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Published on: April 23, 2014
[Nonpatient-related tasks in psychiatric hospitals : Results of a multicentre survey with real-time validation]
Johannes Gabriel1, Georg Juckel2
1Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum Bochum, Ruhr-Universität Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Deutschland.
Background:
Hospital staff have complained for years that documentation and administrative duties consume a large share of working time. Profession-wide data on clinical psychiatry are scarce.
Objective:
To quantify time spent on patient-distant tasks in psychiatric hospitals by category and profession, and to cross-check self-reports against a prospective real-time measurement.
Materials And Methods:
Multicentre cross-sectional study at four psychiatric hospitals of the LWL Psychiatry Network Westphalia (three adult psychiatry, one child and adolescent psychiatry). An anonymous questionnaire assessed 27 patient-distant tasks in six categories (n = 287 from five professional groups). An additional prospective day-by-day observation tracked n = 34 employees over 76 working days.
Results:
Both methods concurred at the aggregate level at about 61% of working time (~24 h/week, part-time-adjusted) spent on patient-distant tasks. Part-time employees were disproportionately burdened. Largest categories: internal exchange and coordination (27%), internal documentation (24%) and organization of treatment (20%); the most time-consuming single activity was patient-related team meetings (4.2 h/week). Real-time measurement yielded only 10.5% for documentation; informal short conversations emerged as an underestimated time factor.
Conclusion:
Patient-distant tasks account for the majority of working time in psychiatric staff. Contrary to public debate, documentation is not the dominant burden; meetings and coordination weigh more heavily. Alongside political deregulation, hospitals should use internal organisational levers.