Senior house officers' work activities in an accident and emergency department

A study of senior house officers' daytime work activities was conducted in the accident and emergency department of the Cardiff Royal Infirmary. Activities were timed every 15 seconds by a single observer and were subdivided into working periods, meal periods and periods when no patient was waiting to be seen. A total of 96.1 h was analysed. The SHOs were found to be working for 78% of their time, of which 18.5% was taken up by non-doctor tasks. The SHOs took an average of 10.4 min for each walking wounded patient, 10.6 min for each paediatric patient and 27.3 min for a trolley patient. Each patient required an average of 14.2 min for assessment and treatment, which meant that 3.3 patients were seen each hour. However, considering that SHOs worked for 78% of their time, the actual rate of work was 4.2 patients for each working hour. The implications for staffing are discussed.