Evaluation of the Time Spent by Anesthetist on Clinical Tasks in the Operating Room.

Vincent Compère,Nicolas Sturzenegger,Bertrand Dureuil,Thomas Elie,Emmanuel Besnier,Florent Lefranc,Jean Baptiste Hardy,Frederic Jegou,Thomas Clavier,Nicolas Byhet

doi:10.3389/fmed.2021.768919

Abstract

BackgroundChanges in the health system in Western countries have increased the scope of the daily tasks assigned to physicians', anesthetists included. As already shown in other specialties, increased non-clinical burden reduces the clinical time spent with patients.MethodsThis was a multicenter, prospective, observational study conducted in 6 public and private hospitals in France. The primary endpoint was the evaluation by an external observer of the time spent per day (in minutes) by anesthetists on clinical tasks in the operating room. Secondary endpoints were the time spent per day (in minutes) on non-clinical organizational tasks and the number of task interruptions per hour of work.ResultsBetween October 2017 and April 2018, 54 anesthetists from six hospitals (1 public university hospital, two public general hospitals and three private hospitals) were included. They were followed for 96 days corresponding to 550 hours of work. The proportion of overall clinical time was 62% (58% 95%CI [53; 63] for direct care. The proportion of organizational time was higher in public hospitals (11% in the university hospital (p < 0.001) and 4% in general hospitals (p < 0.01)) compared to private hospitals (1%). The number of task interruptions (1.5/h ± 1.4 in all hospitals) was 4 times higher in the university hospital (2.2/h ± 1.6) compared to private hospitals (0.5/h ± 0.3) (p < 0.05).ConclusionsMost time in the operating room was spent on clinical care with a significant contrast between public and private hospitals for organizational time.

Highlights

Changes in the health system in Western countries have increased the scope of the tasks assigned to physicians in their daily lives
We evaluated the time spent by anesthetists on clinical tasks during 1 day in the operating room
The primary endpoint was the evaluation by an external observer of the time spent per day by anesthetist on clinical tasks in the operating room

Summary

Introduction

Changes in the health system in Western countries have increased the scope of the tasks assigned to physicians in their daily lives. A recent work showed that in four different specialties (general medicine, internal medicine, cardiology and orthopedics), for every hour spent with a patient, a physician spent 2 h on tasks in the patient’s absence [1]. This result is consistent with that of the study of Wenger et al which found a ratio of 1 to 3 for time spent with the patient vs administrative tasks in a population of 36 internal medicine residents [2]. As already shown in other specialties, increased non-clinical burden reduces the clinical time spent with patients

Methods

Results

Discussion

Conclusion