AMU patient list generation: from junior scribe to junior doctor

Area of Science:

• Healthcare Management
• Medical Informatics
• Quality Improvement in Medicine

Background:

• The acute medical unit (AMU) patient list is crucial for morning ward rounds, categorizing patients for clerking, post-take (PTWR), and post-post-take (PPTWR) reviews.
• Manual generation of this daily list by junior doctors is time-consuming, especially given high patient turnover and weekend requirements for 'outlier' patients.
• Existing administrative burdens impact physician well-being and potentially patient care efficiency.

Purpose of the Study:

• To assess the impact of automating patient list generation on the AMU.
• To measure the effect of automation on time spent generating lists and the number of patients clerked.
• To evaluate changes in junior doctors' attitudes towards list generation.

Main Methods:

• A quality improvement project (QIP) utilizing a pilot study and three 'plan-do-study-act' (PDSA) cycles.
• Intervention involved implementing an automated patient list generator.
• Measures included time for list generation (process), patients clerked per night (outcome), and doctors' attitudes (balancing).

Main Results:

• Automation significantly reduced list generation time by 44.3 min (66.3%) on weekdays and 37.8 min (42%) on weekends.
• Significant reductions in negative doctor attitudes were observed: 63.5% decrease on weekdays (p<0.00001) and 50.5% on weekends (p=0.0007).
• Pre-intervention 'time-consuming' attitude shifted to 'easy to make' post-intervention; some doctors reported clerking additional patients.

Conclusions:

• Automating labor-intensive administrative tasks like patient list generation yields substantial time savings.
• This automation improves doctor attitudes and well-being, contributing to better quality patient care.
• The QIP demonstrates a successful model for enhancing efficiency and job satisfaction in acute medical settings.