Evidence map›Paper›PMID 34507910›Full record

ArticleJournal of surgical education

Estimation of Surgical Resident Duty Hours and Workload in Real Time Using Electronic Health Record Data.

Joseph A Lin, Logan Pierce, Sara G Murray, Hossein Soleimani, Elizabeth C Wick, Julie Ann Sosa, Kenzo Hirose

Abstract read
In one paragraph

Article in Journal of surgical education. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Joseph A LinDepartment of Surgery, University of California San Francisco, San Francisco, California. Electronic address: joseph.lin@ucsf.edu.
Logan PierceDepartment of Medicine, University of California San Francisco, San Francisco, California.
Sara G MurrayDepartment of Medicine, University of California San Francisco, San Francisco, California; Health Informatics, University of California San Francisco, San Francisco, California.
Hossein SoleimaniHealth Informatics, University of California San Francisco, San Francisco, California.
Elizabeth C WickDepartment of Surgery, University of California San Francisco, San Francisco, California.
Julie Ann SosaDepartment of Surgery, University of California San Francisco, San Francisco, California; Department of Medicine, University of California San Francisco, San Francisco, California.
Kenzo HiroseDepartment of Surgery, University of California San Francisco, San Francisco, California.

Funding

Surgical Oncology Training GrantT32CA251070 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI ESSERMAN, LAURA J · 2020 to 2024
$1.5M
AHRQ HHS R01 HS024532NCI NIH HHS T32 CA251070
6 · The paper itself

Abstract

objectiveTo explore the use of electronic health record (EHR) data to estimate surgery resident duty hours and monitor real time workload.

designRetrospective analysis of resident duty hours logged using a voluntary global positioning system (GPS)-based smartphone application compared to duty hour estimates by an EHR-based algorithm. The algorithm estimated duty hours using EHR activity data and operating room logs. A dashboard was developed through Plan-Do-Study-Act cycles for real-time monitoring of workload.

settingSingle tertiary/quaternary medical center general surgery residency program with approximately 90 categorical, preliminary, and integrated residents at eight clinical sites.

participantsCategorical, preliminary, and integrated surgery residents of all clinical years who volunteered to pilot a GPS application to track duty hours.

resultsOf 2,623 work periods by 59 residents were logged with both methods. EHR-estimated work periods started later than GPS logs (median 0.3 hours, interquartile range [IQR] -0.1 - 0.3); EHR-estimated work periods ended earlier than GPS logs (median 0.1 hours, IQR -0.7 - 0.3); and EHR-estimated duty hour totals were less than totals logged by GPS (median -0.3 hours, IQR -0.8 - +0.1). Overall correlation between weekly duty hours logged by EHR and GPS was 0.79. Correlations between the 2 systems stratified from PGY-1 through PGY-5 were 0.76, 0.64, 0.82, 0.87, and 0.83, respectively. The algorithm identified six 80-hour workweek violations (averaged over 4 weeks), while GPS logs identified 8. EHR-based duty hours and operational data were integrated into a dashboard to enable real time monitoring of resident workloads.

conclusionsEHR-based estimation of surgical resident duty hours has good correlation with GPS-based assessment of duty hours and identifies most workweek duty hour violations. This approach allows for dynamic workload monitoring and may be combined with operational data to anticipate and prevent duty hour violations, thereby optimizing learning.

Indexed as

General SurgeryInternship and ResidencyElectronic Health RecordsHumansPersonnel Staffing and SchedulingRetrospective StudiesWorkloadWork Schedule Toleranceduty hour violationselectronic health recordsResident duty hours

Identifiers

PMID34507910
PMCPMC9335013

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.