Study: Hospitalists Say Heavy Workloads Are Hurting Patient Care
Nearly two in five hospitalists say they struggle with unsafe patient workloads at least once a week, according to a new study published in JAMA Internal Medicine, Kaiser Health News' "Capsules" reports.
For the study, researchers from Johns Hopkins University analyzed survey responses from 506 hospitalists. The survey asked the hospitalists -- specialists that coordinate a patient's care and medications among specialists during hospital stays -- about various hospital issues, including the impact of heavy workloads on patient care (Tran, Kaiser Health News, "Capsules," 1/28).
Altogether, 40% of hospitalists said their typical inpatient workload exceeded safe levels at least once per month, while 36% of hospitalists said it exceeded safe levels at least once per week.
The survey responses also show that, because of excessive workloads:
- More than 25% of respondents said that they were unable to fully answer patient questions or discuss treatment options;
- 22% said they delayed admitting or discharging a patient until a subsequent shift;
- 22% said they ordered potentially unnecessary tests, procedures, or consultations;
- 18% said that their patient hand-offs were negatively affected;
- 12% said that their overall quality of care was negatively affected; and
- 10% said that they failed to note or act on critical laboratory results.
Furthermore, 14% of hospitalists reported that their heavy workload increased readmission rates, and 19% said it reduced patient satisfaction (Petrochko, MedPage Today, 1/28).
Based on the findings, researchers urged hospitals to routinely assess their physicians' workloads and establish safety benchmarks for the number of patient encounters per shift, according to Modern Healthcare.
"As perceived by physicians, workload issues have the significant potential to do harm and decrease quality," lead study author Henry Michtalik said in a news release, adding, "It is the elephant in the room that cannot be ignored. We have to find that balance between safety, quality and efficiency" (McKinney, Modern Healthcare, 1/28).
According to Healthcare Optimization CEO Eugene Litvak, who was not involved in the study, the findings may be "common sense, but it's important to have data to support it."
He told Kaiser Health News' "Capsules" that excessive workloads are "the result of our mismanaged patient flow." He suggested that "[s]moothing [peaks in patient volumes] is the only alternative to reducing physician workloads short of hiring more physicians" (Kaiser Health News, "Capsules," 1/28).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.