Use of a 90-Minute Admission Window and Front-Fill System to Reduce Work Compression on a General Medicine Inpatient Teaching Service

Abstract

Background Duty hour limits have shortened intern shifts without concurrent reductions in workload, creating work compression. Multiple admissions during shortened shifts can result in poor training experience and patient care.

Assessment of Inpatient Time Allocation Among First-Year Internal Medicine Residents Using Time-Motion Observations

“…3,5 Multitasking is important to understand because it may reflect residents trying to compress their clinical and educational demands into a finite number of hours. 17,18 Multitasking episodes may be challenging in learning environments because time spent engaged in multiple activities may be less efficient than focusing on each activity separately. 19 In addition, although prior studies have measured multitasking as the co-occurrence of any activity, 4 we measure and provide more targeted definitions of multitasking.…”

“…Second, we provide measures of multitasking, which few studies of training programs have included . Multitasking is important to understand because it may reflect residents trying to compress their clinical and educational demands into a finite number of hours . Multitasking episodes may be challenging in learning environments because time spent engaged in multiple activities may be less efficient than focusing on each activity separately .…”

Do Time Limits per Admission Allow for Sufficient Deliberate Practice?

“…hoi et al 1 shared an innovation model to pace admissions to internal medicine resident teams in order to streamline workload for residents. Given that a recent study found burnout is prevalent in many residency programs despite duty hour restrictions, 2 we applaud this program for implementing innovative strategies to improve its residents' learning and working environment.…”