Journal article
Estimating Time Physicians and Other Health Care Workers Spend with Patients in an Intensive Care Unit Using a Sensor Network
The American journal of medicine, Vol.131(8), pp.972.e9-972.e15
08/2018
DOI: 10.1016/j.amjmed.2018.03.015
PMID: 29649458
Abstract
Time and motion studies have been used to investigate how much time various health care professionals spend with patients as opposed to performing other tasks. However, the majority of such studies are done in outpatient settings, and rely on surveys (which are subject to recall bias) or human observers (which are subject to observation bias). Our goal was to accurately measure the time physicians, nurses, and critical support staff in a medical intensive care unit spend in direct patient contact, using a novel method that does not rely on self-report or human observers.
We used a network of stationary and wearable mote-based sensors to electronically record location and contacts among health care workers and patients under their care in a 20-bed intensive care unit for a 10-day period covering both day and night shifts. Location and contact data were used to classify the type of task being performed by health care workers.
For physicians, 14.73% (17.96%) of their time in the unit during the day shift (night shift) was spent in patient rooms, compared with 40.63% (30.09%) spent in the physician work room; the remaining 44.64% (51.95%) of their time was spent elsewhere. For nurses, 32.97% (32.85%) of their time on unit was spent in patient rooms, with an additional 11.34% (11.79%) spent just outside patient rooms. They spent 11.58% (13.16%) of their time at the nurses' station and 23.89% (24.34%) elsewhere in the unit. From a patient's perspective, we found that care times, defined as time with at least one health care worker of a designated type in their intensive care unit room, were distributed as follows: 13.11% (9.90%) with physicians, 86.14% (88.15%) with nurses, and 8.14% (7.52%) with critical support staff (eg, respiratory therapists, pharmacists).
Physicians, nurses, and critical support staff spend very little of their time in direct patient contact in an intensive care unit setting, similar to reported observations in both outpatient and inpatient settings. Not surprisingly, nurses spend far more time with patients than physicians. Additionally, physicians spend more than twice as much time in the physician work room (where electronic medical record review and documentation occurs) than the time they spend with all of their patients combined.
Details
- Title: Subtitle
- Estimating Time Physicians and Other Health Care Workers Spend with Patients in an Intensive Care Unit Using a Sensor Network
- Creators
- Rachel Butler - Department of Internal Medicine, University of Iowa, Iowa CityMauricio Monsalve - Department of Epidemiology, University of Iowa, Iowa City; Centro de Investigación para la Gestión Integrada de Desastres Naturales, Santiago, ChileGeb W Thomas - Department of Mechanical and Industrial Engineering, University of Iowa, Iowa CityTed Herman - Department of Computer Science, University of Iowa, Iowa CityAlberto M Segre - Department of Computer Science, University of Iowa, Iowa CityPhilip M Polgreen - Department of Internal Medicine, University of Iowa, Iowa City; Department of Epidemiology, University of Iowa, Iowa CityManish Suneja - Department of Internal Medicine, University of Iowa, Iowa City. Electronic address: manish-suneja@uiowa.edu
- Resource Type
- Journal article
- Publication Details
- The American journal of medicine, Vol.131(8), pp.972.e9-972.e15
- DOI
- 10.1016/j.amjmed.2018.03.015
- PMID
- 29649458
- NLM abbreviation
- Am J Med
- ISSN
- 0002-9343
- eISSN
- 1555-7162
- Grant note
- DOI: 10.13039/100000030, name: Centers for Disease Control and Prevention
- Language
- English
- Date published
- 08/2018
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Infectious Diseases; Epidemiology; Orthopedics and Rehabilitation; Industrial and Systems Engineering; Nursing; Fraternal Order of Eagles Diabetes Research Center; Injury Prevention Research Center; Computer Science; Nephrology; Internal Medicine
- Record Identifier
- 9984094735402771
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