A real-time locating system observes physician time-motion patterns during walk-rounds: a pilot study

Area of Science:

• Medical Education
• Clinical Workflow Optimization
• Health Informatics

Background:

• Bedside teaching is crucial for medical education but its proportion is declining.
• Complex patient care and workflow impediments contribute to reduced bedside teaching.
• Real-time locating systems (RTLS) show potential for improving workflow by monitoring patients and equipment.

Purpose of the Study:

• To utilize RTLS technology to observe and track attending physician movement patterns during medical teaching team patient care rounds.
• To analyze time-motion patterns during mandatory walk-rounds.

Main Methods:

• A pilot study used RTLS to track eight attending physicians during weekly team rounding sessions.
• Collected data was visualized as motion paths on a floor plan.
• Two researchers analyzed time-motion data, describing rounding events by time spent inside or outside patient rooms.

Main Results:

• Patient care rounds varied significantly in duration (60-425 minutes).
• Physicians spent a median of approximately 33% of total time within patient rooms (range 20-50%).
• Three distinct time-motion patterns emerged: hallway-focused, conference room-focused, and a balanced pattern.

Conclusions:

• RTLS technology identified varied physician rounding styles based on time-motion patterns.
• Further research can explore how time allocation during walk-rounds affects patient and learner satisfaction, and physician workflow.