Dataset Information

Using the time and motion method to study clinical work processes and workflow: methodological inconsistencies and a call for standardized research.

ABSTRACT:

Objective

To identify ways for improving the consistency of design, conduct, and results reporting of time and motion (T&M) research in health informatics.

Materials and methods

We analyzed the commonalities and divergences of empirical studies published 1990-2010 that have applied the T&M approach to examine the impact of health IT implementation on clinical work processes and workflow. The analysis led to the development of a suggested 'checklist' intended to help future T&M research produce compatible and comparable results. We call this checklist STAMP (Suggested Time And Motion Procedures).

Results

STAMP outlines a minimum set of 29 data/ information elements organized into eight key areas, plus three supplemental elements contained in an 'Ancillary Data' area, that researchers may consider collecting and reporting in their future T&M endeavors.

Discussion

T&M is generally regarded as the most reliable approach for assessing the impact of health IT implementation on clinical work. However, there exist considerable inconsistencies in how previous T&M studies were conducted and/or how their results were reported, many of which do not seem necessary yet can have a significant impact on quality of research and generalisability of results. Therefore, we deem it is time to call for standards that can help improve the consistency of T&M research in health informatics. This study represents an initial attempt.

Conclusion

We developed a suggested checklist to improve the methodological and results reporting consistency of T&M research, so that meaningful insights can be derived from across-study synthesis and health informatics, as a field, will be able to accumulate knowledge from these studies.

SUBMITTER: Zheng K

PROVIDER: S-EPMC3168304 | biostudies-literature | 2011 Sep-Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Using the time and motion method to study clinical work processes and workflow: methodological inconsistencies and a call for standardized research.

Zheng Kai K Guo Michael H MH Hanauer David A DA

Journal of the American Medical Informatics Association : JAMIA 20110427 5

<h4>Objective</h4>To identify ways for improving the consistency of design, conduct, and results reporting of time and motion (T&M) research in health informatics.<h4>Materials and methods</h4>We analyzed the commonalities and divergences of empirical studies published 1990-2010 that have applied the T&M approach to examine the impact of health IT implementation on clinical work processes and workflow. The analysis led to the development of a suggested 'checklist' intended to help future T&M res ...[more]

PMID: 21527407

Similar Datasets

Project description:PurposeMotion management of tumors within the lung and abdomen is challenging because it requires balancing tissue sparing with accuracy of hitting the target, while considering treatment delivery efficiency. Physicists can play an important role in analyzing four-dimensional computed tomography (4DCT) data to recommend the optimal respiratory gating parameters for a patient. The goal of this work was to develop a standardized procedure for making recommendations regarding gating parameters and planning margins for lung and gastrointestinal stereotactic body radiotherapy (SBRT) treatments. In doing so, we hoped to simplify decision-making and analysis, and provide a tool for troubleshooting complex cases.MethodsFactors that impact gating decisions and planning target volume (PTV) margins were identified. The gating options included gating on exhale with approximately a 50% duty cycle (Gate3070), exhale gating with a reduced duty cycle (Gate4060), and treating for most of respiration, excluding only extreme inhales and exhales (Gate100). A standard operating procedure was developed, as well as a physics consult document to communicate motion management recommendations to other members of the treatment team. This procedure was implemented clinically for 1 year and results are reported below.ResultsIdentified factors that impact motion management included the magnitude of motion observed on 4DCT, the regularity of breathing and quality of 4DCT data, and ability to observe the target on fluoroscopy. These were collated into two decision tables-one specific to lung tumors and another for gastrointestinal tumors-such that a physicist could answer a series of questions to determine the optimal gating and PTV margin. The procedure was used clinically for 252 sites from 213 patients treated with respiratory-gated SBRT and standardized practice across our 12-member physics team.ConclusionImplementation of a standardized procedure for respiratory gating had a positive impact in our clinic, improving efficiency and ease of 4DCT analysis and standardizing gating decision-making amongst physicists.

Dataset Information

Using the time and motion method to study clinical work processes and workflow: methodological inconsistencies and a call for standardized research.

Objective

Materials and methods

Results

Discussion

Conclusion

Publications

Using the time and motion method to study clinical work processes and workflow: methodological inconsistencies and a call for standardized research.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets