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PubMed1985

A study of workload units in five microbiology laboratories.

A study of a modified Canadian unit system of measuring laboratory workload was undertaken in five joint Public Health Laboratory Service and hospital microbiology laboratories. Ten percent of the specimens received over six months were sampled, the number of units expended on each was recorded, and the results were analysed on a central computer. The process of gathering information in the absence of laboratory computers was time consuming and, despite careful planning, differences were found in the recording practices of the laboratories. The analysis of results did not lead to major changes in data gathering techniques because the same information about laboratory workload could be obtained by collecting numbers of clearly defined specimens. Analysis of workload units could be useful for particular purposes, such as comparing differences between laboratories using different techniques for the same investigation or assessing the possible benefits of automation. It must be appreciated, however, that workload units are measures of quantity not of laboratory performance.

Blood↗

PubMed1994

Toward a psychophysiological assessment of dynamic changes in mental workload.

The main goal of the present study was to examine the feasibility of employing event-related brain potentials to measure dynamic changes in mental workload. Subjects performed two tasks, monitoring and mental arithmetic, both separately and together. Following an analysis of the performance, subjective workload ratings, and average ERP data in the single- and dual-task conditions, two different conditions from each of the tasks were selected for further analysis. A bootstrapping approach was employed to determine the amount of ERP data required to discriminate between these conditions. The results of these analyses indicated that (a) 90% correct discrimination could be achieved with from 1 to 11 s of ERP data, (b) the best ERP measures varied across tasks and subjects, and (c) the inclusion of temporal and spatial aspects of the ERP data improved the ability to discriminate among workload levels. The data is discussed with respect to real-time assessment of mental workload.

Adult↗

PubMed1985

Slow-release nifedipine versus placebo in the treatment of arterial hypertension. A double blind ergometric evaluation of cardiac workload.

The effects of slow-release nifedipine on blood pressure and cardiac workload have been studied during bicycle exercise testing in a randomized, double blind trial in 20 patients with mild to moderate hypertension. After a fortnight's wash-out, patients were allocated to either slow-release nifedipine (20 mg twice daily) or placebo for a 2-month period. At baseline and at the end of treatment blood pressure and heart rate were measured at rest and during ergometric exercise; cardiac workload was calculated as the product of systolic blood pressure by heart rate. Significant decreases in blood pressure at rest and in cardiac workload on exercise were demonstrated at the end of nifedipine treatment. The reduction of cardiac workload was mainly due to the lower baseline values of resting blood pressure. Heart rate showed a reduction of its increase during ergometric exercise at the end of nifedipine treatment as compared to baseline, likely due to an improvement in stroke volume.

Adult↗

PubMed1983

Supply, workload and utilization: a population-based analysis of surgery in rural Manitoba.

This paper explores the relationships among physician supply, workload (output per physician), and utilization (physician services per capita) in rural Manitoba. Surgery taking place within a patient's home area and that taking place outside this area are discussed. Longitudinal and cross-sectional analyses are compared. Although the average surgeon does more surgical procedures than does the average general practitioner, the number of procedures performed varies greatly within each specialty. Individual physician workloads remained fairly stable over time when a surgically active physician moved into an area, while population utilization increased 17 per cent. When such physicians left an area, the surgical workloads of the physicians increased significantly (18.7 per cent) while population utilization stayed essentially the same. Both physician workload and surgical utilization in control areas increased gradually (between 6 and 7 per cent) over the period studied. Several models of physician behavior were investigated using data on individual procedures as well as overall figures. A model emphasizing the importance of physician discretion appeared to provide the best fit with the data.

Economics, Medical↗

PubMed1998

Comparison of cardiac response to managerial workload between men and women.

The aim of the study, was to estimate the reaction of selected circulatory system parameters to psychic workload in industrial managers and to answer the question whether may affect this reaction. The study was performed in 23 men (mean 46 +/- 6 years of age) and 16 women (mean 42 +/- 6 years of age), employed as executives in a large industrial plant. The subjects had their 24-h ECG recorded using Medilog 3000 (Oxford). The ECG recordings were classified as pathological according to the standards of Bjerregaard. Heart rate was calculated for working time, leisure time and sleep. The subjects were also asked to estimate the perceived psychic load according to a method involving subjective estimation of work-demands and of an ability to cope with them. Generally, the subjects reported high work demands, but coping abilities were higher than work demands. Both in the men and women, a relationship was found between the intensity of subjective estimation of psychic load and heart rate response. However, the reaction of the circulatory system to the psychic workload in men was long-lasting (its effects continued until late at night); in women it was more direct (only during work). The frequency of abnormalities in 24-h Holter ECG recordings for both test groups was not very high, a little higher in men (30%) than in women (25%), and was comparable with the frequencies in selected general population groups. Our results may indicate that mental workload of the managerial staff, does not cause increased frequency of ECG abnormalities. However, in view of the fact that cardiovascular diseases are more frequent among men than among women, different reaction of the circulatory system to workload should also be accounted for in an attempt to explain the sources of that phenomenon.

Administrative Personnel↗

PubMed1998

Blood lactate disappearance during breathing hyperoxic gas after exercise in two different physical fitness groups--on the workload fixed at 130% AT.

This study aimed to investigate the effects of hyperoxic gas breathing on the disappearance of blood lactate after exercise in two groups having different physical fitness and to determine the most effective O2 concentration in consideration of workload. Our previous study has demonstrated that hyperoxic gas breathing brought out different effects among subjects. In respect of these effects, it was thought necessary to pay attention to exercise intensity. Therefore, the exercise intensity of this study was set by using relative workload of anaerobic threshold (AT) from the aspect of blood lactate. Ten healthy male students participated as subjects and were divided into 2 groups; a group consisting of 5 active students whose mean AT was 60.4% VO2max (Higher AT group) and the other group consisting of 5 inactive students having the mean AT of 48.8% VO2max (Lower AT group). All subjects underwent three cycles of ergometer exercise on a bicycle (workload; 130% AT) for 5 min and recovery session for 6 min. The hyperoxic gas breathing was given only for the recovery session. The conditions of breathing were air, 30, 40, 60 or 80% O2. Blood for determination of the blood lactate level was taken only in the recovery session. When compared with air-breathing, the blood lactate level was significantly reduced in the condition of more than about 60% O2 breathing in Higher AT group, but not in Lower AT one. Together with the previous findings, it was found that the blood lactate level was markedly reduced by more than 60% O2 breathing in Higher AT group without relation to the workload in the range of about 70 to 80% VO2max. In Lower AT group, however, the effects of hyperoxic gas breathing were dependent on the exercise intensity; 30% and 40% O2 breathings were effective for the subjects with more than about 65% VO2max, but not in a lower intensity than it. These results indicate that the effects of hyperoxic gas breathing on the disappearance of blood lactate are dependent on the exercise intensity and the physical capacity.

Adult↗

PubMedDate not supplied

Inspiratory muscle workload due to dynamic intrinsic PEEP in stable COPD patients: effects of two different settings of non-invasive pressure-support ventilation.

BACKGROUND: In severe stable hypercapnic COPD patients the amount of pressure time product (PTP) spent to counterbalance their dynamic intrinsic positive end expiratory pressure (PEEPi,dyn) is high: no data are available on the best setting of non invasive pressure support ventilation (NPSV) to reduce the inspiratory muscle workload due to PEEPi,dyn. METHODS: The objectives of this randomised controlled physiological study were: 1. To measure the inspiratory muscle workload due to PEEPi,dyn 2. To measure the effects on this parameter of two settings of NPSV in stable COPD patients with chronic hypercapnia admitted in a Pulmonary Division of two Rehabilitation Centers. Twenty-three stable COPD patients with chronic hypercapnia on domiciliary nocturnal NPSV for 30 +/- 20 months were submitted to an evaluation of breathing pattern, PEEPi,dyn, inspiratory muscle workload and its partitioning during both assisted and unassisted ventilation. Two settings of NPSV were randomly applied for 30 minutes each: i- "at patient's comfort" (C): Inspiratory pressure support (IPS) was the maximal tolerated pressure able to reduce awake PaCO2 with the addition of a pre-set level of external PEEP (PEEPe); ii- "physiological setting" (PH): the level of IPS able to achieve a > 40% and < 90% decrease in transdiaphragmatic pressure in comparison to spontaneous breathing (SB). A PEEPe level able to reduce PEEPi,dyn by at least 50% was added. RESULTS: During SB the tidal diaphragmatic pressure-time product (PTPdi/b) was 17.62 +/- 7.22 cmH2O*sec, the component due to PEEPi,dyn (PTPdiPEEPi,dyn) being 38 +/- 17% (range: 16-65%). Compared to SB,PTPdiPEEPi,dyn was reduced significantly with both settings, the reduction being greater with PH compared to C. CONCLUSIONS: In conclusion in severe COPD patients with chronic hypercapnia the inspiratory muscle workload due to PEEPidyn is high and is reduced by NPSV at a greater extent when ventilator setting is tailored to patient's mechanics.

Aged↗

PubMed1987

A system of workload measurement for clinical dietitians.

Although the role of the clinical dietitian has undergone dramatic change in recent years, standards for staffing patterns that were developed in 1935 and often still in use. The need for workload measurement systems to quantify the daily activities performed by clinical dietitians led to the development of a new system at the University of Alberta Hospitals in 1984. The workload of clinical dietitians was divided into eight major categories and further divided into 60 activities. A one- or two-week study was conducted four times over an 18-month period. The results indicated that 44 to 54% of the dietitians' time was spent in activities involving direct patient care and team approach. The system has enabled this institution to quantify the workload of its clinical dietitians and may provide a vehicle to measure the impact of major changes on that workload. Since the system covers all possible activities of the clinical dietitian, it may be applicable for use in other institutions. In view of rising health care costs, hospitals must make greater efforts to improve the efficiency of their operations while maintaining the quality of health care services provided to patients. This issue, as it applies to clinical dietetics, was recently addressed by the Nutrition and Food Services Department at the University of Alberta Hospitals.

Alberta↗

PubMed1989

Measuring workload in a newborn center pharmacy.

In order to identify and quantify tasks performed by pharmacists and technicians in the Newborn Center Satellite Pharmacy, a workload assessment using a time ladder log was performed. Two pharmacists and one technician documented their daily activities in 2-minute increments for 1 month. Tasks were divided into three categories: patient days, calendar days, and variable activities. The average time to perform each task was determined. Standard times for each category were recorded onto a monthly workload report, which was used to calculate full-time equivalents (FTEs) required to perform all tasks. The number of FTEs increased seasonally, as did the number of patient days. Therefore, this workload reporting system can be used to identify peak workload time periods and to justify staffing requirements.

Efficiency↗

PubMed2000

Expectant parents' anticipated changes in workload after the birth of their first child.

OBJECTIVE: We hoped to evaluate gender differences in prenatal workload and anticipated prenatal to postpartum changes in workload for a group of expectant parents. METHODS: We included a total of 149 couples who were living together, expecting their first child, and enrolled in prenatal classes presented by 2 metropolitan hospitals. The couples completed a prenatal survey containing information about demographic characteristics and prenatal work responsibilities and a worksheet listing the number of hours per week that each partner planned to devote to various household, child care, and employment responsibilities at 6 months postpartum. RESULTS: Though both men and women anticipated large increases in workload from the prenatal to the postpartum period, women expected greater increases (85% vs 53%). As a result of their greater anticipated involvement in household work and child care, women planned to work 9 hours more per week than men after the arrival of the baby. These expectant parents tended to occupy somewhat traditional gender work roles, with women contributing more time to cooking, cleaning, laundry, and shopping, and men devoting more time to lawn care, snow removal, household repairs, and employment. Men appeared to be more satisfied than women with their partner's contribution to household work (mean=6.0 and 5.4; P=.000). Partners' perceptions of how they shared household work were congruent, with 90% of the couples' summed congruency scores in the range within 1 point of a perfect match. CONCLUSIONS: Expectant parents in this study anticipated large increases in workload after childbirth. The projected work increases were greater for women than for men. It is interesting to note that these gender differences are anticipated even when couples were given an opportunity to systematically plan their postpartum work distribution together.

Adult↗

PubMed1989

Measuring moment-to-moment pilot workload using synchronous presentations of secondary tasks in a motion-based trainer.

A simulation was conducted to determine whether the sensitivity of secondary task measures of pilot workload could be improved by synchronizing their presentation to the occurrence of specific events or pilot actions. This synchronous method of presentation was compared to the more typical asynchronous method, where secondary task presentations are independent of pilot's flight-related activities. Twelve pilots flew low- and high-difficulty scenarios in a motion-base trainer with and without concurrent secondary tasks (e.g., choice reaction time, time production). The difficulty of each scenario was manipulated by the addition of 21 flight-related tasks superimposed on a standard approach and landing sequence. Secondary task performance did reflect workload differences between scenarios and among flight segments within scenarios, replicating the results of an earlier study in which the secondary tasks were presented asynchronously. In addition, the choice reaction time secondary task was also sensitive to the workload of specific activities within flight segments. Workload ratings were virtually identical between this and the earlier study.

Aerospace Medicine↗

PubMed1983

Measuring nursing workload in an outpatient department.

Estimating outpatient nursing workload on the basis of visit volume loses validity as utilization of services by patients with complex nursing needs increases. In response to this challenge, nursing administrators at all levels must maintain an awareness of new methods to measure and predict outpatient nursing workload. Accurate quantification of the workload is a valuable tool in justifying costs, particularly in the face of health care regulation, and in developing billing systems that reflect actual nursing practice. Using the concept of relative value units (RVU), the authors describe a nursing workload measurement system developed in the outpatient department of a regional cancer center.

Cancer Care Facilities↗

PubMed1994

Speech measures indicating workload demand.

Heart rate and six speech measures were evaluated using a manual tracking task under different workload demands. Following training, 17 male subjects performed three task trials: a difficult trial, with a $50 incentive for successful performance at a very demanding level; an easy trial, with a $2 incentive for successful performance at a simple level; and a baseline trial, in which there was physiological monitoring but no tracking performance. Subjects counted aloud during the trials. It was found that heart rate, speaking fundamental frequency (pitch), and vocal intensity (loudness) increased significantly with workload demands. Speaking rate showed a marginal increase, while vocal jitter and vocal shimmer did not show reliable changes. A derived speech measure, which statistically combined information from all other speech measures except shimmer, was also evaluated. It increased significantly with workload demands and was surprisingly robust in showing differences for individual subjects. It appears that speech analysis can provide practical workload information.

Adult↗

PubMed1996

[Audit of histopathological activities in the laboratories of 7 general hospitals. 1. Types of resources and quantitative aspects of the workload].

Following a major reorganization of the National Health Service, competition for resources will depend to a great extent on the quality of the service offered, and audit will be of increasing importance. The present investigation deals with the quantitative aspects of the histopathology workload. A retrospective analysis of the biopsy handling of 1,000 consecutive cases was conducted in each histopathology lab of seven general hospitals. The data collected included information on specimen type, diagnosis, block/section/stain details for each specimen, as well as information about human resources, total workload and technical equipment. Among the seven labs, the histopathology workload ranged between 6,600 and 15,600 cases/year. The workload per person/year ranged between 1,400 and 2,600 (mean 1,900) for pathologists, between 800 and 3,000 (mean 1,500) for technicians, and between 2,200 and 8,300 (mean 4,400) for secretarial staff. The prevalence of biopsy fragments (endoscopic, endometrial curettage , etc.), "small" surgery (skin, appendix, gallbladder, etc.) and surgery was, respectively, between 42 and 50%, 34 and 47%, 9 and 21%. In all labs but one, 80% of cases were within 1-3 blocks; the seven labs had a mean of blocks/case ranging from 1.8 to 4.0 (total mean = 2.8). Differences in performing special stains were astonishing: one lab performed special stains in about 40%, and another in only 0.6% of cases (mean of the seven labs = 15%). Finally, the labs performed immunohistochemical stains within a range of 2.7-8% of cases (mean of the seven labs = 4.6%). The data we have collected provided baseline information on the laboratory running, and this is likely to be an integral part of laboratory administration in the near future.

Biopsy↗

PubMed1996

Mental workload in heat: toward a framework for analyses of stress states.

BACKGROUND: Effects of stress on performance are often interpreted by recourse to the arousal theory, which accounts for performance effects only in relation to the level of nervous system activity. This omits voluntary control that may be exerted in moderating stress effects. The present work elaborates on two control processes (viz., strategies and effort exertion) from the standpoint of the theory of mental workload, which was assessed in two experiments as a function of task demand and heat stress. Task demand was varied by increasing the complexity of decision rules and by presenting feedback indicating efficiency of task-strategies. HYPOTHESES: As decision rules are made more complex, task demand increases, causing longer reaction time (RT) and higher workload. Feedback improves performance by affecting strategies and effort exertion. Heat's effect on performance is related to the generated thermophysiological state and degree of effort exerted to maintain efficiency. METHOD: Performance and workload were measured in a decision-making task as a function of complexity of decision rules and feedback in 22 degrees C and 40 degrees C temperature conditions. Workload was measured by secondary task RT (STRT), subjective rating of effort (SRE), and heart rate (HR). Core temperature (Tc) was monitored continuously. RESULTS: Primary task RT (PTRT), STRT, SRE, and HR increased as complexity of decision rules increased. Feedback decreased PTRT, and increased STRT, SRE, and HR. In heat, a higher Tc was associated with a shorter PTRT and a longer STRT. CONCLUSIONS: A substantial part of variation in adaptation to demand was accounted for by control processes that involved higher cognitive functions.

Adult↗

PubMed2005

Physical workload, work intensification, and prevalence of pain in low wage workers: results from a participatory research project with hotel room cleaners in Las Vegas.

BACKGROUND: Occupational injury rates among hotel workers exceed the national service sector average. This study assesses the prevalence of back and neck pain, and its associations with physical workload, ergonomic problems, and increasing work demands. METHODS: Nine hundred forty-one unionized hotel room cleaners completed a survey about health and working conditions. Associations between job demands and pain were determined by logistic regression models adjusting for individual characteristics, cumulative work demands, care-taking responsibilities at home, and psychosocial job factors. RESULTS: The 1-month prevalence of severe bodily pain was 47% in general, 43% for neck, 59% for upper back, and 63% for low back pain. Workers in the highest exposure quartiles for physical workload and ergonomic problems were between 3.24 and 5.42 times more likely to report severe pain than workers in the lowest quartile. Adjusted odds ratios for work intensification ranged from 1.74 (upper back) to 2.33 (neck). CONCLUSIONS: Most room cleaners experience severe back or neck pain. Severe pain showed strong associations with physical workload, work intensification, and ergonomic problems.

Adult↗

PubMed1994

Surgical workload as a consequence of screening for abdominal aortic aneurysm.

A study was performed to evaluate the surgical workload that has resulted from screening an at-risk population for abdominal aortic aneurysm (AAA) and to forecast the likely workload from an established screening programme. Over an 8-year period 8944 people aged 65-80 years were screened; 356 were found to have an AAA of 3 cm or greater in diameter. There were 288 outpatient consultations involving 171 patients, and 43 patients (4.8 per 1000 screened) had surgery during the study period. A fully operational screening programme for a population of 250,000, screening men and women at a rate of 2000 per year, would be expected to produce a surgical workload of nine or ten operations for AAA per year. Screening men only would increase this to 34 annually.

Aged↗

PubMed2003

Population-based study of the surgical workload and economic impact of bowel obstruction caused by postoperative adhesions.

BACKGROUND: Intestinal obstruction is the most severe consequence of adhesion formation. This study examined the annual surgical workload and costs of intestinal obstruction caused by postoperative intra-abdominal adhesions. METHODS: The study was a retrospective case-note review of patients hospitalized for intestinal obstruction caused by postoperative adhesions in a well defined geographical area. The surgical workload and direct costs of inpatient care were analysed. RESULTS: There were 138 admissions for postoperative adhesion-related intestinal obstruction during the study with a total of 1118 inpatient days. The median hospital stay was 4 (range 1-58) days among patients who had non-operative treatment and 11 (range 2-34) days for those who had surgery. Surgery was necessary in 40 patients (29.0 per cent). The mean operating time (time from skin incision to last stitch) and the mean time spent in the operating theatre were 79 and 141 min respectively. The cumulative operating time for the surgical group was 52 h 20 min and the cumulative theatre time was 93 h 44 min. The annual direct hospital cost for postoperative adhesional intestinal obstruction was pound 181 653 in the district studied and the estimated cost for the whole of Finland was pound 2 077 796. CONCLUSION: This population-based study indicates that the workload and costs associated with bowel obstruction caused by postoperative adhesions are substantial.

Adult↗