Identifying how GPs spend their time and the obstacles they face: a mixed-methods study.

Area of Science:

• Primary Care Research
• Health Systems Analysis
• Human Factors in Medicine

Background:

• Operational failures, problems impairing task completion, are a significant concern in primary care.
• Despite their importance, operational failures in general practice have been understudied.

Purpose of the Study:

• To quantify the time general practitioners (GPs) dedicate to various clinical activities.
• To identify the frequency and nature of operational failures encountered by GPs.
• To assess the impact of these failures on GPs and their work.

Main Methods:

• A mixed-method triangulation study involving 61 GPs across 28 general practices in England.
• Employed time-motion methods, ethnographic observations, and qualitative interviews.
• Data collected between December 2018 and December 2019.

Main Results:

• Time-motion data indicated operational failures accounted for approximately 5.0% of GP tasks and 3.9% of clinical time.
• Qualitative findings revealed that time-motion methods underestimated operational failures, which included system, technology, and coordination issues.
• Operational failures had significant negative impacts on GPs' work experiences.

Conclusions:

• GPs frequently encounter operational failures that disrupt patient care and negatively affect their work experience.
• A deeper understanding of operational failures is essential for identifying improvement targets.
• Coordinated actions are needed to support GPs and mitigate the burden of operational failures.