How Demanding Is Healthcare Work? A Meta-Analytic Review of TLX Scores.

Abstract

This study establishes how demanding healthcare work is experienced to be and whether nurses and physicians experience different levels of workload. A meta-analytic review was conducted of 87 studies that reported Task Load Index (TLX) scores for healthcare work. Of these studies, 37 were conducted in real-life settings and 50 in lab settings without real patients. In real-life settings, clinicians experienced a workload with a mean TLX of 49 (on a 0-100 scale). Divided onto staff groups, the mean TLX for nurses was 63, which was significantly higher than the mean of 40 for physicians. Among the six TLX subscales, the main contributors to workload were mental demand, temporal demand, and effort. They were higher than physical demand and frustration. The clinicians experienced their performance - the last subscale - as closer to poor than good in 38% of the studies conducted in real-life settings. The difference between nurses and physicians was consistent across all subscales, except mental demand. Finally, it is methodologically important that TLX scores appeared not to transfer directly from lab to real-life settings. To reduce the risk of errors and burnout, new healthcare procedures and technologies should be evaluated for their impact on workload.