Hours, volume, and type of work of preregistration house officers

Abstract

Objective: To determine the hours, volume, and type of work undertaken by preregistration house officers.

Design: Continuous observation of 472 hours of work performed by 12 preregistration house officers based in medical wards, using standard procedures for studying work patterns.

Setting: A teaching hospital with 340 beds assigned to general medicine and coronary care.

Subjects: 12 Of the 16 preregistration house officers in medicine at the hospital.

Main outcome measures: The hours, volume, and type of work undertaken by preregistration house officers in February 1989, as recorded by trained observers on a one to one basis.

Results: The hours of duty ranged from 83 to 101 hours each week, the longest period of continuous duty being 58 hours. Each shift, house officers spent up to 25 minutes travelling between wards and an average of 85 minutes treating patients in wards that were cross covered. Between 50% and 71% of house officers' time was spent on patient oriented duties during the day; this fell to between 21% and 53% at night. Each doctor spent an average of 40 minutes filing when off duty after 6 pm.

Conclusions: Established procedures for studying workload were effective in monitoring doctors' hours, providing accurate information on the volume and type of work, which is essential to resolve the problems of medical staffing. The study showed that more house officers were needed and that the cross cover system should be stopped. As a result three extra preregistration house officers were appointed.