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A prospective observational study in the Intensive Care Unit and the Medium Care Unit in a university hospital in Amsterdam. Recent studies show that administrative tasks occupy more than 30% of the workload. One-third of these administrative tasks is unrelated to care. The administrative workload of physicians and nurses will be observed and quantified using two different methods. The amount of time physicians and nurses are logged on into the patient data management system (PDMS) will be measured and the time spent on different work tasks will be monitored with a work sampling method. Two different patient data management systems will be compared.
In recent years, regulatory authorities request a growing number of protocols and checklists to improve healthcare. Though the intention is to prevent medical mistakes and to improve patient care, these demands might result in an increased administrative workload for physicians and nurses. Recent studies show that administrative tasks and documentation occupy more than thirty percent of the workload of physicians, of which one-third is unrelated to care. This time spent on administration could lower the amount of time spent with the patient and the patient's family. In the Intensive Care Unit and the Medium Care Unit, most of the administrative tasks are executed within the patient data management system. The way an electronic patient data management system is set up could impact the administrative workload for physicians and nurses. A prospective observational study at the department of Intensive and Medium Care of the University medical centre will be performed with the aim to quantify the time spent on direct patient care versus administrative work. Two different patient data management systems will be compared at different points in time. The Nursing Activity Score and other patient characteristics will be registered for all the admitted patients during the two study periods.
The administrative workload of physicians and nurses will be measured before and after the implementation of a new patient data management system, using the following methods:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients admitted during measurement 1 | All patients admitted to the Intensive Care and Medium Care Unit during a two-week study period before the implementation of a new electronic patient data management system | ||
| Patients admitted during measurement 2 | All patients admitted to the Intensive Care and Medium Care Unit during a two-week study period after the implementation of a new electronic patient data management system |
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| Measure | Description | Time Frame |
|---|---|---|
| Login time in the PDMS per hour for nurses | The amount of time being logged on to the PDMS per hour will be calculated for different shifts | 24 hours a day |
| Login time in the PDMS per hour for doctors | The amount of time being logged on to the PDMS per hour will be calculated for different shifts | 24 hours a day |
| Amount of time spent on administrative work and documentation per shift for nurses | The amount of time spent on administrative tasks and documentation during dayshifts measured with a work sampling methode | 9 hours a day |
| Amount of time spent on administrative work and documentation per shift for doctors | The amount of time spent on administrative tasks and documentation during dayshifts measured with a work sampling methode | 9 hours a day |
| Measure | Description | Time Frame |
|---|---|---|
| Amount of time spent on direct patient care per shift for nurses | The amount of time spent on direct care during dayshifts measured with a work sampling methode | 9 hours a day |
| Amount of time spent on direct patient care per shift for doctors |
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Inclusion Criteria:
Exclusion Criteria:
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All patients admitted to the Intensive Care Unit during one of the two study periods
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jantine G Röttgering, Bsc | Contact | +31204443697 | j.rottgering@vumc.nl | |
| Angelique ME Spoelstra - de Man, MD PhD | Contact | +31204443697 | am.spoelstra@vumc.nl |
| Name | Affiliation | Role |
|---|---|---|
| Angelique ME Spoelstra - de Man, MD PhD | Amsterdam UMC, location VUmc | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| VUMedicalCentre | Recruiting | Amsterdam | North Holland | 1007 MB | Netherlands |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26282253 | Background | Li L, Hains I, Hordern T, Milliss D, Raper R, Westbrook J. What do ICU doctors do? A multisite time and motion study of the clinical work patterns of registrars. Crit Care Resusc. 2015 Sep;17(3):159-66. | |
| 26484461 | Background | Armstrong E, de Waard MC, de Grooth HJ, Heymans MW, Reis Miranda D, Girbes AR, Spijkstra JJ. Using Nursing Activities Score to Assess Nursing Workload on a Medium Care Unit. Anesth Analg. 2015 Nov;121(5):1274-80. doi: 10.1213/ANE.0000000000000968. |
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| ID | Term |
|---|---|
| D016638 | Critical Illness |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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The amount of time spent on direct care during dayshifts measured with a work sampling methode
| 9 hours a day |
| 19449613 | Background | Bosman RJ. Impact of computerized information systems on workload in operating room and intensive care unit. Best Pract Res Clin Anaesthesiol. 2009 Mar;23(1):15-26. doi: 10.1016/j.bpa.2008.10.001. |
| 9300013 | Background | Urden LD, Roode JI. Work sampling. A decision-making tool for determining resources and work redesign. J Nurs Adm. 1997 Sep;27(9):34-41. doi: 10.1097/00005110-199709000-00009. |
| 12603719 | Background | Pelletier D, Duffield C. Work sampling: valuable methodology to define nursing practice patterns. Nurs Health Sci. 2003 Mar;5(1):31-8. doi: 10.1046/j.1442-2018.2003.00132.x. |
| 9260381 | Background | Marasovic C, Kenney C, Elliott D, Sindhusake D. A comparison of nursing activities associated with manual and automated documentation in an Australian intensive care unit. Comput Nurs. 1997 Jul-Aug;15(4):205-11. |