Associations between attending physician workload, teaching effectiveness, and patient safety

Area of Science:

• Medical Education
• Patient Safety
• Healthcare Management

Background:

• Prior studies suggest a link between high physician workload and reduced teaching effectiveness and patient outcomes.
• These associations have not been rigorously examined using objective workload and safety measures.

Purpose of the Study:

• To investigate the relationship between attending physician workload, teaching effectiveness, and patient safety.
• To test the hypothesis that increased workload correlates with diminished teaching effectiveness and adverse patient outcomes.

Main Methods:

• Retrospective analysis of 69,386 resident evaluations of 107 attending physicians over six years.
• Workload assessed via hospital census, patient length of stay, admissions, discharges, and outpatient duties.
• Teaching effectiveness measured by resident evaluations; patient safety by indicators (PSIs), ICU transfers, RRT calls, and deaths.

Main Results:

• Higher workload (midnight census, daily discharges) correlated with lower teaching evaluation scores.
• Increased daily admissions were associated with higher teaching scores but also with increased patient safety indicators (PSIs).
• The study identified specific workload metrics impacting teaching and patient safety.

Conclusions:

• Attending physician workload measures show a slight association with reduced teaching effectiveness.
• Patient safety may be compromised during periods of high patient admissions.
• Residency programs should implement strategies to optimize attending physician workload for a better learning environment and patient care.