data, and increased supervision may limit the amount of time interns spend with patients.
  • Publisher: Boston: Springer US
  • Language: English
  • Identifier: ISSN: 0884-8734
    EISSN: 1525-1497
    DOI: 10.1007/s11606-013-2376-6
    PMID: 23595927
  • Source: Geneva Foundation Free Medical Journals at publisher websites
    MEDLINE
    PubMed Central
    Alma/SFX Local Collection
    ProQuest Central
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