Quantification of the amount of time spent in various patient care activities among doctors in peadiatric wards of hospitals in Nairobi County

Abstract

Background: This paper presents work sampling study among doctors in selected hospitals of Nairobi County in Kenya. Among the activities doctors perform in their work some contribute directly to patient care, some indirectly and others not at all. With changing landscape in doctor patient relationship more attention is being paid to documentation, patient education and consultation with colleagues. Most work sampling studies among health workers in hospitals have been done on nurses with few studies done among on doctors.

Objective: The study sought to determine the difference in the proportion of time required to carry out activities by doctors that contribute directly, indirectly or not at all to patient care in paediatric wards of the hospitals under study.

Design: Work sampling study

Setting: Paediatric Wards of four hospitals in Nairobi County, Kenya namely Kenyatta National Hospital (KNH), Aga Khan University Hospital, Nairobi (AKUH, N), St. Mary’s Mission Hospital (SMMH) and Mbagathi District Hospital (MDH).

Materials and Methods: Key informant interviews were used to establish the different types of activities that physicians carry out in their daily routine. The results of the interviews helped design the work sampling study which was carried out using an Observation Schedule & Work Sampling Data Collection application tool. The data collected was analyzed using Statistical Package for Social Sciences (SPSS) version 22.

Results: A total of 6188 observations were made out of which 79.0 % (4,890) were for direct patient care activities, 12.5 % (771) were for indirect patient care activities and 8.5% (527) were allowance activities. Documentation and Daily patient rounds consumed the highest proportion of total man hours (28.3% and 21.7% respectively). Significant correlation was found between direct patient care activities and ward occupancy (p= 0.001). No Significant correlation was found between indirect patient care activities and ward occupancy (p= 0.345).

Discussions: Direct patient care activities consume more time than other categories of patient care activities; Documentation of care given consumes the highest proportion of time among individual patient care tasks inexcess of even daily patient round.