American Society of Clinical Oncology 2001 Presidential Initiative: Impact of Regulatory Burdens on Quality Cancer Care

Einhorn, Lawrence H.; Levinson, Jenifer; Li, Susan; Lamar, L. Q. C.; Kamin, Deborah Y.; Mendelson, Dan

doi:10.1200/jco.2002.02.011

Cited by 8 publications

(8 citation statements)

References 8 publications

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“…Work demands, in the form of increased documentation (e.g. associated with Medicare requirements) were found by Einhorn et al (2002) to be a greater stress than the stress of dealing with ill or dying patients.…”

Section: Discussionmentioning

confidence: 99%

Job stress and job satisfaction of cancer care workers

et al. 2004

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Section: Discussionmentioning

confidence: 99%

Job stress and job satisfaction of cancer care workers

et al. 2004

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“…In comparison, previous studies have found rates of career satisfaction of 79–80% among medical and surgical oncologists (43,44), and 80% among primary care physicians (45). These results may be viewed as reassuring given the high levels of stress associated with cancer patient care, as well as administrative, reimbursement, and management duties and growing regulatory and administrative burdens imposed by private and public payers (46). It is possible that physicians specializing in breast cancer face somewhat lower levels of stress associated with end‐of‐life issues, given the better prognosis for breast cancer overall as compared with many other cancers.…”

Section: Discussionmentioning

confidence: 93%

The Structural Landscape of the Health Care System for Breast Cancer Care: Results from The Los Angeles Women’s Health Study

et al. 2009

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The structure of health care has been rapidly evolving in response to financial pressures and demands to improve quality. Little work has documented the structure of care and its impact in the context of breast cancer care. We conducted a survey to characterize Los Angeles physicians caring for breast cancer patients and the structural landscape of the healthcare system in which they practice. Crosssectional survey of physicians who treated a population-based cohort of breast cancer patients. We surveyed 477 physicians, targeting all Los Angeles County medical oncologists, radiation oncologists, and surgeons reported by patients participating in the Los Angeles Women's Health Study (77% response rate). Specialty-specific questionnaires were developed. Items were based on the structure and quality of care literature, cognitive interviews with cancer care specialists, and existing physician survey instruments. Breast cancer care providers in Los Angeles are diverse, with one-third non-white and 46% speaking a non-English language. Group practice is most common, (37% single specialty, 16% group-model HMO, 8% multi-specialty group). Minimal teaching involvement predominates. Mean new breast cancer patient volumes are relatively high (8 per month overall; six for surgeons), representing 46% of new cancer patients. Physicians reported high career satisfaction levels (83-92%). Physicians were least satisfied with the amount of time spent with patients (82%). Data from this study represent important building blocks for further analyses to determine the impact of structural characteristics on the quality of care that breast cancer patient's experience. Keywordsbreast cancer; quality of care; structure of care Address correspondence and reprint requests to:

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“…13 Other studies have reported that family practitioners spend 1.2 h per day documenting, 14 and oncologists spend 1.4 h per day documenting. 15 In 1997, internal medicine residents who were on call were reported to have spent 2.6 h on paper chart review and 2.2 h on paper documentation, with an additional half hour on the computer. 20 Our results contradict a study of medical resident's perceptions of time spent on documentation.…”

Section: Discussionmentioning

confidence: 99%

Use of Electronic Clinical Documentation: Time Spent and Team Interactions

2011

SciVee

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Objective To measure the time spent authoring and viewing documentation and to study patterns of usage in healthcare practice. Design Audit logs for an electronic health record were used to calculate rates, and social network analysis was applied to ascertain usage patterns. Subjects comprised all care providers at an urban academic medical center who authored or viewed electronic documentation. Measurement Rate and time of authoring and viewing clinical documentation, and associations among users were measured. Results Users spent 20e103 min per day authoring notes and 7e56 min per day viewing notes, with physicians spending less than 90 min per day total. About 16% of attendings' notes, 8% of residents' notes, and 38% of nurses' notes went unread by other users, and, overall, 16% of notes were never read by anyone. Viewing of notes dropped quickly with the age of the note, but notes were read at a low but measurable rate, even after 2 years. Most healthcare teams (77%) included a nurse, an attending, and a resident, and those three users' groups were the first to write notes during an admission. Limitations The limitations were restriction to a single academic medical center and use of log files without direct observation. Conclusions Care providers spend a significant amount of time viewing and authoring notes. Many notes are never read, and rates of usage vary significantly by author and viewer. While the rate of viewing a note drops quickly with its age, even after 2 years inpatient notes are still viewed.

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American Society of Clinical Oncology 2001 Presidential Initiative: Impact of Regulatory Burdens on Quality Cancer Care

Cited by 8 publications

References 8 publications

Job stress and job satisfaction of cancer care workers

Job stress and job satisfaction of cancer care workers

The Structural Landscape of the Health Care System for Breast Cancer Care: Results from The Los Angeles Women’s Health Study

Use of Electronic Clinical Documentation: Time Spent and Team Interactions

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