Care Left Undone Among Physicians: An Explorative Thematic Analysis

Area of Science:

• Medical practice and healthcare delivery
• Physician well-being and patient safety
• Qualitative research methodologies

Background:

• Limited research exists on physicians' experiences with care left undone, contrasting with extensive studies on nurses.
• Understanding physicians' perspectives is crucial for improving healthcare quality and patient safety.

Purpose of the Study:

• To explore physicians' conceptualization, experience, and management of care left undone.
• To identify factors contributing to and consequences of care left undone in a hospital setting.

Main Methods:

• Qualitative study involving semi-structured interviews with 12 physicians.
• Thematic analysis guided by existing literature on missed care, allowing for emergent insights.

Main Results:

• Physicians recognized 'care left undone' as routine, driven by time scarcity and competing demands.
• Omissions often involved administrative tasks, psychosocial support, and communication, deprioritized over diagnostic/therapeutic actions.
• Consequences included compromised patient safety, disrupted care continuity, moral distress, and burnout, with proposed solutions at organizational, interpersonal, and patient levels.

Conclusions:

• Care left undone is a significant, understudied issue for physicians in acute care.
• Interventions must be profession-sensitive, considering physicians' roles, autonomy, and identity.
• Quality improvement initiatives necessitate physician involvement in co-designing contextually relevant solutions.