Objectives & Background It is a frequent source of frustration to many clinicians (and others) that they do not understand what each other do all day. This can result in unnecessary antagonism and frustration. As a relatively new (and evolving) specialty EM has the potential to be poorly understood by other clinicians and groups.
We aimed to break down the activities of consultants on shop floor shifts so that they might be better understood both internally and externally to our department.
Methods This is a single site, convenience sample (all consultant shifts covered), 2 month study in a MTC. GAfREC approval was given. A group of 6 medical students were identified and trained in methodology for using our locally derived consultant activity tool.
We decided upon an iterative method of recording consultant activity. Consultant activity was recorded in 4 hour blocks, with minute by minute subdivision.
A recording tool revision occurred after 12 hours, with minor changes. Results were entered into Excel and are shown below.
Results 48 hours of shop floor consultant time have been observed. The most common task was discussing or reviewing patients- 26% 15% of the shift is spent dealing with operational issues in the department.
Consultants are interrupted approx 17 times per hour. 14% of the shift is spent actively (explicitly) teaching Both running trauma and performing procedures take about 4% of the time each.
Conclusion Shop floor shifts require consultants to be performing a myriad of different tasks. Task saturation is clearly a risk and interruptions are frequent.
Operational issues take up a significant amount of time but reassuingly the single most time consuming activity is direct patient care (through discussion or actually seeing the patient).
Further work around the psychological toll and techniques used to promote resilience in the consultant body would be valuable⇓.
- emergency departments
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