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General and visceral surgery practice in German hospitals: a real-time work analysis on surgeons’ work flow

  • Training and Education in Surgery
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Background

Surgeons have criticized the working conditions at German hospitals. They complain in particular about long working hours, an inadequate salary for their work, insufficient training/supervision, and an increasing amount of time spent on administration duties. Since these critics are only subjective perceptions, they should be compared to data that can be quantified more objectively and accurately. In this study, we sought to report precise data on surgeons’ workflow in several German hospitals.

Method

General surgeons were shadowed unobtrusively over 567 h during their shifts at four urban German hospitals. All job tasks surgeons performed were recorded using a tablet PC.

Results

The average work day of the surgeons in this study was 9 h 26 min (95% CI 09:10:30 to 09:42:44 h). Within this time span, an average of 02:03:08 h were spent on documentation and administration duties (95% CI 01:47:29 to 02:18:47 h), 01:47:40 h on operating procedures (95% CI 01:20:44 to 02:14:35 h), 01:43:46 h on internal communication (95% CI 01:32:55 to 01:54:36 h), and 0:48:25 h on ward rounds (95% CI 0:39:55 to 0:56:55 h).

Conclusion

For the first time, surgeons’ workflow in German hospitals was studied in real time. The study results substantiate physicians’ statements about their own working conditions, especially with concerns to large amount of time spent on administration tasks. The findings of this study form a basis upon which further analysis can be built and recommendations for improvements in physicians’ workflows at German hospitals can be made.

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Acknowledgements

We thank Lindy Musial-Bright for language editing. We also thank all the physicians for their participation.

This study was supported by the German Society of Surgery and the Institution for Statutory Accident Insurance in the Health and Welfare Services.

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Authors and Affiliations

  1. Institute of Occupational Medicine, Charité, Universitätsmedizin Berlin, Free University and Humboldt University, Thielallee 69-73, 14195, Berlin, Germany

    Stefanie Mache, Ramona Kelm & David A. Groneberg

  2. Department of Respiratory Medicine, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany

    Stefanie Mache

  3. Department of Medicine/Psychosomatics, Charité, Universitätsmedizin Berlin, Free University and Humboldt University, Luisenstrasse 13a, 10117, Berlin, Germany

    Stefanie Mache & Burghard F. Klapp

  4. German Society of Surgery, Luisenstrasse 58/59, 10117, Berlin, Germany

    Hartwig Bauer

  5. Institution for Statutory Accident Insurance in the Health and Welfare Services, Pappelallee 35/37, 22089, Hamburg, Germany

    Albert Nienhaus

Authors
  1. Stefanie Mache
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  2. Ramona Kelm
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  3. Hartwig Bauer
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  4. Albert Nienhaus
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  5. Burghard F. Klapp
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  6. David A. Groneberg
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Corresponding author

Correspondence to Stefanie Mache.

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Mache, S., Kelm, R., Bauer, H. et al. General and visceral surgery practice in German hospitals: a real-time work analysis on surgeons’ work flow. Langenbecks Arch Surg 395, 81–87 (2010). https://doi.org/10.1007/s00423-009-0541-5

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  • DOI: https://doi.org/10.1007/s00423-009-0541-5

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