How much time do emergency department physicians spend on medication-related tasks? A time- and-motion study

Area of Science:

• Emergency Medicine
• Health Services Research
• Patient Safety

Background:

• Medication-related problems are a significant cause of emergency department (ED) visits, with medication errors affecting up to 60% of patients.
• Medication reconciliation and review are crucial for preventing these issues but are time-intensive.
• In EDs without pharmacists, physicians bear the responsibility for medication reconciliation alongside patient care.

Purpose of the Study:

• To quantify the time emergency department (ED) physicians dedicate to medication-related tasks in the absence of on-site pharmacists.

Main Methods:

• An observational time-and-motion study utilized the Work Observation Method by Activity Timing (WOMBAT) tool.
• Data were collected over 386 hours across 225 observation sessions in three Northern Norwegian EDs.
• Observations occurred weekdays between 8 am and 8 pm from November 2020 to October 2021.

Main Results:

• Physicians allocated 8.7% of their work time to medication-related tasks.
• Oral communication with physicians (3.0%) and medication documentation (3.2%) consumed the most time.
• Medication reconciliation tasks, including information retrieval and documentation, accounted for 2.2 minutes per hour.

Conclusions:

• Physicians in Norwegian EDs spent 8.7% of their time on medication tasks and 85.6% on other duties.
• The limited time (2.2 min/hr) for medication reconciliation raises concerns about patient safety.
• Integrating pharmacists into ED workflows could alleviate physician burden and enhance patient care and safety.