Observations of residents' work activities for 24 consecutive hours: implications for workflow redesign.

Purpose: To examine resident workflow as part of an institutional approach to redesigning the processes of health care delivery.

Method: In 2003 the authors observed the workflows for 24 hours of seven residents who were at various levels of training (two each from the internal medicine, pediatrics, and obstetrics and gynecology programs, and one from general surgery) at Denver Health Medical Center, an urban, public teaching hospital.

Results: Although the residents spent varying proportions of their time in various activities, all had extremely fragmented workflows as they engaged in from 5.