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To the Editor: Traditionally, the daily inpatient census has been used to determine medical house staff workload. However, recent fundamental changes in the practice of medicine have resulted in substantially shorter lengths of stay (LOS), more technologic interventions, and a preference for outpatient treatment whenever possible.^1-2 These changes have resulted in a concentration of activities during a given hospitalization and more coordination between inpatient and outpatient activities.

The impact of these changes on house staff workload is concealed by a system that examines only daily census to assess workload without acknowledging underlying dynamics. We suggest a novel means of estimating house staff workload that accounts for the impact of time spent on admissions and discharges as well as daily patient care.

Methods

Data were derived from the in-house census and admission/discharge/transfer data tables at the Memorial Sloan-Kettering Cancer Center (MSKCC) from January 1, 1998, through December 31, 2000. All patients admitted . . . [Full Text of this Article]

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ABSTRACT