244 - Implementation of A Resident Task Coordinator Program to Define, Explore, and Expand the Resident Task Coordinator Role in the Pediatric Inpatient Setting (RECAP)

Publication Number: 244.5422

Lisbel Guzman, The Children's Hospital at Montefiore, Bronx, NY, United States; Michael D.. Cabana, Children's Hospital at Montefiore/Albert Einstein College of Medicine, New York, NY, United States; Brenda Anosike, Albert Einstein College of Medicine, Bronx, NY, United States

Background: Residents balance non-clinical duties with clinical responsibilities, which may sometimes result in reduced direct patient care and lower job satisfaction. To alleviate this burden, some residency programs have introduced Resident Task Coordinators (RTCs) to assist with non-clinical tasks. There is limited understanding of specific tasks assigned to and completed by RTCs as well as their time allocation.

Objective: We conducted a single-center observational study from March to October 2024 to examine the tasks completed by RTCs in the pediatric inpatient setting from 10 am to 3 pm, seeking to identify task variability and need.

Design/Methods: Each day, a research assistant would observe the RTC and document the RTC task assignments in 5-minute increments for a random one-hour interval. We cataloged each task and used descriptive statistics to characterize the frequency of RTC tasks. We used heat maps to illustrate a task frequency index (TFI), which reflects the task frequency, by the specific shift hour (compared to all shift hours). A TFI of 1.0 indicates an even balance, while values < 1.0 (in blue) indicate decreased frequency and >1.0 (in red) represent increased frequency from the mean. Darker shades indicate greater difference from mean time spent on the task.

Results: During the seven-month study, we identified 21 types of non-clinical tasks completed by RTCs. The most time-intensive tasks were filling out medical forms (16.8%), contacting the radiology service (11.0%), and calling third-party payors for prior authorizations (9.6%). Task demand varied by day and hour, with requests for interpreters and nurses peaking from 10 am to 11 am, while patient information requests were highest from 11 am to 12 noon. The TFI for arranging for interpreter support or locating a patient's nurse was exceptionally high at 7.5, indicating a significantly greater demand for these services than anticipated in the morning hours.

Conclusion(s): Our findings emphasize the need for targeted support in high-demand tasks to enhance efficiency at key times of the workday. This is the first study systematically documents the different tasks completed by RTCs for pediatric residents. Understanding task distribution can inform staffing decisions, as well as potentially improve patient care and resident work satisfaction.

Table 1: RTC Task List
Complete list of the various RTC tasks and the coding system used to classify the tasks.

Figure 1: Percentage of time dedicated to each RTC task
The time dedicated to each RTC task was divided by the total time dedicated to all RTC tasks and multiplied by 100% to calculate the percentage of total time spent on each specific task.

Figure 2: RTC tasks across shift hours
The heatmap displays the TFI for RTC tasks across shift hours, highlighting variations in task completion based on different times of day. Shift Hour 1 is 10AM-11AM, Shift Hour 2 is 11AM-12PM, Shift Hour 3 is 12PM-1PM, Shift Hour 4 is 1PM-2PM, and Shift Hour 5 is 2PM-3PM.