Tick, Tock, Tick, Tock


A new study in this month's Journal of Hospital Medicine that catalogues the daily routine of HM practitioners is a first step in helping streamline the hospitalist’s workflow for efficiency, say several people associated with the report.

The report, “Where Did the Day Go? A Time-Motion Study of Hospitalists,” attempted to capture the amount of time hospitalists spent on various activities, including interacting with electronic health records (EHR) (34.1%), communication with colleagues (25.9%), and direct care (7.4%) (J Hosp Med. 2010;5(6):323-328). But one of the report’s senior authors, as well as the co-author of an accompanying editorial, anticipate that the study will serve as a springboard for future research on how hospitalists can best use their time.

Hospitalists need to “lay the foundation to figure how not to just observe what the doctors are doing, but how, in the future, to what they should be doing,” says Mark Williams, MD, FHM, professor and chief of hospital medicine at Northwestern University's Feinberg School of Medicine in Chicago. “We’ve got to have a good understanding of what we’re doing every day to move forward.”

The research, which furthered a similar Northwestern study completed in 2006 found that 16% of all activities occurred simultaneously, meaning that the surveyed hospitalists spent about 9% of their average 10.3-hour shift multitasking.

“Sadly, we documented that the vast majority [of time] is away from the patient, not with the patient,” Dr. Williams says.

Dr. Williams and Amit Prachand, an administrator in the HM department at Northwestern, hope to see more research done to define the best workflow for a hospitalist. Both agree, though, that dedicated funding will have to be set aside, either by federal agencies or research institutions, to make that happen.

“We need to convince people the money is well spent in focusing on this,” says Prachand, co-author of the editorial “Hospitalists: Lean Leaders for Hospitals.” “I think the hospital is going to be the one with the most to gain by supporting these opportunities.”

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