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Emergency department physicians' distribution of time in the fast paced-workflow-a novel time-motion study of drug-related activities
Diakonhjemmet Hosp Pharm, Norway;Univ Oslo, Norway.
Univ Oslo, Norway.
Macquarie Univ, Australia.
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. UiT Arctic Univ Norway, Norway.ORCID iD: 0000-0003-1428-5476
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2022 (English)In: International Journal of Clinical Pharmacy, ISSN 2210-7703, E-ISSN 2210-7711, Vol. 44, p. 448-458Article in journal (Refereed) Published
Abstract [en]

Background In the emergency department physicians are forced to distribute their time to ensure that all admitted patients receive appropriate emergency care. Previous studies have raised concerns about medication discrepancies in patient's drug lists at admission to the emergency department. Thus, it is important to study how emergency department physicians distribute their time, to highlight where workflow redesign can be needed. Aim to quantify how emergency department physicians distribute their time between various task categories, with particular focus on drug-related tasks. Method Direct observation, time-motion study of emergency department physicians at Diakonhjemmet Hospital, Oslo, Norway. Physicians' activities were categorized in discrete categories and data were collected with the validated method of Work Observation Method By Activity Timing between October 2018 to January 2019. Bootstrap analysis determined 95% confidence intervals for proportions and interruption rates. Results During the observation time of 91.4 h, 31 emergency department physicians were observed. In total, physicians spent majority of their time gathering information (36.5%), communicating (26.3%), and documenting (24.2%). Further, physicians spent 17.8% (95% CI 16.8%, 19.3%) of their time on drug-related tasks. On average, physicians spent 7.8 min (95% CI 7.2, 8.6) per hour to obtain and document patients' drug lists. Conclusion Emergency department physicians are required to conduct numerous essential tasks and distributes a minor proportion of their time on drug-related tasks. More efficient information flow regarding drugs should be facilitated at transitions of care. The presence of healthcare personnel dedicated to obtaining drug lists in the emergency department should be considered.

Place, publisher, year, edition, pages
Springer Nature, 2022. Vol. 44, p. 448-458
Keywords [en]
Emergency service hospital, Medication reconciliation, Medication errors, Practice management medical, Time and motion studies, Time management
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
URN: urn:nbn:se:lnu:diva-109663DOI: 10.1007/s11096-021-01364-6ISI: 000733263900001PubMedID: 34939132Scopus ID: 2-s2.0-85121562326Local ID: 2021OAI: oai:DiVA.org:lnu-109663DiVA, id: diva2:1630658
Available from: 2022-01-20 Created: 2022-01-20 Last updated: 2022-05-09Bibliographically approved

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Lehnbom, Elin C.

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