Assessing Task-Shifting Progress in Obstetrics and Gynecology: A Nationwide Survey of Japanese Obstetricians and Gynecologists

TL;DR

A nationwide survey in Japan found that task shifting in obstetrics and gynecology has limited progress, with potential to improve efficiency and reduce workload.

Contribution

The study provides a comprehensive assessment of task-shifting progress and its perceived impact on medical care quality and working hours in Japan.

Findings

Only tasks like moving patients and collecting blood samples are commonly delegated, indicating limited task-shifting progress.

Most doctors believe task shifting could improve care quality, while a small percentage fear it might decrease.

Longer working hours correlate with perceptions of limited task-shifting progress.

Abstract

Background/Objectives: This study identified tasks suitable for delegation and gathered insights on how task shifting might affect medical care quality and working hours. Methods: A questionnaire survey was conducted among obstetricians and gynecologists working in hospitals nationwide. A multivariate logistic regression analysis was conducted. Then, opinions were collected on the individual tasks that should be task-shifted and the impact that task-shifting promotion would have on medical care quality and working hours. Results: Valid responses were obtained from 1164 doctors (16.3% of the 7127 obstetricians and gynecologists) working in hospitals. An analysis of the characteristics of the 31.2% of doctors who thought that task shifting had hardly progressed at their workplace showed that the odds of working 60–80 h were significantly higher (1.72, 95% CI: 1.06–2.77, p = 0.03) than those working <40 h and 3.50 (95% CI: 1.19–10.25, p = 0.02) for those working ≥100 h. Most obstetricians said that the only items “transferred” were “moving patients (e.g., from the operating room to the ward)”, “collecting blood culture samples”, and “ensuring chemotherapy lines”, revealing that task shifting had not progressed. Regarding the impact on medical care quality, if obstetricians and gynecologists promoted task shifting, most doctors said that the quality of care would improve, while 13% said that it would decrease. Conclusions: This study provides a comprehensive assessment of task shifting among OBGYNs in Japan, revealing its limited progress despite physician work reform efforts. Findings indicate that expanding task shifting could improve efficiency without compromising medical care quality, reinforcing its potential as a strategy for reducing physician workload.

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