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At least 73 records · Page 4Linked to original sources

PubMed1990

Junior doctors' on call activities: differences in workload and work patterns among grades.

OBJECTIVE: To examine the workload and work patterns of junior doctors of all grades while on call. DESIGN: Pilot study of activity data self recorded by junior doctors, with the help of students during busy periods. SETTING: A general surgical firm and a general medical firm based at University Hospital, Nottingham. SUBJECTS: Four registrars, three senior house officers, and five preregistration house officers. RESULTS: Senior house officers and preregistration house officers spent nearly half of all their on call duty time working, but less than half of that time was spent in direct contact with patients. Registrars were on call more often than the house officers but spent less than one fifth of their on call duty time working, and almost two thirds of that time was spent in direct contact with patients. CONCLUSIONS: Workload while on duty is excessive for both senior and preregistration house officers. Changes in some administrative procedures and employment of more non-medical staff during on call periods might reduce the time spent on non-clinical activities, thereby reducing the overall workload and allowing more time for patient contact.

England↗

PubMed1991

Management importance of common treatments: contribution of top 20 procedures to surgical workload and cost.

OBJECTIVE: To assess the contribution of the most frequently performed procedures to surgical workload and to evaluate the financial implications. DESIGN: Analysis of data held on the department's computerised clinical information system. SETTING: Department of surgery in a district general hospital. PATIENTS: 4845 patients were treated by surgeons in three consultant firms over an 18 month period and 5346 patients by surgeons in a single firm over a five year period. MAIN OUTCOME MEASURES: Percentage and cumulative percentage contribution to workload in order of frequency by procedure. Costs of the commonest and costliest treatments. RESULTS: Half of the workload of the department was encompassed by eight procedures. Twenty procedures accounted for 70% of the work. For a single firm 20 procedures represented over 80% of all the surgical work. Transurethral prostatectomy was the treatment that consumed most resources (pounds 240,900 for 198 patients in 18 months). The costliest patients were those who had undergone complicated large bowel surgery, vascular reconstructions, or amputation. CONCLUSIONS: Clinicians and managers need to appreciate the importance of the most common surgical procedures. It is vital that performance and costing of these procedures are optimum as they contribute disproportionately to overall results and finance.

England↗

PubMed1991

Gastric cancer in Scotland: changing epidemiology, unchanging workload.

OBJECTIVE: To determine the changes in incidence of and mortality from gastric cancer in Scotland between 1978 and 1987 and in the operative workload in Lothian between 1979 and 1988. DESIGN: Analysis of national incidence statistics for gastric cancer derived from the Scottish national cancer registry, deaths from gastric cancer recorded by the registrar general for Scotland, and Lothian surgical audit data. SETTING: Scotland and Lothian Health Board area. PATIENTS: Patients in Scotland with gastric cancer during 1978 to 1987 inclusive; patients in Scotland with gastric cancer recorded on their death certificate as cause of death during 1978 to 1987; patients who had an operation in Lothian for gastric cancer during 1979 to 1988. MAIN OUTCOME MEASURES: Changes in incidence of and mortality from gastric cancer in Scotland from 1978 to 1987 and in the number of operations performed for gastric cancer in Lothian from 1979 to 1988. RESULTS: Mortality from gastric cancer in Scotland fell by about 25% over the 10 years. The incidence and standardised incidence of gastric cancer showed a marginal decline of about 9%. The differences in trends between incidence and mortality were significant (p less than 0.05). CONCLUSIONS: This study shows that the surgical workload associated with gastric cancer is not declining. This is because the incidence has remained almost static, which may be due to the relative increase in the numbers of older people in the population, who are at greater risk of developing gastric cancer. Gastric cancer should not be regarded as a disease in decline. Incidence and workload should determine resources allocated to this disease rather than mortality statistics.

Adult↗

PubMed1989

Assessment of mental workload on older workers during performance of a calculating task.

Twenty-four healthy male clerical workers (50-59 years of age) in an automobile manufacturing plant performed as accurately as they could a calculating task consisting of the addition or subtraction of two 2-digit numbers at five grades of task load for 5 min each. The workers' work capacities were inferior in speed but not in precision to those of male students determined previously. The resting levels of occipital midline beta-2 (Oz beta 2) amplitude were significantly lower for the workers than for the students. The workers' mental workloads were objectively shown to be lighter than the students' based on a significant difference between the percent increases in Oz beta 2 amplitude over resting levels. The workers' subjective mental workloads assessed by subjective rating of task difficulty (SRTD) were lighter than the students' at higher task loads. From the trend that there was no undue rise in either SRTD or percent increase in Oz beta 2 amplitude, it was judged that no task load could induce excessive mental workload on workers.

Adult↗

PubMed1977

Assessment of workload in the microbiology laboratory.

Workload measurement is necessary for laboratory management and planning. Adaptation of the College of American Pathologists' scheme to the requirements of a large clinical microbiology laboratory is described. Our method of applying basic work values is simpler and the calculation of workload is easily adapted to take account of alterations in laboratory method. The resulting system of workload measurement can be instituted without undue effort.

Australia↗

PubMed1986

Faculty workload: myths and realities.

This survey was done to determine the current workload policies and practices in collegiate schools of nursing. A 40-item questionnaire was mailed to all schools holding membership in the American Association of Colleges of Nursing. Seventy-two percent of the schools responded. Analysis of the data shows that quantifiable factors which relate directly to teaching are of considerable importance to deans in determining faculty workload while less quantifiable factors such as student advisement, research, publication and involvement in direct client care are of little or no importance in determining workload.

Education, Nursing, Baccalaureate↗

PubMedDate not supplied

Satisfaction with nursing workload systems: report of a survey of Canadian hospitals. Part A.

Senior nursing executives from a representative sample of Canadian hospitals were surveyed on their attitudes and views of nursing workload measurement systems. In terms of a profile of users and their satisfaction, the survey found that about 50% of hospitals were using a system, and that among those using a system, 70% used information from the system frequently or all the time. The senior nurse respondents were generally satisfied with their current systems; slightly lower levels of satisfaction were reported for staff nurses, with the most common objection being the perception that the systems do not reflect true workload. A subsequent article--Part B--explores senior nurse executives' needs and expectations for nursing workload systems.

Canada↗

PubMedDate not supplied

Brief report: emergency department workload described.

A review of workload in the ED setting shows trauma still account for the majority of patients, but that non-trauma emergencies nonetheless comprise a sizable proportion (45.2%) of the total workload. Resuscitation patients account for 10.1% of cases and overall 17.3% of patients require admission. Recalls are a very small and decreasing proportion of total workload.

Diagnosis-Related Groups↗

PubMed1987

Potentiation of right ventricular function at a reduced workload: a potential pitfall in assessing right ventricular function by exercise radionuclide ventriculography.

Right ventricular ejection fraction (RVEF) determinations at rest (R) and exercise (E) are a means of demonstrating exercise-induced RV dysfunction. Not all patients are able to maintain peak (P) cardiac workloads during a gated RVEF study or, if a first-pass study is performed, for multiple acquisitions. Reductions from P cardiac workloads have been shown to potentiate LV function; however, the effect on RVEF has not been studied. Supine exercise radionuclide ventriculography was performed on 26 patients: nine normal subjects and 17 patients with coronary artery disease (CAD) (greater than 50% stenosis of one or more coronary artery). Gated RVEF's were obtained from sequential left anterior oblique views obtained at R, P, and at a workload reduced approximately 40% from P work levels postpeak (PP). In normals, RVEFs were at R, P, and PP 27, 38 and 44. In CAD patient RVEFs were 31, 35 and 39, at R, P, and PP, respectively. The conclusions are that RVEF improves from rest to PP exercise levels in normal subjects and in CAD patients and from P to PP levels in normal subjects. This improvement must be considered in interpreting exercise RV studies to aid in the detection of patients with CAD.

Adult↗

PubMed1988

An analysis of the multiple approaches to measuring nursing workload.

This article reviews the multiple theoretical approaches to the measurement of nursing workload. A focus on current measurement issues provides direction for future research questions in this area. The underlying assumption is that workload measurement tools must focus on the complexity of the patient situation in determining nursing workload rather than on the traditional focus of tasks in which nurses are involved.

Humans↗

PubMed1987

Workload measurement of a clinical pharmacy residency program.

The types of activities performed by four clinical pharmacy residents and the amount of time spent on each activity were studied using a workload measurement system. A workload measurement system was developed to record all activities performed by pharmacy residents. The system included 50 activities that were grouped under 11 general headings; residents' time was divided among 10 major areas of service. The following data were collected and analyzed each month during the six-month study period: units of work, weighted units of work, total productive hours, total service hours, and productivity. The residents participated in 39 of 50 clinical pharmacy activities. Activities performed most frequently included nursing-home-care-unit drug reviews, drug monitoring, and rounds. The most time-consuming activities were clinical education, administration, and drug-use review. Productivity ranged from 80 to 115% and was influenced by residents' assigned rotations. A workload measurement system for quantifying the time spent by residents performing various clinical pharmacy activities provided objective data that were used to restructure a clinical pharmacy residency program.

California↗

PubMed1986

A health professions faculty workload plan for a liberal arts setting.

This case study describes an approach to planning the workload and expenditure of allied health faculty effort. The plan is based upon a review of the literature, a survey of other schools in similar settings, and faculty negotiation. It meets the need for faculty accountability, congruence between faculty workloads and institutional goals, faculty staffing determinations, and a means to compare nursing and allied health faculty workloads with those of more traditional liberal arts faculty. The plan may serve as a model for other health professions academic units.

Faculty↗

PubMed1985

Assessment of methods for assigning treadmill exercise workloads for lean and obese women.

The use of relative oxygen consumption (% VO2 max) to equate workloads between trained and untrained subjects is considered appropriate. Whether this method (% VO2 max) is correct when testing lean versus obese subjects has not been studied. Using three experimental sessions separated by at least one week we studied seven obese, nondiabetic women weighting 140 +/- 21 kg (mean +/- s.d.) and 10 lean women of similar age weighing 51 +/- 5 kg during treadmill walking. Body fat determined by hydrostatic weighing was 50 +/- 7 and 23 +/- 7 percent in obese and lean groups, respectively (P less than 0.05). Absolute maximal VO2 (VO2 max) in obese women (3.18 +/- 0.28 l/min) significantly exceeded VO2 max for lean women (2.45 +/- 0.31 l/min, P less than 0.05). However, in obese women VO2 max relative to total body weight (TBW) was lower (P less than 0.05) while VO2 max relative to fat-free weight (FFW) was similar to corresponding values for lean women. Submaximal treadmill exercise at 75m/min with 0, 5 and 10 percent inclines resulted in higher VO2 (l/min) and heart rate (HR) in the obese group (P less than 0.05). At each incline VO2 relative to BW was significantly lower in the obese (P less than 0.05) yet significantly higher when expressed relative to FFW (P less than 0.05). The relationship between HR and %VO2 max was similar for lean and obese. Ten minutes of walking at 70% VO2 max resulted in no significant differences between the groups in the 10 min values for HR, total work done, rise in rectal temperature, plasma lactic acid, perceived exertion and oxygen consumption relative to FFW. We conclude that either fixed absolute workloads or fixed oxygen consumption (absolute or relative to BW or FFW) are inappropriate methods for equating workloads when lean and obese subjects are compared. Relative VO2 accurately defines physiologically comparable exercise intensities for these groups and this should be the method of preference when studies are designed to investigate metabolic, endocrine or cardiovascular similarities and/or differences between these groups.

Adult↗

PubMed1985

Study of trainer/trainee workload with special reference to the care of the elderly.

A study of the workload of trainers and their trainees in general practice, was undertaken throughout East Anglia. Thirty trainer/trainee pairs returned data over a two-week period and follow-up information was obtained from five pairs, eight months later. A simple encounter form was used.Trainee workloads were found to be similar to those of earlier studies, though there was considerable variation between the workloads. Trainees had little experience with elderly patients, and there was a lack of teamwork between members of the practices in providing care for the elderly.

Efficiency↗

PubMed1985

Documenting workload to better integrate clinical and distributive services.

Use of workload and work-flow documentation in two pharmacy satellites to evaluate pharmacists' productivity is described. Workload was evaluated during 14 consecutive days in May 1983 and 7 consecutive days in May 1984. All pharmacists and technicians working in the satellites recorded times for their activities on a form that listed every possible activity; interruptions such as answering the telephone, responding to walking requests, replacing stock, and lunches and break times were also recorded. Concurrently, the clinical coordinator observed and evaluated work performed for four-hour time blocks at least once each day. Analysis of workload and work-flow information identified problems with scheduling, priorities, interruptions, and pharmacists' knowledge of clinical pharmacy practice. Based on these observations, the following changes were implemented: pharmacists were scheduled to work either inside or outside the satellites for two-week or one-month time periods, priorities were assigned to certain tasks performed inside or outside the satellites, job assignments were made based on the pharmacist's capabilities and the needs of the patient-care areas, a form for documenting potential problem orders was created, and pharmacists were evaluated monthly and given one-on-one instruction by the clinical coordinator. Documentation of time use identified problems and led to changes in assignments that better integrated clinical, educational, and distributive responsibilities for the purpose of providing more efficient and effective services.

Appointments and Schedules↗

PubMed1979

Measurement and scaling of workload in complex performance.

Two groups of paid male volunteers (Groups I, N = 51, tested with identical schedules on two successive days; Group II, N = 43, tested on one day only) performed over nine intervals on various combinations of the six tasks of the CAMI Multiple Task Performance Battery. Two of the tasks involved monitoring static (lights) and dynamic (meters) processes, and four more-active tasks involved mental arithmetic, elementary problem solving, pattern identification, two-dimensional compensatory tracking. Five of the nine intervals provided different complex tasks consisting of concurrent monitoring tasks and two of the active tasks. Other trials provided data on the single active tasks as well as the combined monitoring tasks. The results indicated that all performance measures--a total of 12 for the six tasks--varied significantly as a function of the different task-combination conditions. A standard psychological scaling technique (Thurstone Case V) was applied to the monitoring data (response times for green and red lights, and for meter monitoring) to develop an index of workload for the five complex task combinations. Since better performance was presumed to indicate a lower workload, workload was inferred to increase as performance declined across conditions. The best performances, which were assigned scale values of 0, were found to be associated with single-task performances, as expected. Scale values for the complex task-combination conditions were found to be consistent between groups and between the two days of testing of Group I (r's of 0.947 to 0.993). Although the scale values are specific to the task and task-combination conditions employed, the scaling-procedure application shows promise for cases in which quantitative measures of performance can be acquired with moderately large samples of subjects (N's greater than 50).

Adolescent↗

PubMed1978

Stress and workload in pilots.

Several studies have highlighted the increase in physiological activity which occurs in pilots during flight and especially during takeoffs and landings. For example, it has been clearly demonstrated that pilots' heart rates increase during the landing approach to reach a peak at or just before touchdown. These changes have been attributed to workload and to psychological or emotional stress. This paper examines a number of test pilots' heart rate responses recorded during various flight trials involving different types of aircraft. Examples include ramp takeoffs in a VTOL fighter, automatic landings in fog, supersonic flight through monsoon rain, and a sortie in which the pilot developed acute appendicitis. It is concluded that heart rate responses in experienced pilots are influenced almost entirely by workload-related factors and not by emotional stressors, such as risk and anxiety. Because of the emotional overtones of the word "stress," it is suggested that the term workload should be used when referring to the reason for increased cardiovascular activity of pilots.

Adaptation, Physiological↗

PubMed1978

Inflight measurement of pilot workload: a panel discussion.

A group of U.S. scientists engaged in inflight measurements of pilot workload discussed the problems and aspects of workload; the techniques used for inflight measurements; the various workload models, such as design-oriented, operational, psychological, and physiological concepts; different experimental approaches; and experiences, results and further plans, during the 48th Annual Scientific Meeting of the Aerospace Medical Association in Las Vegas, Nv, on May 10, 1977. The contributions by the chairman and the five panel members are summarized.

Aerospace Medicine↗