Charge de travail des médecins des urgences : problème quantitatif ou qualitatif? De la sérénité du médecin des urgences

Abstract

Workload in emergency departments is known to be heavy, and may lead to “burn out” of the medical staff. Although the quantitative factors have been much studied, very few studies on qualitative factors interfering with medical activities are available.

Method: From April to June 1998, eight physicians working in five emergency departments of the south-east of France answered a self-7-day activity evaluation. Quantity of workload, duration and nature of necessary and unjustified breaks were registered.

Results: During the 631 hours of activity, these eight seniors saw 3,961 patients (21.2% of the emergency departments patients, two patients/hour/senior). Time for clinical work was 70%, for administrative work 6.5%, for authorized breaks 16.7%, and for unexpected breaks 6.2%. Unexpected breaks (UB) were justified in 66% and unjustified in 34%, and happened every 132 minutes. They are due to a resident (20.8% of UB), a secretary (14.7% of UB), another patient (13% of UB), a nurse (12.1% of UB), commercial representatives (12.3% of UB), and other people (21% of UB). Medical directors (two physicians) had a heavier administrative workload, and were more frequently interrupted than other physicians (p < 0.01, and p < 0.05).

Conclusion: Qualitative factors should be considered as important as quantitative ones in the evaluation of emergency department physician's workload.