按医生专业和工作环境划分的每周 40 小时工作时间所安排的病人小时数:利用电子健康记录事件日志数据进行的横断面研究。

IF 4.7 2区 医学 Q1 COMPUTER SCIENCE, INFORMATION SYSTEMS Journal of the American Medical Informatics Association Pub Date : 2024-10-16 DOI:10.1093/jamia/ocae266
Christine A Sinsky, Lisa Rotenstein, A Jay Holmgren, Nate C Apathy
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引用次数: 0

摘要

目的量化非住院医师每周 40 小时工作时间(PSH40)所需的病人预定小时数,并确定不同专业和执业类型的 PSH40 有何差异:我们计算了 2021 年 11 月至 2022 年 4 月期间 395 家机构中 186 188 名非住院医师的 PSH40,并按专业进行了分层:样本的 PSH40 中位数为 33.2 小时(IQR:28.7-36.5)。传染病科(26.2,IQR:21.6-31.1)、老年病科(27.2,IQR:21.5-32.0)和血液科(28.6,IQR:23.6-32.6)的 PSH40 最低,整形外科(35.7,IQR:32.8-37.7)、疼痛科(35.8,IQR:32.6-37.9)和运动医学科(36.0,IQR:33.3-38.1)的 PSH40 最高:讨论:医疗系统领导和医生将受益于数据驱动和透明的工时预期讨论。PSH40测量方法还可用于量化临床护理环境的变化对医生门诊病人护理时间的影响:PSH40 是一种新颖的衡量标准,可从供应商提供的指标中生成,并由业务领导者用于告知工作预期。它还能支持研究医疗环境的变化对医生工作量和能力的影响。
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The number of patient scheduled hours resulting in a 40-hour work week by physician specialty and setting: a cross-sectional study using electronic health record event log data.

Objective: To quantify how many patient scheduled hours would result in a 40-h work week (PSH40) for ambulatory physicians and to determine how PSH40 varies by specialty and practice type.

Methods: We calculated PSH40 for 186 188 ambulatory physicians across 395 organizations from November 2021 through April 2022 stratified by specialty.

Results: Median PSH40 for the sample was 33.2 h (IQR: 28.7-36.5). PSH40 was lowest in infectious disease (26.2, IQR: 21.6-31.1), geriatrics (27.2, IQR: 21.5-32.0) and hematology (28.6, IQR: 23.6-32.6) and highest in plastic surgery (35.7, IQR: 32.8-37.7), pain medicine (35.8, IQR: 32.6-37.9) and sports medicine (36.0, IQR: 33.3-38.1).

Discussion: Health system leaders and physicians will benefit from data driven and transparent discussions about work hour expectations. The PSH40 measure can also be used to quantify the impact of variations in the clinical care environment on the in-person ambulatory patient care time available to physicians.

Conclusions: PSH40 is a novel measure that can be generated from vendor-derived metrics and used by operational leaders to inform work expectations. It can also support research into the impact of changes in the care environment on physicians' workload and capacity.

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来源期刊
Journal of the American Medical Informatics Association
Journal of the American Medical Informatics Association 医学-计算机:跨学科应用
CiteScore
14.50
自引率
7.80%
发文量
230
审稿时长
3-8 weeks
期刊介绍: JAMIA is AMIA''s premier peer-reviewed journal for biomedical and health informatics. Covering the full spectrum of activities in the field, JAMIA includes informatics articles in the areas of clinical care, clinical research, translational science, implementation science, imaging, education, consumer health, public health, and policy. JAMIA''s articles describe innovative informatics research and systems that help to advance biomedical science and to promote health. Case reports, perspectives and reviews also help readers stay connected with the most important informatics developments in implementation, policy and education.
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