Some techniques for the analysis of work sampling data

More physicians in public health: Less public health work?

Aim: The object was to assess changes in work priorities in local public health medicine in Norway over the period from 1994 to 1999. Methods: Two cross-sectional studies were undertaken of physicians working in local public health medicine in all Norwegian municipalities, using a postal questionnaire. Results: Half of the physicians working in public health in 1999 were recruited after 1994. Although the number of physicians working in public health increased from 505 in 1994 to 555 in 1999 (10%) an estimation of the total weekly hours worked decreased by 3.7% from 8,715 hours in 1994 to 8,386 hours in 1999. The vast majority of physicians worked in combined posts (87%), and they reduced their engagement in public health by 2.6 hours on average from 1994 to 1999. The reduction depended on remuneration model, speciality in community medicine, and municipality size. Conclusions: Local public health in Norway was under pressure in the 1990s. For public health physicians, preventive medicine lost out to clinical work. No promising signals of change in the professional or political framework or in incentives for public health work are seen.

Impact of computerized information systems on workload in operating room and intensive care unit

The number of operating rooms and intensive care departments equipped with a clinical information system (CIS) is rapidly expanding. Amongst the putative advantages of such an installation, reduction in workload for the clinician is one of the most appealing. The scarce studies looking at workload variations associated with the implementation of a CIS, only focus on direct workload discarding indirect changes in workload. Descriptions of the various methods to quantify workload are provided. The hypothesis that a third generation CIS can reduce documentation time for ICU nurses and increase time they spend on patient care, is supported by recent literature. Though it seems obvious to extrapolate these advantages of a CIS to the anesthesiology department or physicians in the intensive care, studies examining this assumption are scarce.

Effects of computer-based prescribing on pharmacist work patterns

OBJECTIVE

To measure the effect of computer-based outpatient prescription writing by internal medicine physicians on pharmacist work patterns.

DESIGN

Work sampling at a hospital-based outpatient pharmacy. Data were collected from pharmacists wearing silent, random-signal generators before and after the implementation of computer-based prescribing.

MEASUREMENTS

The type of work performed by pharmacists (activity), the reason for their work (function), and the people they contacted (contact) were measured.

RESULTS

Total staff hours and prescriptions handled were similar before and after computer-based prescribing. Pharmacists recorded 4,687 observations before and 4,735 observations after implementation of computer-based outpatient prescription writing. After implementation, pharmacists spent 12.9 percent more time correcting prescription problems, had 3.9 percent less idle time, and spent 2.2 percent less time in discussions with others. Pharmacists also spent 34.0 percent less time filling prescriptions, 45.8 percent more time in problem-solving activities involving prescriptions, and 3.4 percent less time providing advice. Over 80 percent of pharmacist time was spent working alone both before and after computer-based outpatient prescription writing.

CONCLUSION

Computer-based prescribing results in major changes in the type of work done by hospital-based outpatient pharmacists and in the reason for their work and small changes in the people contacted during their work.