There is a need to reduce the amount of time medical residents spend on administrative duties from 40% of their workday to less than 10% in order to decrease rates of burnout, medical error, and improve patient care. Existing solutions have not adequately addressed this problem. The average workweek for residents is 68 hours compared to 40 for most other professions, and administrative tasks are a leading cause of work-related stress and burnout for residents. This can negatively impact patient safety and outcomes, as burnout and long work hours are associated with increased medical errors. Finding a solution that reduces administrative burdens on residents could decrease error rates, improve work-life balance and quality of care.

1. Is Patient Health More Important Than Resident Health?
Aakash Saraiya, OMS-II, Dr. Anilchandra Attaluri, PhD, Dr. Jennifer Kadlowec, PhD, Dr. Jane Ryan, PhD, Dr.
Robert Hirsh, MD, Dr. Tom Merrill, PhD and Mr. Sameer Sood OMS-IV
College of Engineering – Rowan University, Rowan University School of Osteopathic Medicine, Cooper
Medical School at Rowan University
Rowan Bioengineering Scholars Program
The Need
There is a need to optimize the amount of time
spent on administrative duties carried out by
residents from 40% of their work day to less than
10% to decrease rates of burnout and medical
error.
The Problem
Existing Solutions and Market
Administrative overload:
- 40% of residents time is spent doing clinical
computer work1
- 87% of residents reported that the leading
cause of work-related stress and burnout was
paperwork and administrative concerns
- 73% of 1515 trainees indicated that overall
patient care was negatively affected by clinical
documentation requirements2
- 88% of residents feel that they could provide
better quality care if clinical documentation
were reduced
Burnout Prevalence:
- Of study of 1104 residents, 76% of residents
met criteria for burnout3.
- Overall, burnout is associated with a variety of
negative consequences including depression,
risk of medical errors, and negative effects on
patient safety.
- The three biggest causes of burnout are
bureaucratic tasks, spending too many hours
at work and inability to provide patients with
the quality care they need.
- The average workweek of a resident is 68
hours compared to the 40 of most professions4
Medical Error Causes:
- Medical errors are 35.9% more during a
schedule with shifts of 24 or more consecutive
hours
- Sleep deprivation of about 20 hours produce
impairments equivalent to legal levels of
alcohol intoxication
Suicide Rate:
- The resident suicide rate is 3 times greater
than the suicide rate of the general populace.
Needs Criteria
References
Residents:
- Total 123,000 medical and surgical residents in
the United States5
- Average residency cost per resident: $55,000
per year
Medical Errors:
- The cost of total medical errors is $37.6 billion
dollars annually6
- 39% of the preventable medical errors are
through post operative procedures.
- The total cost of preventable medical errors
equals to about $17.1 billion dollars per year
- The average cost per medical error is $13,000
- The number of deaths that occur because of a
medical mistake: 440,000 deaths per year.
- The medical system is charged over $980
billion dollars for quality-adjusted life of the
deaths7
- Over 1.5 million medical injuries per year that
can be avoided8
- Absolute
- Must allow for medical residents to have a
better balance of work and social life
- Must decrease the rate of burnout/suicide in
medical residents
- Must decrease the rate of resident errors in a
clinical care setting
- Optional
- If it does not put extra work load on other
providers
Figure 3: Healthcare Referendum Stakeholder
Analysis
Stakeholder Analysis
Figure 1: Graph depicts the efficiency of Global
Healthcare systems
Potential Solutions
Figures 4 & 5: Current vs. Proposed Resident
Average Workday Distribution
1. Tarrant, C., et al. (2004). "Models of the medical consultation: opportunities
and limitations of a game theory perspective." Quality & safety in health care
13(6): 461-466.
2. IsHak, W. W., et al. (2009). "Burnout During Residency Training: A Literature
Review." Journal of Graduate Medical Education 1(2): 236-242.
3. Olds, D. M. and S. P. Clarke (2010). "The Effect of Work Hours on Adverse
Events and Errors in Health Care." Journal of safety research 41(2): 153-162.
4. Christino, M. A., et al. (2013). "Paperwork Versus Patient Care: A Nationwide
Survey of Residents' Perceptions of Clinical Documentation Requirements and
Patient Care." Journal of Graduate Medical Education 5(4): 600-604.
5. Landers, S. H. and A. R. Sehgal (2000). "HOw do physicians lobby their
members of congress?" Archives of Internal Medicine 160(21): 3248-3251.
6. Lockley , S. W., et al. (2004). "Effect of Reducing Interns' Weekly Work Hours on
Sleep and Attentional Failures." New England Journal of Medicine 351(18):
1829-1837.
7. Landrigan , C. P., et al. (2004). "Effect of Reducing Interns' Work Hours on
Serious Medical Errors in Intensive Care Units." New England Journal of
Medicine 351(18): 1838-1848.
8. Shanafelt, T. D., et al. (2012). "BUrnout and satisfaction with work-life balance
among us physicians relative to the general us population." Archives of Internal
Medicine 172(18): 1377-1385.
9.
Figure 2: Graph depicts average work hours by
residents compared to other professions
Patients:
- Lower error rate and decreased wait time
because of less admin. duties.
Government Representatives:
- Less lawsuits for medical error which means
more satisfied voters/populace.
Physicians:
- Would not want to change hours because it
gives them less labor power to reach all of the
patients.
Residents:
- Primary change candidate; better outcome,
very low influence
Insurance companies:
- Interested in optimization of hours lead to
lower cost of healthcare errors
Hospitals:
- Would decrease amount of labor depending on
solution