BackgroundIf one party has more or better information than the other, an information asymmetry can be assumed. The aim of the study was to identify the origin of incomplete patient-related preoperative information, which led to disruptions and losses of time during pre-anaesthetic patient briefing. We hypothesized that lower employees’ educational level increases the amount of disruptive factors.MethodsA prospective observational study design was used. Patient selection was depending on the current patient flow in the area of the clinic for pre-anesthetic patient briefing. Data were collected over a period of 8 weeks. A stopwatch was used to record the time of disruptive factors. Various causes of time losses were grouped to facilitate statistical evaluation, which was performed by using the U-test of Mann and Whitney, Chi-square test or the Welch-t-test, as required.ResultsOut of 221 patients, 130 patient briefings (58.8%) had been disrupted. Residents were affected more often than consultants (66% vs. 47%, p = 0.008). Duration of disruptions was independent of the level of training and lasted about 2,5 minutes and 10% of the total time of patient briefing. Most time-consuming disruptive factors were missing study results, incomplete case histories, and limited patient compliance.ConclusionsDisruptions during pre-anesthetic patient briefings that were caused by patient-related information asymmetry are common and account for a significant loss of time. The resultant costs justify investments in appropriate personnel allocation.
Zusammenfassung Zielsetzung: Im Rahmen der an?sthesiologischen Patientenaufkl?rung ?bt der Arzt-Patientenkontakt einen nachhaltigen Einfluss auf die Ergebnisqualit?t aus. Dabei kann diese Leistung nennenswerte St?rungen durch fehlende medizinische Informationen erfahren. Das Ziel dieser Studie lag in der zeitlichen Erfassung aller St?rfaktoren, die w?hrend der an?sthesiologischen Patientenaufkl?rung auftraten. Methodik: Im Bereich einer Pr?medikationsambulanz wurden alle St?rungen zeitlich erfasst, dem ?rztlichen Ausbildungsstand (?rzte in der Weiterbildung [AiW] versus Fach?rzte [FA]) zugeordnet und verglichen. Ergebnisse: Von insgesamt 139 Patientengespr?chen erfuhren 77 Gespr?che (55,4?%) eine St?rung. Hierbei waren AiW doppelt so h?ufig betroffen wie FA (66,3 vs. 31,8?%, p?=?0,015). Die St?rungszeit betrug dabei unabh?ngig vom Ausbildungsgrad ca. 10?% der Pr?medikationszeit. W?hrend sich AiW w?hrend des Gespr?chs ?ber medizinische Aspekte informierten, waren FA zumeist von fehlenden Untersuchungsbefunden und einer eingeschr?nkten Patientencompliance betroffen. Unabh?ngig vom Ausbildungsstand erforderte die IT-Systemnutzung zwischen 15?% und 19?% der jeweiligen St?rungszeit. Schlussfolgerung: St?rungen sind h?ufig und generieren summiert einen nennenswerten Zeitaufwand. Konsentierte Verfahrensanordnungen und die strukturierte Einbindung der Patienten im Informationstransfer k?nnten eine bedeutende Zeitersparnis erm?glichen.
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