Time Allocation in Clinical Training (TACT): National Study Reveals Resident Doctors Spend Four Hours on Admin for Every Hour With Patients.

IF 7.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Sammy Arab, Karanjot Chhatwal, Thomas Hargreaves, Michela Sorbini, Sara El-Toukhy, Chiara J Vedi, Yusuf Alghabra, Jude Merzah, Stuart D Rosen
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Abstract

Background: Resident Doctors (RDs) in the UK must balance clinical training with non-clinical administrative tasks. Concerns increase over how these tasks impact their professional development, job satisfaction, and patient care. The shift toward consultant-delivered care has led to a redistribution of responsibilities, increasing administrative burden on RDs. This study aims to quantify how RDs allocate time between patient-facing and non-patient-facing tasks and assess impact on job satisfaction.

Methods: The Time Allocation in Clinical Training (TACT) study is a multicentre, observational cohort study conducted over seven months (January-July 2024) at secondary NHS centres. 137 RDs, from Foundation Year 1 to Specialty Training Year 8, were observed for four-hour periods, with time tracked using stopwatches for five task categories. An optional survey assessed job satisfaction, rated on a five-point Likert scale.

Results: RDs spent 73.0% of their time on non-patient-facing tasks, and 17.9% on patient-facing activities. Women spent more time on non-patient-facing tasks compared to men (75.0% vs. 69.9%, p = 0.03). Junior RDs (Foundation years and Core trainees) spent significantly less time on patient-facing tasks compared to senior RDs (ST6-8) (38.4% vs 17.8%; p = 0.004). Most RDs (62%) reported dissatisfaction with the administrative burden. Electronic health record users spent significantly more time on administrative tasks than paper-based record users (44.1% vs 37.3%; p = 0.02).

Conclusions: The study reveals a significant imbalance between clinical and administrative tasks, with excessive administrative workload contributing to RD dissatisfaction. Streamlining administrative duties and integrating digital solutions is crucial for improving job satisfaction, clinical development, and healthcare delivery in the NHS.

临床培训的时间分配(TACT):国家研究显示住院医生每花4小时管理病人。
背景:在英国住院医生(rd)必须平衡临床培训与非临床管理任务。人们越来越关注这些任务如何影响他们的专业发展、工作满意度和病人护理。向顾问提供护理的转变导致了责任的重新分配,增加了rd的行政负担。本研究旨在量化研发人员如何在面对病人和非面对病人的任务之间分配时间,并评估其对工作满意度的影响。方法:临床培训时间分配(TACT)研究是一项多中心、观察性队列研究,在二级NHS中心进行了7个月(2024年1月至7月)。137名rd,从基础一年级到专业培训八年级,观察了四个小时,用秒表记录了五个任务类别的时间。一项可选调查评估了工作满意度,用李克特五分制打分。结果:注册医生将73.0%的时间用于非面向患者的任务,17.9%的时间用于面向患者的活动。与男性相比,女性花在非患者任务上的时间更多(75.0%比69.9%,p = 0.03)。初级研发人员(基础年和核心实习生)在面对患者的任务上花费的时间明显少于高级研发人员(ST6-8) (38.4% vs 17.8%;p = 0.004)。大多数注册会计师(62%)对行政负担表示不满。电子病历用户在管理任务上花费的时间明显多于纸质病历用户(44.1% vs 37.3%;p = 0.02)。结论:该研究揭示了临床和行政任务之间的显著不平衡,过多的行政工作量导致了RD的不满。简化行政职责和集成数字解决方案对于提高NHS的工作满意度、临床开发和医疗保健服务至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.90
自引率
5.30%
发文量
263
审稿时长
4-8 weeks
期刊介绍: QJM, a renowned and reputable general medical journal, has been a prominent source of knowledge in the field of internal medicine. With a steadfast commitment to advancing medical science and practice, it features a selection of rigorously reviewed articles. Released on a monthly basis, QJM encompasses a wide range of article types. These include original papers that contribute innovative research, editorials that offer expert opinions, and reviews that provide comprehensive analyses of specific topics. The journal also presents commentary papers aimed at initiating discussions on controversial subjects and allocates a dedicated section for reader correspondence. In summary, QJM's reputable standing stems from its enduring presence in the medical community, consistent publication schedule, and diverse range of content designed to inform and engage readers.
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