응급의학과 인턴 의사의 업무 및 소요 시간 분석: 다기관 단면 연구

Abstract

Purpose: This study was conducted in order to describe howintern physicians in the emergency department (ED) spenttheir time, and the frequency of tasks performed by them. Methods: This was an observational, time-motion study for 15intern physicians in 15 emergency centers. Observers in eachhospital shadowed interns for a 60-minute period, two times,both day and night shift. They recorded time spent on variousactivities, type and number of activities. The proportion of activitythat can be replaced by other staff members was calculated. Results: Average number of duty hours of interns was 80.9hours (63~87.8) per week. A total of 662 activities wereobserved during 30 hours. Interns’ activities were classifiedas direct patient care 28.2%, personal time 24.2%, documentation17.0%, procedures 16.7%, communication 8.1%,transportation 2.6%, indirect patient care 2.0%, learningactivity 0.8%, and administrative work 0.4%. The proportionof procedural task showed negative correlation with thenumber of emergency medical technicians (r=-0.710,p=0.003). The proportion of activity that can be replaced bystaff members other than doctors was 24.3% (0~47%) oftime, except personal or learning activity. Conclusion: Results of this study showed that only 24.3%of interns’ activity in the emergency department could bereplaced by staff members other than doctors. Because theproportion of activities that could be replaced was variableamong hospitals, each hospital should perform task analysisof interns’ activity in order to forecast alternative manpower.