Date of Award

10-12-2009

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

John Moriarty

Abstract

HOW INTERNS SPEND THEIR TIME: A TIME-MOTION STUDY AT YALE NEW HAVEN HOSPITAL. Oliver Rothschild (Sponsored by John Moriarty). Department of Internal Medicine, Yale University School of Medicine, New Haven, CT. The goal of this research is to evaluate the effects of placing a clerical assistant on an inpatient internal medicine housestaff team and to identify segments of intern work that are perceived by interns as of particularly high or low value for patient care and education. Data was collected through a time-motion study, following six interns over six days, recording their activities, with whom they spent their time, and how valuable they found each activity to their patients and to their own educations. Compared to interns on teams without a clerical assistant, interns on teams with a clerical assistant spent more time in educational activities (27.5% of their time vs. 19.1% of their time) and less time on the phone (7.2% of their time vs. 14.9% of their time). In addition, direct patient care was consistently rated as high value for patients (4.81 + 0.12 out of 5) and educational activities were rated as high value for education (3.83 + 0.60 out of 5). However, much more time was spent by interns on indirect patient care (251.67 + 48.75 minutes) compared with either educational activities (163.33 + 57.85 minutes) or patient care (50 + 21.91 minutes). In conclusion, our study found that interns spend a large proportion of their time in activities that are not directly related to patient care or education and that clerical assistants can assume some of the non-clinical activities interns currently assume. Assumption of these duties by a clerical assistant however, does not necessarily increase direct patient care and education of interns implying that other barriers need to be identified and addressed.

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