Skip to main content
Log in

Observation and analysis of junior OB/GYNs’ workflow in German hospitals

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Over the past few years the numbers of German physicians choosing to work abroad or leaving the medical profession have been growing. Main reasons for physicians’ dissatisfaction are the lack of autonomy and the subsequent workload. Studies have employed subjective instruments of evaluation to investigate levels of occupational stress. However, there is a lack of objective work task analysis. The aim of this study is to monitor the workflow of German obstetrician/gynecologists (OB/GYN) through an objective, computer-based analysis.

Methods

From 10/08 to 02/09 twenty OB/GYNs in three hospitals in Berlin were monitored (n = 19 females, n = 1 male, age 23–38 years). Each one of them was accompanied throughout three entire workdays.

Results

The junior physicians’ average workday lasted 9:24:35 h (SD = 01:05:07 h). During this time period, they spent an average of 02:41:56 h/day (SD = 00:33:35 h) on internal communication (28.68%). On average 01:19:11 h (SD = 00:55:15 h) were spent in the operating room (14.03%). An average total of 5:38:28 h (SD = 00:11:22 h) were spent attending to indirect patient.

Conclusions

The workflow is disorganized and full of interruptions, which could cause medical errors. Improving the physicians’ work environment will likely require a reorganization of medical processes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Bell DJ, Bringman J, Bush A, Phillips OP (2006) Job satisfaction among obstetrician-gynecologists: a comparison between private practice physicians and academic physicians. Am J Obstet Gynecol 5:1474–1478

    Google Scholar 

  2. Blazek BA, Zollinger TW, Look KY (2005) Obstetrics-gynecology resident satisfaction. Am J Obstet Gynecol 5:1798–1803

    Article  Google Scholar 

  3. Buddeberg-Fischer B, Klaghofer R, Buddeberg C (2005) Stress at work and well-being in junior residents. Z Psychosom Med Psychother 2:163–178

    Google Scholar 

  4. Buddeberg-Fischer B, Klaghofer R, Stamm M, Siegrist J, Buddeberg C (2008) Work stress and reduced health in young physicians: prospective evidence from Swiss residents. Int Arch Occup Environ Health 82(1):31–38

    Google Scholar 

  5. Cohen JS, Patten S (2005) Well-being in residency training: a survey examining resident physician satisfaction both within and outside of residency training and mental health in Alberta. BMC Med Educ 5:21

    Google Scholar 

  6. Collier VU, McCue JD, Markus A, Smith L (2002) Stress in medical residency: status quo after a decade of reform? Ann Intern Med 5:384–390

    Google Scholar 

  7. Elit L, Trim K, Mand-Bains IH, Sussman J, Grunfeld E (2004) Job satisfaction, stress, and burnout among Canadian gynecologic oncologists. Gynecol Oncol 1:134–139

    Article  Google Scholar 

  8. Emmons SL, Nichols M, Schulkin J, James KE, Cain JM (2006) The influence of physician gender on practice satisfaction among obstetrician gynecologists. Am J Obstet Gynecol 6:1728–1738; discussion 1739

    Article  Google Scholar 

  9. Gabow PA, Karkhanis A, Knight A, Dixon P, Eisert S, Albert RK (2006) Observations of residents’ work activities for 24 consecutive hours: implications for workflow redesign. Acad Med 8:766–775

    Article  Google Scholar 

  10. Girard NJ (2007) Multitasking: how much is too much? AORN J 3:505–506

    Article  Google Scholar 

  11. Gordinier ME et al (2000) Survey of female gynecologic oncologists and fellows: balancing professional and personal life. Gynecol Oncol 2:309–314

    Article  Google Scholar 

  12. Hirst W, Kalmar D (1987) Characterizing attentional resources. J Exp Psychol Gen 1:68–81

    Article  Google Scholar 

  13. Hitchen L (2008) Frequent interruptions linked to drug errors. BMJ 7654:1155

    Google Scholar 

  14. Janus K, Amelung VE, Gaitanides M, Schwartz FW (2007) German physicians “on strike”—shedding light on the roots of physician dissatisfaction. Health Policy 3:357–365

    Article  Google Scholar 

  15. Jungbauer J, Alfermann D, Kamenik C, Brahler E (2003) Psychosocial skills training unsatisfactory results from interviews with medical school graduates from seven German universities. Psychother Psychosom Med Psychol 7:319–321

    Google Scholar 

  16. Kopetsch T (2004) Ärztestatistik: Moderater Zugang. Überalterung setzt sich fort. Deutsches Ärzteblatt 20:A1396–A1398

    Google Scholar 

  17. Landon BE, Reschovsky J, Blumenthal D (2003) Changes in career satisfaction among primary care and specialist physicians, 1997–2001. JAMA 4:442–449

    Article  Google Scholar 

  18. Laxmisan A, Hakimzada F, Sayan OR, Green RA, Zhang J, Patel VL (2007) The multitasking clinician: decision-making and cognitive demand during and after team handoffs in emergency care. Int J Med Inform 11–12:801–811

    Article  Google Scholar 

  19. Levey RE (2001) Sources of stress for residents and recommendations for programs to assist them. Acad Med 2:142–150

    Article  Google Scholar 

  20. Mache S et al (2008) Development and evaluation of a computer-based medical work assessment programme. J Occup Med Toxicol 3:35

    Google Scholar 

  21. McMurray JE, Linzer M, Konrad TR, Douglas J, Shugerman R, Nelson K (2000) The work lives of women physicians results from the physician work life study. The SGIM Career Satisfaction Study Group. J Gen Intern Med 6:372–380

    Google Scholar 

  22. O’Meara AT, Averette HE (2000) Job satisfaction among gynecologic oncologists practicing in the United States. Gynecol Oncol 2:163–169

    Article  Google Scholar 

  23. Rosta J (2007) Working hours of hospital doctors in Germany. Deutsches Ärzteblatt 36:2417–2423

    Google Scholar 

  24. Rovik JO et al (2007) Job stress in young physicians with an emphasis on the work-home interface: a nine-year, nationwide and longitudinal study of its course and predictors. Ind Health 5:662–671

    Article  Google Scholar 

  25. Shanafelt TD, Bradley KA, Wipf JE, Back AL (2002) Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med 5:358–367

    Google Scholar 

  26. Ulich E (2005) Arbeitspsychologie. Zürich

  27. Volpp KG, Grande D (2003) Residents’ suggestions for reducing errors in teaching hospitals. N Engl J Med 9:851–855

    Article  Google Scholar 

Download references

Acknowledgment

We would like to thank all the physicians for their participation.

Conflict of interest statement

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lisa Kloß.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kloß, L., Musial-Bright, L., Klapp, B.F. et al. Observation and analysis of junior OB/GYNs’ workflow in German hospitals. Arch Gynecol Obstet 281, 871–878 (2010). https://doi.org/10.1007/s00404-009-1194-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-009-1194-x

Keywords

Navigation