Objective measures of workload in healthcare: a narrative review.

IF 1 Q4 HEALTH POLICY & SERVICES INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE Pub Date : 2019-12-20 DOI:10.1108/IJHCQA-12-2018-0288

Daniela Fishbein, Siddhartha Nambiar, Kendall McKenzie, Maria Mayorga, Kristen Miller, Kevin Tran, Laura Schubel, Joseph Agor, Tracy Kim, Muge Capan

{"title":"Objective measures of workload in healthcare: a narrative review.","authors":"Daniela Fishbein, Siddhartha Nambiar, Kendall McKenzie, Maria Mayorga, Kristen Miller, Kevin Tran, Laura Schubel, Joseph Agor, Tracy Kim, Muge Capan","doi":"10.1108/IJHCQA-12-2018-0288","DOIUrl":null,"url":null,"abstract":"Purpose: Workload is a critical concept in the evaluation of performance and quality in healthcare systems, but its definition relies on the perspective (e.g. individual clinician-level vs unit-level workload) and type of available metrics (e.g. objective vs subjective measures). The purpose of this paper is to provide an overview of objective measures of workload associated with direct care delivery in tertiary healthcare settings, with a focus on measures that can be obtained from electronic records to inform operationalization of workload measurement.Design/methodology/approach: Relevant papers published between January 2008 and July 2018 were identified through a search in Pubmed and Compendex databases using the Sample, Phenomenon of Interest, Design, Evaluation, Research Type framework. Identified measures were classified into four levels of workload: task, patient, clinician and unit.Findings: Of 30 papers reviewed, 9 used task-level metrics, 14 used patient-level metrics, 7 used clinician-level metrics and 20 used unit-level metrics. Key objective measures of workload include: patient turnover (n=9), volume of patients (n=6), acuity (n=6), nurse-to-patient ratios (n=5) and direct care time (n=5). Several methods for operationalization of these metrics into measurement tools were identified.Originality/value: This review highlights the key objective workload measures available in electronic records that can be utilized to develop an operational approach for quantifying workload. Insights gained from this review can inform the design of processes to track workload and mitigate the effects of increased workload on patient outcomes and clinician performance.","PeriodicalId":47455,"journal":{"name":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHCQA-12-2018-0288","citationCount":"14","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1108/IJHCQA-12-2018-0288","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}

引用次数: 14

Abstract

Purpose: Workload is a critical concept in the evaluation of performance and quality in healthcare systems, but its definition relies on the perspective (e.g. individual clinician-level vs unit-level workload) and type of available metrics (e.g. objective vs subjective measures). The purpose of this paper is to provide an overview of objective measures of workload associated with direct care delivery in tertiary healthcare settings, with a focus on measures that can be obtained from electronic records to inform operationalization of workload measurement.

Design/methodology/approach: Relevant papers published between January 2008 and July 2018 were identified through a search in Pubmed and Compendex databases using the Sample, Phenomenon of Interest, Design, Evaluation, Research Type framework. Identified measures were classified into four levels of workload: task, patient, clinician and unit.

Findings: Of 30 papers reviewed, 9 used task-level metrics, 14 used patient-level metrics, 7 used clinician-level metrics and 20 used unit-level metrics. Key objective measures of workload include: patient turnover (n=9), volume of patients (n=6), acuity (n=6), nurse-to-patient ratios (n=5) and direct care time (n=5). Several methods for operationalization of these metrics into measurement tools were identified.

Originality/value: This review highlights the key objective workload measures available in electronic records that can be utilized to develop an operational approach for quantifying workload. Insights gained from this review can inform the design of processes to track workload and mitigate the effects of increased workload on patient outcomes and clinician performance.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

医疗工作量的客观测量:一个叙述性的回顾。

目的:工作量是评估医疗保健系统绩效和质量的一个关键概念，但其定义依赖于角度(例如，个体临床医生级别vs单位级别的工作量)和可用度量类型(例如，客观vs主观度量)。本文的目的是概述三级医疗机构中与直接护理提供相关的工作量的客观测量，重点是可以从电子记录中获得的测量，以便为工作量测量的操作提供信息。设计/方法/方法:通过使用样本、感兴趣现象、设计、评估、研究类型框架在Pubmed和Compendex数据库中检索2008年1月至2018年7月期间发表的相关论文。确定的措施被分为四个级别的工作量:任务，病人，临床医生和单位。研究结果:在回顾的30篇论文中，9篇使用任务级指标，14篇使用患者级指标，7篇使用临床级指标，20篇使用单位级指标。工作量的主要客观测量指标包括:患者流动率(n=9)、患者数量(n=6)、视力(n=6)、护士与患者比例(n=5)和直接护理时间(n=5)。确定了将这些度量标准操作化为度量工具的几种方法。原创性/价值:本审查强调了电子记录中可用的关键客观工作量度量，可用于开发量化工作量的操作方法。从本综述中获得的见解可以为跟踪工作量的流程设计提供信息，并减轻工作量增加对患者预后和临床医生表现的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE HEALTH POLICY & SERVICES-

CiteScore

4.00

自引率

6.70%

发文量

期刊介绍： ■Successful quality/continuous improvement projects ■The use of quality tools and models in leadership management development such as the EFQM Excellence Model, Balanced Scorecard, Quality Standards, Managed Care ■Issues relating to process control such as Six Sigma, Leadership, Managing Change and Process Mapping ■Improving patient care through quality related programmes and/or research Articles that use quantitative and qualitative methods are encouraged.