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PubMed1993

Assessment of pilot performance and mental workload in rotary wing aircraft.

This research examined the processing demands imposed upon experienced pilots by two different communication formats, digital and verbal, in a high fidelity simulation of an advanced multi-function helicopter. The mental workload imposed by the type and magnitude of communications was assessed by a battery of subjective, performance, secondary, and physiological measures. The performance data indicated that the pilots had difficulty adhering to the Nap of the Earth altitude criterion with high communication demands, particularly with the digital communication system. This was presumably due to the requirement to spend more time scanning the multi-function displays with the digital than with the verbal communication system. On the other hand, the pilots were less prone to task shedding when they used the digital communication system possibly due to the provision of a permanent list of queries that was unavailable with the verbal system. Measures of heart rate variability and blink rate were larger with the verbal than with the digital system, presumably reflecting increased respiratory demands in the verbal condition as well as increased visual processing demands with the digital format. Finally, the probe evoked P300 component decreased in amplitude as a function of increases in the magnitude of communications. The results are discussed in terms of the structural and capacity demands of the communications systems that were proposed for the advanced multi-function helicopter.

Adult↗

PubMed1995

Physical workload of lorry drivers: a comparison of four methods of transport.

Four groups of eight lorry drivers, transporting goods on wheeled cages, as packed goods, on pallets, or as bulk cargo, were studied during a complete working day. The drivers working with bulk cargo served as a reference group. Manual materials handling and the working postures were studied by observation. The heart rate (HR) was continuously recorded and related to observed tasks. The relationship between HR and oxygen uptake during a simulation of loading and unloading and the maximal oxygen uptake (VO2max) were measured in a laboratory for every driver. The lorry drivers worked long hours, only the group transporting wheeled cages worked less than 11 h d-1 on average. Driving made up almost half of the total working time in all groups. In general, the highest HR was found during loading and unloading. Loading and unloading of wheeled cages was done for 2 h d-1, at 50% of VO2max. The drivers transporting packed goods and pallets loaded and unloaded for around 100 min d-1, at 48% and 35% of VO2max respectively. When the drivers of these two groups lifted, their trunks were flexed for more than 60% of the time. The most important difference between the reference group and the other groups was that the drivers of the former rarely pushed or pulled anything. It is suggested that the required pushing and pulling forces were largely responsible for the high physical workload during loading and unloading.

Adult↗

PubMed1996

Prevalence of back pain and characteristics of the physical workload of community nurses.

A research project is described that analyses the back pain prevalence and physical working conditions of community nurses. The purpose was to compare the position of nurses working in institutional care with the specific situation of nurses working in the private homes of their patients. The results of a questionnaire showed that the back pain prevalence was relatively high as compared to other occupations and also when compared to other health care sectors. The home care organization is influenced not only by sick leave due to back pain, but also its efficiency is hampered by nurses with back pain who continue to work. It appeared that the total sick leave incidence due to musculoskeletal disorders other than back pain exceeds that due to back pain alone. The physical exposure level not only consisted of frequent and heavy lifting and transferring of patients but also a substantial static workload was present. The onset of back pain seems to result from a gradual build up of overload reaching its maximum. A preventive approach should take these differential loading factors into account. The consequences for preventive interventions are discussed resulting in recommendations towards a (participatory) ergonomic approach. This material forms the baseline of a controlled prospective trial in home care.

Adult↗

PubMed1998

Evaluation of work-rest schedules with respect to the effects of postural workload in standing work.

The influence of four work-rest schedules (60-min shift-15-min break, 45-15, 30-15, 30-30) on acute effects of physical workload in the back and legs due to standing work was investigated in 12 poultry inspectors. Subjective discomfort in the legs and back, and swelling in the distal lower leg were significantly affected, with the 60-15 schedule leading to a higher postural load as compared with the other schedules. No effect on spinal shrinkage was found. It was concluded that the 60-15 schedule should be avoided. An optimal work-rest schedule considering visco-elastic deformation of the spine would probably involve frequent short breaks, whereas longer breaks would seem more effective considering leg swelling.

Adult↗

PubMed1995

Mental Workload and Health: A Latent Threat.

The aim of this study is to investigate changes in cardiovascular activity associated with a high mental workload. The reported experiments, carried out in naturalistic settings, point to information load and information processing under time pressure as main risk factors. This kind of occupational stress had to be dealt with by two of the three groups under investigation: brokers and simultaneous interpreters; it was not experienced by lecturing university professors. The pattern of cardiovascular activity of the two former groups consisted of overmobilization of cardiovascular activity at the beginning of work, and only partial normalization of task-evoked changes in cardiovascular activity at the end of work. Substantial elevations of diastolic blood pressure and tachycardia, which followed earlier overmobilization, resemble a miniature copy of changes seen in the development of cardiovascular diseases.

blood pressure↗

PubMed2002

Driver workload response to in-vehicle device operations.

A central concern of Intelligent Transportation Systems (ITS) is the effect of in-vehicle devices (e.g., cell phones, navigation systems, radios, etc.) on driver performance and safety. As diverse and innovative technologies are designed and implemented for in-vehicle use, questions regarding the presence and use of these devices assume progressively greater importance. Further concerns for advanced driver training require us to develop and validate reliable and effective procedures for assessing such effects. This work examines a number of candidate procedures, in particular the evaluation of change in cognitive workload as a strategy by which such goals might be achieved.

Attention↗

PubMed2006

A study of the workload of underground trammers in the Ranigang coal field area of West Bengal, India.

Thirty healthy trammers were examined in underground haulage mines during their normal activity. Physiological strain in terms of heart rate (HR) varied between 101.6 and 104.7 beats/min with mean net cardiac cost of 33.06 and 34.06 beats/min for younger and older groups respectively. The average relative cardiac cost was lower for younger subjects than for older ones. Oxygen consumption (VO2) was measured with an Oxylog-II machine (UK); subsequently values were estimated. Maximum aerobic capacity was estimated with an indirect method following a standard step test protocol. The responses revealed that the average VO2 during the activity was 0.75 and 0.8 L/min, which corresponded to energy expenditure (EE) of 3.8 and 3.97 Kcal/min for younger and older subjects respectively. The workload in terms of HR and EE was moderate, whereas the aerobic strain experienced by aged workers was above the acceptable level.

Adult↗

PubMedDate not supplied

Internet-accessible emergency department workload information reduces ambulance diversion.

OBJECTIVE: To determine the effect of pre-emptive ambulance distribution based on the implementation of a real-time, Internet-accessible emergency department (ED) workload schematic and prehospital Australasian Triage Scale (ATS) allocations on ambulance diversion in Western Australia. METHODS: Comparison of July-December 2002 and July-December 2003 metropolitan Perth ED cubicle occupancy, ambulance diversion, ambulance distribution, and ambulance unloading delays at four inner and four outer metropolitan EDs. RESULTS: Ambulance diversion fell from 1,788 hours in 2002 to 1,138 hours in 2003 (p < 0.001) despite an increase in mean weekly ED cubicle occupancy from 31 patients (95% confidence internal [CI] 29-33) in 2002 to 39 patients in 2003 (95% CI 36-43, p < 0.001). Inner metropolitan ED ambulance attendances fell 2.7% from 27,475 in 2002 to 26,743 in 2003, and outer metropolitan correspondingly rose from 5,877 to 6,628 ambulance attendances (p < 0.001). Unloading delays were similar in 2002 (219, 0.66%) and 2003 (223, 0.67%, p = 0.84); however, median duration of unloading delays increased from 38 minutes (interquartile range [IQR] 18-68) in 2002 to 50 minutes (IQR 25-108) in 2003 (p < 0.001). CONCLUSIONS: The implementation of pre-emptive ambulance distribution using Internet-accessible ED information and prehospital ATS allocations was associated with reduced ambulance diversion, probably consequent upon the redistribution of ambulances from inner to outer metropolitan EDs. The rise in ED cubicle occupancy between the study periods suggests that this approach to reducing ambulance diversion should be viewed only as complementary to direct efforts to reduce ambulance diversion by improving hospital inpatient flow and the balance between acute and elective hospital inpatient accommodation.

Ambulances↗

PubMed2006

Workload, work stress, and sickness absence in Swedish male and female white-collar employees.

AIMS: This study aimed to analyse, in a homogeneous population of highly educated men and women, gender differences in self-reported sickness absence as related to paid and unpaid work and combinations of these (double exposure), as well as to perceived work stress and work-home conflict, i.e. conflict between demands from the home and work environment. METHODS: A total of 743 women and 596 men, full-time working white-collar employees randomly selected from the general Swedish population aged 32-58, were assessed by a Swedish total workload instrument. The influence of conditions in paid and unpaid work and combinations of these on self-reported sickness absence was investigated by multivariate regression analyses. Analysis of variance (ANOVA) was used to assess differences between men and women. RESULTS: Overtime was associated with lower sickness absence, not only for men but also for women, and a double-exposure situation did not increase the risk of sick leave. Contrary to what is normally seen, conflict between demands did not emerge as a risk factor for sickness absence for women, but for men. CONCLUSIONS: Our assumption that sickness absence patterns would be more similar for white-collar men and women than for the general population was not confirmed. However, the women working most hours were also the least sick-listed and assumed less responsibility for household chores. These women were mainly in top-level positions and therefore we conclude that men and women in these high-level positions seem to share household burdens more evenly, but they can also afford to employ someone to assist in the household.

Conflict, Psychological↗

PubMed2005

Workload and short-term outcome of babies weighing 2,500 grams or more at birth admitted to the paediatric unit of the Rotunda Hospital.

BACKGROUND: Audit is important in ensuring adequate use of resources and maintaining optimum standards of care. Most of the emphasis in neonatal audit is focused on very low birth weight infants. However, term and near-term infants account for a significant proportion of the workload in neonatal units and warrant regular audit. In addition, audit of these infants may be useful as a marker of the organisation of the perinatal service. METHODS: A retrospective audit was performed of all infants with birth weights greater than or equal to 2,500 grams admitted to the neonatal department in the first week of life over a two-year period, examining mode of delivery, level of care, duration of stay, diagnosis and short-term outcome. RESULTS: Eight hundred and seventy infants were admitted greater than or equal to 2,500 grams birth weight, 54% of all neonatal admissions, during the study period. Six hundred and eighty seven of these infants were admitted in the first week of life and were included in the study; this was 5.8% of infants born with a birth weight 2500 grams or more. Infants born by caesarean section were twice as likely to require admission (9.8%) compared with infants born by vaginal delivery (4.5%). The median length of stay was 3 days (3 hours to 45 days). One hundred and six (15.4%) infants required level 1 or level 2 care. One hundred and eleven infants received normal care, only. Most of these infants were admitted for maternal or social reasons. Other common reasons for admission were jaundice, respiratory disease, neonatal abstinence syndrome and congenital abnormality. Forty-one infants required transfer to another hospital, most commonly for surgical or cardiac conditions. Six infants died after admission. However, only one normally formed infant delivered in our hospital died prior to discharge or transfer. One infant was born at home and four infants who had a lethal congenital abnormality are known to have died following transfer. CONCLUSION: Term and near-term infants account for a significant proportion of neonatal admissions and deserve regular audit. Many admissions are potentially avoidable. Survival for infants weighing 2,500 grams or greater is excellent. Only one normally formed infant died following admission during the study period. The number of "social" admissions of "well" infants highlighted by this study reflects poorly on the services available for well infant whose mothers are unable to care for them for whatever reason. We recommend regular audit of these infants in order to ensure efficient use of neonatal resources and to ensure optimum levels of neonatal intensive care.

Birth Weight↗

PubMed2005

Total workload, work stress and perceived symptoms in Swedish male and female white-collar employees.

BACKGROUND: The aim of this study was to analyse how paid work, unpaid household tasks, child care, work-child care interactions and perceived work stress are associated with reported symptoms in male and female white-collar employees. METHODS: A questionnaire was mailed to 1300 men and 1300 women belonging to the white-collar sector, with at least 35 hours of regular employment a week and a participant age of between 32 and 58 years. It contained items relating to total workload (hours spent on paid work, unpaid household tasks and childcare), subjective indices for work stress and symptoms. The response rate was 65% (743 women; 595 men). Gender difference in symptom prevalence was tested by analyses of variance. Odds ratios were used to estimate the bivariate associations between work-related variables and symptom prevalence. A multivariate analysis estimated the effect of paid and unpaid work interaction, work-childcare interplay and possible synergy. RESULTS: The frequency and severity of symptoms was higher in women than in men (P < 0.0001). Employed women's health was determined by the interaction between conditions at work and household duties (OR 2.09; 1.06-4.14), whereas men responded more selectively to long working hours, i.e. >50 h/week (OR 1.61; 1.02-2.54). However, childcare (<21 h/week) appeared to have a buffer effect on the risk of a high level of symptoms in men working long hours. CONCLUSION: Working life and private circumstances and the interplay between them need to be taken into account to curb stress-related ill health in both men and women.

Adult↗

PubMed2002

The implementation of a call-back system reduces the doctor's workload, and improves accessibility by telephone in general practice.

BACKGROUND: In a general practice in The Netherlands, the demand for direct telephone consultation with the doctor became extreme, which resulted in poorly managed consultations, and poor telephone access due to busy lines. A call-back telephone appointment system was therefore introduced: all calls are answered and, when possible, managed by the practice assistant. If the assistant feels incapable, or if the patient prefers to speak to the doctor, a telephone appointment is scheduled, at which time the doctor returns the patient's call. OBJECTIVE: Our aim was to evaluate the effects of a call-back telephone appointment system on doctors' workload and patients' telephone access to doctors. METHODS: Telephone consultation data over 10 weeks were selected before and after the introduction of the call-back telephone appointment system. The outcomes measured were: number and duration of telephone calls to doctors, the reason for each call and how often telephone lines were engaged during the specified telephone hour. RESULTS: The number of calls requiring the doctor's attention was reduced by 59% and total time spent on the telephone by the GPs was reduced by 39%. This reduction is explained by a change in the reasons for calling. Telephone accessibility improved, as busy telephone lines were no longer an issue. CONCLUSION: The call-back telephone appointment system is superior to the previously used open access telephone hour.

Appointments and Schedules↗

PubMed2006

Excessive workload, uncertain career opportunities and lack of funding are important barriers to recruiting and retaining primary care medical researchers: a qualitative interview study.

BACKGROUND: Research activity in primary care has been steadily increasing, but is still insufficient and more researchers are needed. Many initiatives have been launched to recruit and retain primary care researchers, but only little is known about barriers and facilitators to a research career in primary care. OBJECTIVE: To examine barriers and facilitators to recruiting and retaining primary care medical researchers. METHODS: Semi-structured interviews with 33 primary care medical researchers, all medical doctors. We used a phenomenological approach to analysing the interviews. RESULTS: Important barriers to pursuing a research career in primary care were heavy workload, isolation at work, short-term funding and low salary. Important facilitators to attracting and retaining primary care researchers were the desire and opportunity to improve primary care, the flexible working conditions, the career opportunities, including the possibility of combining university-based research with clinical work and a friendly and competent research environment. CONCLUSION: Better strategies for recruiting and retaining researchers are a prerequisite for the development of primary care, and in future the main emphasis should be on working conditions, networking and mentoring. Studies including those primary care physicians who have chosen not to do research are highly needed.

Adult↗

PubMed2001

A process for reducing workload and enhancing residents' education at an academic medical center.

Academic medical centers are under increasing pressure to find alternatives to residents for the provision of patient care and to expand and improve the educational opportunities for residents. To address these concerns, the authors performed a study of the medical wards at Harborview Medical Center, a county-owned medical center managed by the University of Washington School of Medicine. Admitting diagnoses, provider names, and billings were obtained from professional practice plan billing records. Based on the distribution of admitting diagnoses, a subset of patients was identified that could be removed from routine care by residents and could instead be cared for by non-physician providers (i.e., physician assistants and nurse practitioners) using clinical pathways. The cohort was large enough to reduce the number of patients per resident to within national accreditation guidelines, and to provide faculty with more time available for teaching. The authors summarize the approach used to identify the new model for care delivery indicated above and the plans made to implement that model and to analyze its impact on the quality of patient care, hospital costs, residents' education, and the process of implementing change. The authors conclude that solutions to the problems of workload and education that they confronted will vary by department and hospital setting. Yet a systematic approach to discovering solutions, such as they present, can be adapted to any setting.

Academic Medical Centers↗

PubMed1997

Analysis and management of home health nursing caseloads and workloads.

The Easley-Storfjell Instruments for Caseload/Workload Analysis have been used successfully by home health managers to document the type quantity, and complexity of services provided by clinicians, teams, and the entire nursing staff. By measuring both the time requirements and complexity of interventions, these tools have been useful in assigning cases, managing caseloads and workloads establishing benchmarks, and monitoring productivity. Directions for use of these tools and examples are provided.

Community Health Nursing↗

PubMed2002

Rework the workload.

Kindred Healthcare, Inc., the nation's largest full-service network of long-term acute care hospitals, initiated a 3-year strategic plan to re-evaluate its workload management system. Here, follow the project's most important and difficult phase--designing and implementing the patient classification system.

Humans↗

PubMed2003

Clocking care hours with workload measurement tools.

This study compares the Resource Utilization Group Classification System mandated by the Centers for Medicare and Medicaid for use in long-term care facilities to other existing workload measurement models.

Aged↗

PubMed1992

Low back and neck/shoulder pain in construction workers: occupational workload and psychosocial risk factors. Part 1: Relationship to low back pain.

The prevalence rate of musculoskeletal problems, especially low back pain and severe low back pain in a randomly selected sample of 1,773 construction workers was studied. Its relationship to physical and psychosocial factors was analyzed. The workers answered a postal questionnaire. Workload was measured by means of eight manual materials handling indices and ten psychosocial indices, based on results from factor analyses. The 1-year prevalence rate of low back pain was 54% and of severe low back pain 7%. The relationship to heavy manual materials handling differed with age in such a manner that it could be interpreted as a healthy worker effect. Between severe low back pain and both stooping or kneeling a dose-response relationship was found. The most prominent of the psychosocial factors associated with low back pain and severe low back pain were the stress index and the psychosomatic and psychic indices. The age-standardized prevalence rate ratio of low back pain was 1.6 (95% confidence interval 1.4-1.8) and for severe low back pain 3.1 (95% confidence interval 2.3-4), when workers reporting "high" stress were compared to workers reporting "low" stress.

Adult↗