Dataset Information

What do hospital doctors and nurses think wastes their time?

ABSTRACT:

Objective

With regard to limitation in national budget, the relevant authorities of healthcare and treatment throughout the globe are seeking the use of available resources in a way that no wastage of money or time-which is, of course, convertible to money-is acceptable. This study sought the opinions of hospital doctors and nurses on those activities at work that wasted their time.

Methods

A questionnaire designed to identify activities that waste time during hospital care was completed based on the review of previous studies and including hospital wastes items. The authors designed a questionnaire, which was filled out by 209 nurses and 30 doctors in the surgery wards in hospitals affiliated to Shiraz University of Medical Sciences (SUMS). The items for time wasting activities were extracted from previous studies, and the reliability of the questionnaire was more than 0.785 using Cronbach's alpha. The response rate was more than 60%.

Results

The mean age of the participating nurses and doctors was 30.24?±?6.85 and 32.77?±?7.05?years. In all aspects, more time was wasted during the morning and evening shifts in comparison with the night shifts. The activity that was thought to waste time in hospital care the most was paper-based documentation. Preventable wasted time during the shift was 16%-30% in the nurses' view and 18%-34% in the doctors' view. For both nurses and doctors, the highest-rated preventable wasted time was related to time spent waiting in ward for lab data responses, transfer of patients, or delivery of care.

Conclusion

Hospital working environment is complex, and opportunities for improvement of the efficiency of the nurses' and doctors' workload should be analyzed, case by case, in each hospital and work group. Process change (for the decrease in the wasted time for waiting in wards), simple innovative ways (for the decrease in the wasted time for searching the needed equipment), using hospital information system technology for documentation, communication, and the better design of the wards (to decrease the wasted time due to transfer between the ward and restroom) could be helpful for improving efficiency and for a safer and acceptable delivery of care.

SUBMITTER: Bagheri Lankarani K

PROVIDER: S-EPMC6503588 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

What do hospital doctors and nurses think wastes their time?

Bagheri Lankarani Kamran K Ghahramani Sulmaz S Roozitalab Marjan M Zakeri Mohammadreza M Honarvar Behnam B Kasraei Hengameh H

SAGE open medicine 20190505

<h4>Objective</h4>With regard to limitation in national budget, the relevant authorities of healthcare and treatment throughout the globe are seeking the use of available resources in a way that no wastage of money or time-which is, of course, convertible to money-is acceptable. This study sought the opinions of hospital doctors and nurses on those activities at work that wasted their time.<h4>Methods</h4>A questionnaire designed to identify activities that waste time during hospital care was co ...[more]

PMID: 31105937

Similar Datasets

Project description:BACKGROUND:Presenteeism is a behavior in which an employee is physically present at work with reduced performance due to illness or other reasons. Hospital doctors and nurses are more inclined to exhibit presenteeism than other professional groups, resulting in diminished staff health, reduced team productivity and potentially higher indirect presenteeism-related medical costs than absenteeism. Robust presenteeism intervention programs and productivity costing studies are available in the manufacturing and business sectors but not the healthcare sector. This systematic review aims to 1) identify instruments measuring presenteeism and its exposures and outcomes; 2) appraise the related workplace theoretical frameworks; and 3) evaluate the association between presenteeism, its exposures and outcomes, and the financial costs of presenteeism as well as interventions designed to alleviate presenteeism amongst hospital doctors and nurses. METHODS:A systematic search was carried out in ten electronic databases from 1998 to 2017 and screened by two reviewers. Quality assessment was carried out using the Critical Appraisal Skills Program (CASP) tool. Publications meeting predefined assessment criteria were selected for data extraction. RESULTS:A total of 275 unique English publications were identified, 38 were selected for quality assessment, and 24 were retained for data extraction. Seventeen publications reported on presenteeism exposures and outcomes, four on financial costing, one on intervention program and two on economic evaluations. Eight (39%) utilized a theoretical framework, where the Job-Demands Resources (JD-R) framework was the most commonly used model. Most assessed work stressors and resources were positively and negatively associated with presenteeism respectively. Contradictory and limited comparability on findings across studies may be attributed to variability of selected scales for measuring both presenteeism and its exposures/outcomes constructs. CONCLUSION:The heterogeneity of published research and limited quality of measurement tools yielded no conclusive evidence on the association of presenteeism with hypothesized exposures, economic costs, or interventions amongst hospital healthcare workers. This review will aid researchers in developing a standardized multi-dimensional presenteeism exposures and productivity instrument to facilitate future cohort studies in search of potential cost-effective work-place intervention targets to reduce healthcare worker presenteeism and maintain a sustainable workforce.

Project description:Balancing the number of nursing staff in relation to the number of patients is important for hospitals to remain efficient and optimizing the use of resources. One way to do this is to work with a workload management method. Many workload management methods use a time study to determine how nurses spend their time and to relate this to patient characteristics in order to predict nurse workload.In our study, we aim to determine how nurses spend their working day and we will attempt to explain differences between specialized surgical wards.The research took place in an academic hospital in the Netherlands. Six surgical wards were included, capacity 15 to 30 beds.We have used a work sampling methodology where trained observers registered activities of nurses and patient details every ten minutes during the day shift for a time period of three weeks.The work sampling showed that nurses spend between 40.1% and 55.8% of their time on direct patient care. In addition to this, nurses spend between 11.0% and 14.1% on collective patient care. In total, between 52.1% and 68% of time spent on tasks is directly patient related. We found significant differences between wards for 10 of the 21 activity groups. We also found that nurses spend on average 31% with the patient (bedside), which is lower than in another study (37%). However, we noticed a difference between departments. For regular surgical departments in our study this was on average 34% and for two departments that have additional responsibilities in training and education of nursing students, this was on average 25%.We found a relatively low percentage of time spent on direct plus indirect care, and a lower percentage of time spent with the patient. We suspect that this is due to the academic setting of the study; in our hospital, there are more tasks related to education than in hospitals in other study settings. We also found differences between the wards in our study, which are mostly explained by differences in the patient mix, nurse staffing (proportion of nursing students), type of surgery and region of the body where the surgery was performed. However, we could not explain all differences. We made a first attempt in identifying and explaining differences in nurses' activities between wards, however this domain needs more research in order to better explain the differences.

Project description:BackgroundNormalisation process theory reports the importance of contextual integration in successfully embedding novel interventions, with recent propositions detailing the role that 'plasticity' of intervention components and 'elasticity' of an intended setting contribute. We report on the introduction of a clinical pathway assessing patient non-responsiveness to treatment for glaucoma and ocular hypertension. The aim of this study was to assess the feasibility of implementing the Cardiff Model of Glaucoma Care into hospital eye services, identifying any issues of acceptability for staff through the filter of normalisation process theory.MethodsA prospective observational study was undertaken in four hospital eye services. This incorporated detailed qualitative semi-structured interviews with staff (n = 8) to gather their perceptions on the intervention's usefulness and practicality. In addition, observational field notes of patient and staff consultations (n = 88) were collected, as well as broader organisational observations from within the research sites (n = 52). Data collection and analysis was informed by the normalisation process theory framework.ResultsStaff reported the pathway led to beneficial knowledge on managing patient treatment, but the model was sometimes perceived as overly prescriptive. This perception varied significantly based on the composition of clinics in relation to staff experience, staff availability and pre-existing clinical structures. The most commonly recounted barrier came in contextually integrating into sites where wider administrative systems were inflexible to intervention components.ConclusionsFlexibility will be the key determinant of whether the clinical pathway can progress to wider implementation. Addressing the complexity and variation associated with practice between clinics required a remodelling of the pathway to maintain its central benefits but enhance its plasticity. Our study therefore helps to confirm propositions developed in relation to normalisation process theory, contextual integration, intervention plasticity, and setting elasticity. This enables the transferability of findings to healthcare settings other than ophthalmology, where any novel intervention is implemented.

Project description:ObjectivesThe use of rapid point-of-care tests (POCTs) has been advocated for improving patient management and outcomes and for optimising antibiotic prescribing. However, few studies have explored healthcare workers' views about their use in febrile children. The aim of this study was to explore the perceptions of hospital-based doctors and nurses regarding the use of POCTs in England.Study designQualitative in-depth interviews with purposively selected hospital doctors and nurses. Data were analysed thematically.SettingTwo university teaching hospitals in London and Newcastle.Participants24 participants (paediatricians, emergency department doctors, trainee paediatricians and nurses).ResultsThere were diverse views about the use of POCTs in febrile children. The reported advantages included their ease of use and the rapid availability of results. They were seen to contribute to faster clinical decision-making; the targeting of antibiotic use; improvements in patient care, flow and monitoring; cohorting (ie, the physical clustering of hospitalised patients with the same infection to limit spread) and enhancing communication with parents. These advantages were less evident when the turnaround for results of laboratory tests was 1-2 hours. Factors such as clinical experience and specialty, as well as the availability of guidelines recommending POCT use, were also perceived as influential. However, in addition to their perceived inaccuracy, participants were concerned about POCTs not resolving diagnostic uncertainty or altering clinical management, leading to a commonly expressed preference for relying on clinical skills rather than test results solely.ConclusionIn this study conducted at two university teaching hospitals in England, participants expressed mixed opinions about the utility of current POCTs in the management of febrile children. Understanding the current clinical decision-making process and the specific needs and preferences of clinicians in different settings will be critical in ensuring the optimal design and deployment of current and future tests.

Project description:Interventions: This study will use surveys to determine the acceptability of faecal and blood-based bowel screening strategies for triaging individuals with a higher than average risk of colorectal cancer (CRC) to colonoscopy. This will include individuals requiring colonoscopy in response to abnormal gastrointestinal symptoms, a significant family history of CRC, and/or a previous finding of polyps. Individuals invited into the study will be patients who are scheduled to undergo a colonoscopy due to one of these risk factors, and clinicians who are involved in the care of people undergoing colonoscopy. Individuals who are scheduled to undergo a colonoscopy for gastrointestinal symptoms or CRC surveillance at one of the approved study sites (Flinders Medical Centre, Noarlunga Health Service, Tennyson Centre Day Hospital, Queen Elizabeth Hospital) will be identified via clinic and colonoscopy booking lists for invitation into the study. A letter will be sent to eligible participants approximately 2-4 weeks prior to their scheduled colonoscopy to invite them to complete a survey before their procedure. All respondents to this initial survey will be invited to complete a follow-up survey approximately one month after their colonoscopy. Participants will have the option to complete the surveys online (via a link or by scanning a QR code) or through a paper copy sent to them along with a reply-paid envelope. Each survey will take approximately 20-30 minutes to complete and will measure the acceptability of different bowel screening methods along with the following variables: previous clinical testing experiences and knowledge, health beliefs, health literacy, health-related quality of life, and fear of bowel cancer. Clinicians will be invited to complete a single online Primary outcome(s): A primary outcome for colonoscopy consumers will be their acceptability of faecal-based bowel screening tests for use in determining their need for colonoscopy. This will be assessed within the pre- and post-colonoscopy surveys using items that have been designed specifically for this study. [This will be assessed 2-4 weeks prior to and 4 weeks following colonoscopy. ];Another primary outcome for colonoscopy consumers will be their acceptability of blood-based bowel screening tests for use in determining their need for colonoscopy. This will be assessed within the pre- and post-colonoscopy surveys using items that have been designed specifically for this study. [This will be assessed 2-4 weeks prior to and 4 weeks following colonoscopy. ];A primary outcome for clinicians will be their acceptability of faecal-based bowel screening tests for use in triaging people with abnormal gastrointestinal symptoms to colonoscopy. This will be assessed within the single clinician survey using items that have been designed specifically for this study. [This will be assessed at any time following study invitation. ] Study Design: Purpose: Psychosocial;Duration: Longitudinal;Selection: Defined population;Timing: Prospective

Dataset Information

What do hospital doctors and nurses think wastes their time?

Objective

Methods

Results

Conclusion

Publications

What do hospital doctors and nurses think wastes their time?

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets