Showing papers by "Kevin J. O'Leary published in 2006"

How hospitalists spend their time: Insights on efficiency and safety

Abstract: BACKGROUND: Despite the dramatic growth of hospitalists, no studies have evaluated the type and frequency of activities that hospitalists perform. To evaluate the types and frequency of activities that hospitalists perform during routine work, we conducted a time-motion study of hospitalist physicians at our institution. DESIGN: A research assistant shadowed hospitalist physicians for 3- to 5-hour periods. Observation periods were distributed in order to sample all parts of a typical day of a hospitalist, including both admitting and nonadmitting periods. Activities were recorded on a standardized data collection form in 1-minute intervals. Incoming pages were recorded as well. RESULTS: Ten hospitalists were shadowed by a single research assistant for a total of 4467 minutes. Hospitalists spent 18% of their time on direct patient care, 69% on indirect patient care, 4% on personal activities, and 3% each on professional development, education, and travel. Communication accounted for 24% of the total minutes. Multitasking, performing more than one activity at the same time, was done 21% of the time. Hospitalists received an average of 3.4 1.5 pages per hour. CONCLUSIONS: Hospitalists spent most of their time on indirect patient care activities and relatively little time on direct patient care. Hospitalists spent a large amount of time on communication, underscoring the need for hospitalists to have outstanding communication skills and systems that support efficient communication. Multitasking and paging interruptions were common. The inherent distraction caused by interruptions and multitasking is a potential contributor to medical

Outpatient physicians' satisfaction with discharge summaries and perceived need for an electronic discharge summary.

Abstract: BACKGROUND Deficits in information transfer between inpatient and outpatient physicians are common and potentially dangerous. OBJECTIVE To evaluate satisfaction with current discharge summaries, perceptions of preventable adverse events related to suboptimal information transfer, and the perceived need for the electronic discharge summary we plan to design. DESIGN AND PARTICIPANTS: Survey of Department of Medicine physicians with an outpatient practice. MEASUREMENTS Satisfaction with timeliness and quality of discharge summaries was assessed using a 5-point Likert scale. Respondents estimated the number of patients with preventable adverse events related to suboptimal information transfer at discharge. RESULTS Of the 416 eligible respondents, 226 completed the survey (54%). Only 19% of the participants were satisfied or very satisfied with timeliness, and only 32% were satisfied or very satisfied with the quality of discharge summaries. Overall, 41% believed that at least 1 of their patients hospitalized in the previous 6 months had experienced a preventable adverse event related to poor transfer of information at discharge. CONCLUSIONS Physicians were not satisfied with the timeliness or quality of discharge summaries. Physicians indicated that suboptimal transfer of information at hospital discharge contributed to preventable adverse events. Journal of Hospital Medicine 2006;1:317–320. © 2006 Society of Hospital Medicine.