Journal of General Internal Medicine

, Volume 27, Issue 11, pp 1432–1437 | Cite as

The Composition of Intern Work While on Call

  • Kathlyn E. Fletcher
  • Alexis M. Visotcky
  • Jason M. Slagle
  • Sergey Tarima
  • Matthew B. Weinger
  • Marilyn M. Schapira
Original Research

ABSTRACT

BACKGROUND

The work of house staff is being increasingly scrutinized as duty hours continue to be restricted.

OBJECTIVE

To describe the distribution of work performed by internal medicine interns while on call.

DESIGN

Prospective time motion study on general internal medicine wards at a VA hospital affiliated with a tertiary care medical center and internal medicine residency program.

PARTICIPANTS

Internal medicine interns.

MAIN MEASURES

Trained observers followed interns during a “call” day. The observers continuously recorded the tasks performed by interns, using customized task analysis software. We measured the amount of time spent on each task. We calculated means and standard deviations for the amount of time spent on six categories of tasks: clinical computer work (e.g., writing orders and notes), non-patient communication, direct patient care (work done at the bedside), downtime, transit and teaching/learning. We also calculated means and standard deviations for time spent on specific tasks within each category. We compared the amount of time spent on the top three categories using analysis of variance.

KEY RESULTS

The largest proportion of intern time was spent in clinical computer work (40 %). Thirty percent of time was spent on non-patient communication. Only 12 % of intern time was spent at the bedside. Downtime activities, transit and teaching/learning accounted for 11 %, 5 % and 2 % of intern time, respectively.

CONCLUSION

Our results suggest that during on call periods, relatively small amounts of time are spent on direct patient care and teaching/learning activities. As intern duty hours continue to decrease, attention should be directed towards preserving time with patients and increasing time in education.

KEY WORDS

time-motion study graduate medical education 

Supplementary material

11606_2012_2120_MOESM1_ESM.doc (64 kb)
ESM 1Work categories and tasks associated with them. (DOC 64 kb)

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Copyright information

© Society of General Internal Medicine 2012

Authors and Affiliations

  • Kathlyn E. Fletcher
    • 1
    • 2
  • Alexis M. Visotcky
    • 2
  • Jason M. Slagle
    • 3
  • Sergey Tarima
    • 2
  • Matthew B. Weinger
    • 4
    • 3
  • Marilyn M. Schapira
    • 5
    • 6
  1. 1.Clement J. Zablocki VAMCMilwaukeeUSA
  2. 2.Medical College of WisconsinMilwaukeeUSA
  3. 3.Vanderbilt UniversityNashvilleUSA
  4. 4.Tennessee Valley VAMCNashvilleUSA
  5. 5.Philadelphia VAMCPhiladelphiaUSA
  6. 6.University of Pennsylvania Perelman School of MedicinePhiladelphiaUSA

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