title: Analysis and evaluation of geriatricians' working routines in German hospitals.
abstract: BACKGROUND
  Geriatricians are physicians who work primarily with the elderly and deal with diseases that often accompany old age, such as Alzheimer's disease. In the last few years, data from questionnaires have demonstrated increasing criticism of geriatricians regarding their working conditions in geriatric medicine. Ideally, such rather subjective statements should be compared to data about work strain that is not merely accurate but also evaluated on an objective real-time basis. Therefore, the aim of the current study is to deliver exact data about geriatricians' work in different geriatric departments to evaluate their working routines and afterwards to optimize their working conditions.
  
  
  METHODS
  An observational real-time study was conducted by shadowing 15 physicians in geriatric medicine individually during weekday shifts at four hospitals in urban German settings. A total of 368 h of observations were recorded by using an ultra-mobile computer.
  
  
  RESULTS
  The average workday lasted 9 h 36 min 14 s (95% CI = 9.07:35-10.01:23 h) with a high amount of elderly patients to deal with (M = 18) every day. Overall, they spent 14.75% of each workday on indirect patient care, 7.29% on direct patient care and 13.19% on administrative work. Communication took up 4.68% of geriatricians' time, breaks and disruptions 7.5%.
  
  
  CONCLUSIONS
  To our knowledge, this is the first real-time analysis on how geriatricians deal with their working demands and how working routines are organized in geriatric hospital departments. Geriatricians' subjective statements on their working conditions have been partially confirmed. Improving geriatricians work flow could increase work efficiency, job satisfaction and quality of care.
authors: Institute of Occupational Medicine, Charité- Universitätsmedizin Berlin, Free University and Humboldt University, Berlin, Germany. stefanie.mache@charite.de
authors: Stefanie
authors: S
authors: Mache
authors: Bianca
authors: B
authors: Kusma
authors: Karin
authors: K
authors: Vitzthum
authors: Albert
authors: A
authors: Nienhaus
authors: Burghard F
authors: BF
authors: Klapp
authors: David A
authors: DA
authors: Groneberg