Time Study Research Articles

Documentation and Nurses' Time Caring for Patients.

The nursing shortage is growing to dangerous levels and is impacting public safety. The health system is anticipated to need 1.1 million additional nurses by 2022. One-third of the nursing workforce will retire in the next 10 to 15 years. Research has shown that having more nurses to care for patients decreases patient complications and even death.1 Required nursing documentation has risen exponentially, with charting taking more nursing time than direct patient care. Unnecessary documentation is dangerous. Incentivizing hospitals to reduce charting waste will save lives and help nurses stay at the bedside.After being away from direct patient care for 10 years, I returned to the intensive care unit as a bedside nurse during the COVID-19 pandemic. I was overwhelmed by the sheer volume of required documentation fields. The research supports my observation. In 2017, a time-motion study found that 33% of the nurses’ shift was spent interacting with technology.2 In comparison, time spent with the patients accounted for only 22% of a 12-hour shift. No one goes into nursing to spend endless hours charting.The documentation requirements have outpaced the nursing profession’s value of integrity. For example, 5 nursing interventions were to be documented every 2 hours, creating an impossible reality. Many of the hundreds of fields were not meaningful or even used for data analysis or research. The waste was astounding when critically ill patients needed urgent care.We must challenge the longstanding nursing mantra “if care was not charted, it was not done.” Health care has reached a tipping point in quality improvement initiatives. The literature demonstrates that lower patient-to-nurse ratios improve patient care. The charting volume rises with every new clinical update, yet there is a reluctance to remove any documentation. I think hospitals’ fear of lawsuits and reduced reimbursement have created this reluctance.Highly reliable organizations standardize processes across hospital systems. Although this approach improves patient care, it complicates the process of minimizing required documentation. Filling out all the mandatory fields to document the prevention of hospital-acquired conditions, accreditation requirements, and specialty certifications such as stroke prevents nurses from directly caring for patients.Solutions to this problem are multifactorial, and innovative leadership strategies are needed for a culture change. The concept of exnovation needs a role in our health care system. Exnovation stops inefficient processes that are no longer working by removing waste.3 Reducing nursing documentation time should be a top goal in the United States to ensure patient safety. Organizations must produce outcomes highlighting strategies that keep nurses in direct patient care.4Additional strategies include block charting, especially for drip titration, and limiting new checklists. Block charting is supported by regulatory bodies such as The Joint Commission and facilitates easier charting while still providing proper patient care.5 Bedside nurses can collaborate with informatics and quality experts to create protocols that meet standards of care and save precious nursing time. The Institute for Healthcare Improvement has acknowledged that while documentation is supposed to improve patient safety, burdensome documentation has the opposite effect.4 Just because a new tool or checklist worked in one setting, it is not universally meaningful in all environments. Careful vetting of tools with an easy process to remove antiquated documentation fields is called for.A Gallup poll has rated nurses as the most trusted profession for the past 20 years.6 Nurses need the public’s support to get us back to patient care. We need a culture change that rewards organizations that increase nurses’ time caring for patients.

Performance optimization of pillow sheet set sewing assembly line by SAM analysis and lean manufacturing techniques of method study & work measurement

This research was conducted to enhance the productivity of the targeted sewing line at the ABC textile company. The existing SAMs, the capacity of the sewing line for various operations, and several required machines were collected. Moreover, the obtained figures were observed and analyzed by using time study and motion study, and certain improvements were made at the sewing line. Results indicated that SAMs for operations A and B were minimized by -13.64% and -14.54% respectively; whereas, SAM for operation C was increased by 16.67%. Machine requirement for operation C was increased by 100%; moreover, the capacity for operations A, B, and C was increased by 12%, 12.69%, and 40% respectively. When it is to production activities, the little improvements play a significant role in boosting the productivity of the production system. Optimal allocation of human resources, machines, and time are the benefits of line balancing. This can be made possible with the application of the line-balancing framework. With every passing day, the nature and type of article vary at the sewing line thus it is highly needed for the company to get the model developed for an automated line balancing application. Moreover, this work can be extended by the development of a line-balancing framework considering the nature of production.

Workload Measurement Models In Hospital: Literature Review

Nurse workload is all activities, activities, actions taken by a nurse while the nurse is on duty in a hospital service unit. The purpose of this literature is to identify which method is more effective and efficient to measure the workload of nurses. Article review was carried out through several electronic databases including Google Scholar, Google Scholar, Pubmed with the keyword "nurse workload", inclusion criteria included articles published between 2015 and 2022, full text in both English and Indonesian. A literature search found 72 articles, then 51 articles were removed according to the exclusion criteria, so that only 8 articles were identified. The results of the literature study show that the WISN method is most often used to determine the workload of health workers, not only nurses. made by several people including Richa Noprianty et al, 2020 with the topic Analysis of Nurses Staff Needs Using Workload Indicate Staff Need in Pediatric Ward with Time Motion Study, Taufique Joarder et al, 2020 with the topic Assessment of staffing needs for physicians and nurses at Upazila health complexes in Bangladesh using WHO workload indicators of staffing need (WISN) method and Angélica Araújo de Menezes et al, 2022 with the topic Application of the workload indicators of staffing need method to calculate the size of the medical staff at a maternity hospital in the state of Bahia, Brazil. But beyond that, it doesn't mean that other methods are ineffective, because each method has its own advantages and disadvantages, it's up to the researchers or the hospital to choose which method to use.

Feasibility, usability and acceptability of a novel digital hybrid-system for reporting of routine maternal health information in Southern Tanzania: A mixed-methods study.

Health information systems are important for health planning and progress monitoring. Still, data from health facilities are often of limited quality in Low-and-Middle-Income Countries. Quality deficits are partially rooted in the fact that paper-based documentation is still the norm at facility level, leading to mistakes in summarizing and manual copying. Digitization of data at facility level would allow automatization of these procedural steps. Here we aimed to evaluate the feasibility, usability and acceptability of a scanning innovation called Smart Paper Technology for digital data processing. We used a mixed-methods design to understand users' engagement with Smart Paper Technology and identify potential positive and negative effects of this innovation in three health facilities in Southern Tanzania. Eight focus group discussions and 11 in-depth interviews with users were conducted. We quantified time used by health care providers for documentation and patient care using time-motion methods. Thematic analysis was used to analyze qualitative data. Descriptive statistics and multivariable linear models were generated to compare the difference before and after introduction and adjust for confounders. Health care providers and health care managers appreciated the forms' simple design features and perceived Smart Paper Technology as time-saving and easy to use. The time-motion study with 273.3 and 224.0 hours of observations before and after introduction of Smart Paper Technology, respectively, confirmed that working time spent on documentation did not increase (27.0% at baseline and 26.4% post-introduction; adjusted p = 0.763). Time spent on patient care was not negatively impacted (26.9% at baseline and 37.1% at post-intervention; adjusted p = 0.001). Health care providers described positive effects on their accountability for data and service provision relating to the fact that individually signed forms were filled. Health care providers perceived Smart Paper Technology as feasible, easy to integrate and acceptable in their setting, particularly as it did not add time to documentation.

There are just too many labours: productivity improvement in collecting waste at ASL

Research methodology One of the major reasons of layout-related difficulties faced by manufacturing industries is non-value-adding and redundant work. Plant layout study aims at economic production with larger volumes and variety as well. Method studies focus on the effectiveness with efficiency by a systematic critical scrutiny of work being done. The intention is to identify logical sequence of activities highlighting and eliminating the unnecessary mudas. Time and motion study is a combination of time study and motion study analysing and eliminating any unnecessary movement for productivity optimization of that job or process. Thus, through the elimination of unnecessary motions, times for performing the processes may be reduced and productivity increased. The intention is to subdivide the different operations of a job or process into measurable elements. Hence this case has been developed based on the primary data. The primary data was collected using Industrial Engineering Studies like layout study, method study and time and motion study. This case has been classroom tested with MBA students in their Lean Management Course. Case overview/synopsis Arin Synthetics Ltd. (ASL) though had installed modern machinery in its facility, process efficiency and optimization were a concern. Top Brass at ASL believed that ASL was overstaffed and its processes had creep as far as efficiency is concerned. This case focuses on ways to improve the process efficiency to rationalize the manpower at ASL. Presence in large growing global markets put cost pressure on ASL, thus mandating improvement in the efficiency of its processes through manpower rationalization. This case, therefore, discusses one of the highly staffed process of waste collection. Could ASL achieve reduction in the manpower in waste reduction without affecting the overall process? Was there a strategic mistake in the thought process of disposing of the waste generated by the manufacturing complex? Complexity academic level Operations management, Productivity and performance, Quality management, Lean management.

Investigating the provision, nature and associated costs of unfunded pharmacy services: A nationwide study.

There is increasing evidence of pharmacists providing free or partially subsidised patient-focused services in order to meet healthcare needs. Limited information exists about the types of unfunded services and their value. (1) Identify the types of unfunded services provided nationally in New Zealand (NZ) and (2) Determine the costs associated with service provision. A continuous observation time-motion study was conducted across New Zealand to characterise the provision of unfunded pharmacy services and the labour costs associated with their provision. The time-motion study spanned one business day (between seven to eight hours) in each participating pharmacy. The primary investigator (YA) spent one business day in each participating pharmacy (n=51) and recorded details about the patient-focused services that were provided. Details included the type of service provided, approximate duration of the service and out-of-pocket costs borne by the patient. A total of 660 observations of unfunded services were recorded across the 51 pharmacies where 360 observation hours were carried out. Twenty-three types of unfunded services were identified, where minor ailments accounted for over half of the total observations. Labour costs associated with service provision were variable. Pharmacies across New Zealand are providing patient-focused services for which no funding is being provided.

Uncovering and Visualizing Work Process Interruptions through Quantitative Workflow Analysis

Question: Continuous improvement requires visualizing process constraints which interrupt workflows. Production control from a management perspective often operates at lower levels of information granularity than required at operational levels to perform work without interruptions. How can workflow interruptions in plumbing work be analysed and explained? How can an analysis of workflow interruptions help to close the information granularity gap between operational and management levels? Purpose: The purpose of this paper is to evaluate methods for their fit in revealing and closing the information granularity gap between between operational and management levels. Research Method: The paper examines workflows of plumbing work from video footage. This video data is classified and analyzed for frequency, causes, and effects of work interruptions. Findings: Results indicate that value-supporting activities caused the largest proportion of interruptions. Moreover, the proportion of non-value-adding activities increases when durations of interruptions rise. Limitations: The analyzed and tested data includes one working day of one worker in one certain construction project, which limits the meaningfulness of these results and explanations. Implications: The conducted time-motion-study and its classified data set made it possible to develop an agent-based simulation model of construction workers behavior. Value for authors: This paper provides a framework to examine workflow interruptions in craft work so that the information gap between operational and management levels is closed. Keywords: continuous improvement, production control, time-motion study, workflow. Paper type: Full paper

The cost of implementing the Systems Analysis and Improvement Approach for a cluster randomized trial integrating HIV testing into family planning services in Mombasa County, Kenya

BackgroundAlthough HIV testing in family planning (FP) clinics is a promising approach for engaging women in HIV treatment and prevention services, HIV testing rates are low in FP clinics in Kenya. In 2018, a cluster randomized trial was implemented in Mombasa, Kenya applying the Systems Analysis and Improvement Approach (SAIA) to integrate HIV testing into FP services (1K24HD088229-01). We estimated the incremental costs and explored cost drivers of the FP HIV SAIA implementation in Mombasa, Kenya.MethodsWe conducted a costing evaluation from the payer perspective for the FP HIV SAIA randomized control trial. We identified relevant activities for the intervention including start-up, training, research and FP HIV SAIA. We estimated activity time burden using a time-and motion study. We derived unit costs through staff interviews and programmatic budgets. We present cost estimates for two different scenarios: as-implemented including research and projected costs for a Ministry of Health-supported intervention. All costs are reported in 2018 USD.ResultsFor an annual program output of 36,086 HIV tests administered to new FP clients, we estimated the total annual program cost to be $91,994 with an average cost per new FP client served of $2.55. Personnel and HIV rapid testing kits comprised 55% and 21% of programmatic costs, respectively. Assuming no changes to program outputs and with efficiency gains under the MOH scenario, the estimated cost per new FP client served decreased to $1.30 with a programmatic cost reduction of 49%.ConclusionFP HIV SAIA is a low-cost and flexible implementation strategy for facilitating integrated delivery of HIV testing alongside FP services. Although cost implications of the FP HIV SAIA intervention must continue to be evaluated over time, these findings provide context-specific cost data useful for budget planning and decision-making regarding intervention delivery and expansion.Trial registrationThe trial was registeredon December 15, 2016, with clinicaltrials.gov (NCT02994355).

Examining the Needs-Based Time Use of Chinese Nursing Assistants: A Time-Motion Study.

In light of the worldwide shortage of nurses and to maximize the effectiveness of the nursing care available, it is important to investigate the components of the care regularly provided by nursing assistants (NAs) to older adults. Well-organized allocation of NA care activities is directly linked to the quality of care provided to nursing home (NH) residents and their quality of life. However, relevant knowledge about the actual time allocation of NAs in this context is lacking, as previous related studies have focused only on the duration necessary for NAs to complete nursing activities. This study was designed to investigate the time allocation of NAs in completing job tasks necessary to meet the needs of residents in nursing care units at an NH in China. A time-motion method and nonparticipatory observations were used to collect data. Two postgraduate students observed 15 NAs' time expenditure and nursing content simultaneously during day shifts for 3 weeks as the NAs provided care to residents in four different nursing care levels. Data on nursing time and activity frequency were collected using a worklist based on the Zuluaga-Raysmith model. The 119.6 hours of observation included 8,907 discrete observed activities. In terms of the care provided to meet the needs of residents, the most time-consuming activities were physical health care (26.8%) and communication care (18.3%), followed by mental, emotional, social, and spiritual health care (14.1%) and protection and security care (12.6%). The higher the level of care, the higher the proportion of somatic nursing time and nursing activity frequency. However, the time and frequency of psychological and spiritual care showed an opposite trend. Because of their lack of formal nursing training and skills, NAs pay more attention to meeting the physiological needs of residents while ignoring their mental needs. Moreover, their effectiveness in providing spiritual care tends to be quite low. Furthermore, the NA nursing activity classification system based on the Zuluaga-Raysmith model developed in this study is applicable for designing nursing work tasks, organizing NH units, and improving the quality of life of residents, as this model accurately reflects the essence of NA work.

Optimization of Vaccination Clinics to Improve Staffing Decisions for COVID-19: A Time-Motion Study.

As the COVID-19 pandemic disturbed people's daily life for more than 2 years, many COVID-19 vaccines have been carried forward systematically to curb the transmission of the virus. However, high vaccination tasks bring great challenges to personnel allocation. We observed nine vaccination clinics in Huzhou and Shanghai and built a discrete-event simulation model to simulate the optimal staffing of vaccination clinics under 10 different scenarios. Based on the result of the simulations, we optimized the allocation of vaccination staff in different stages of epidemic development by province in China. The results showed that optimizing staffing could both boost service utilization and shorten the queuing time for vaccination recipients. Taking Jilin Province as an example, to increase the booster vaccination rate within 3 months, the number of vaccination staff members needed was 2028, with a continuous small-scale breakout and 2,416 under a stable epidemic situation. When there was a shortage of vaccination staff, the total number of vaccination clinic staff members needed could be significantly reduced by combining the preview and registration steps. This study provides theoretical support for the personnel arrangement of COVID-19 vaccinations of a booster dose by province and the assessment of current vaccination staff reserves.

The Hidden Burden of Equipment Failure in Endoscopy: Uncovered and Improved With Digital Technology.

Objective A growing and ageing population combined with severe disruptions across endoscopy services throughout the United Kingdom (UK) during the recent pandemic has accelerated the backlog of patients awaiting endoscopic procedures. This places increased pressure to improve service efficiencies in an attempt to reduce this growing burden. Moreover, beyond repair costs, the full impact of faulty endoscopes on services is not well documented. This study aimed to outline tasks performed to traditionally report a broken endoscope; measure the impact on staff time, efficiency costs and staff morale; and report outcomes of staff experience and productivity when replacing traditional reporting with a digital reporting tool. Methods This study was conducted over six months at three endoscopy units. Cognitive-task analysis (CTA) and a time-motion study (TMS) were performed to process map all traditional tasks when an endoscope breaks, and again after a digital reporting tool was implemented. Two staff surveys were conducted. Data was aggregated to determine the overall impact and model efficiency costs. Results With traditional processes, on average one faulty endoscope generated 54 tasks, consuming 8 hours 53 minutes of staff time or £325 in efficiency costs, with 60% of staff reporting a negative effect on morale. In comparison, digital reporting generated 41 tasks, consuming 4 hours 31 minutes of time or £147 in efficiency costs, resulting in £45,468 saved annually. Furthermore, 95% of staff said their morale improved, and environmentally all paper-based processes were removed. Conclusion This study demonstrated the immense hidden burden of faulty endoscopes. Given the current challenges to endoscopy recovery,digital reporting tools may present an attractive means to minimise disruption to endoscopy services driven through improved equipment maintenance.

Time allocated on different tasks among nurses in Bangladesh: An observational time–motion study

It is important to identify the time allocated by nurses for different tasks to improve the quality of nursing care and patient outcome. Hence, this time–motion study aimed to determine the time spent on specific activities and the factors contributing to the time allocated by nurses at public and private hospitals in Bangladesh. The data was collected from March to May 2021, and the nursing activities of 52 nurses at surgical wards were identified by observing them through day shifts (8:00am – 2:00pm) on weekdays. The proportions of time in 10 categories were calculated, and relationships of nurses' characteristics were examined. Nurses commonly spent their time on direct care (17.0%), followed by medication administration (15.3%), indirect care (14.2%), personal activities (12.3%), and documentation (11.1%). There was no significant relationship between the duration of providing direct and indirect care and medication administration as well as the characteristics of nurses (such as age, sex, and duration of working experience, educational background, and patient-to-nurse ratio). However, public and private hospitals significantly differed in terms of the proportion of time spent by nurses on documentation, administrative tasks, in-transit work, supervision/education, and social activities. Compared with some studies conducted in 2007, the time allocated on direct care has increased particularly in public hospitals; however, nurses also spend significant time on personal and social activities. There is a need to assess the time spent on nursing tasks and to facilitate a closer supervision to achieve efficient time management.

Evaluation of a Mobile Wound Care Device for Assessment of Wounds: A Time Motion Study

Background: Comprehensive wound assessments are critical in identifying potential complications that affect wound healing and determining appropriate interventions for the patient. A wound care device (WCD) comprising a mobile device integrated with multi-spectral sensors that can capture stereoscopic and thermal images was recently introduced. A trial was conducted to assess potential productivity gains of the device.Methods: A total of 30 inpatients who required wound care were recruited and assessed via a time motion study. For every patient recruited in this study, wound measurements and documentation steps were repeated twice for a total of 55 wounds, once using the WCD and the other using a conventional manual process, with the order of assessment determined using a random group assignment generator. A t-test was used for statistical analysis.Results: The use of the WCD had a mean process time 4.86 minutes shorter than the conventional manual process (P<0.001). This constituted an increase in productivity by 44% for wound measurement, photography, and documentation. With estimated time savings of 5 minutes per patient, this amounts to 6,631 hours per year or a total of 3.42 nursing full-time equivalent savings per year based on an estimated load of 218 patients per day requiring wound care at an acute care institution in Singapore.Conclusion: The adoption of a mobile WCD has potential to improve work productivity and result in full-time equivalent savings for wound care nurses. Most importantly, the WCD could provide clinically beneficial outcomes for the patient by enhancing the management and documentation of wound care.

Work time allocation at primary health care level in two regions of Albania.

Although well-performing workforce is essential to equitable and efficient health service delivery, few countries have systematically addressed performance improvements. How health workers use their work time and what tasks they accomplish is here an important starting point. Therefore, a time motion study was conducted to assess the work time allocation patterns of primary health care doctors and nurses in two regions of Albania. We used observation tool to record the time allocation along eight predefined main categories of activities. Conditional to presence at work, 48 health workers were continuously observed in early 2020 before start of the Covid-19 pandemic over five consecutive working days. The observed health workers spent 40.7% of their overall working time unproductively (36.8% on waiting for patients and 3.9% on breaks), 25.3% on service provision to users, 18.7% on administrative activities, 12.7% on outreach activities, 1.6% on continuous medical education and 1% on meetings. The study found variations in work time allocation patterns across cadres, with nurses spending more time unproductively, on administrative activities and on outreach and less on all other activities than doctors. Further, the work time allocation patterns were similar between urban and rural settings, except for nurses in rural settings spending less time than those in urban settings on administrative work. This study found that primary health care workers in Albania devote a substantial amount of work time to unproductive, service provision to users and administrative activities. Consequently, there is possibility for productivity, respectively efficiency gains in how health workers use their time.

Delegation of patient related tasks to allied health assistants: a time motion study

BackgroundAllied health assistants (AHAs) are support staff who complete patient and non-patient related tasks under the delegation of an allied health professional. Delegating patient related tasks to AHAs can benefit patients and allied health professionals. However, it is unclear whether the AHA workforce is utilised optimally in the provision of patient care. The purpose of this study was to determine the proportion of time AHAs spend on patient related tasks during their working day and any differences across level of AHA experience, clinical setting, and profession delegating the task.MethodsA time motion study was conducted using a self-report, task predominance work sampling method. AHAs were recruited from four publicly-funded health organisations in Victoria, Australia. AHAs worked with dietitians, occupational therapists, physiotherapists, podiatrists, social workers, speech pathologists, psychologists, and exercise physiologists. The primary outcome was quantity of time spent by AHAs on individual task-categories. Tasks were grouped into two main categories: patient or non-patient related activities. Data were collected from July 2020 to May 2021 using an activity capture proforma specifically designed for this study. Logistic mixed-models were used to investigate the extent to which level of experience, setting, and delegating profession were associated with time spent on patient related tasks.ResultsData from 51 AHAs showed that AHAs spent more time on patient related tasks (293 min/day, 64%) than non-patient related tasks (167 min/day, 36%). Time spent in community settings had lower odds of being delegated to patient related tasks than time in the acute hospital setting (OR 0.44, 95%CI 0.28 to 0.69, P < 0.001). Time delegated by exercise physiologists and dietitians was more likely to involve patient related tasks than time delegated by physiotherapists (exercise physiology: OR 3.77, 95% 1.90 to 7.70, P < 0.001; dietetics: OR 2.60, 95%CI 1.40 to 1.90, P = 0.003). Time delegated by other professions (e.g. podiatry, psychology) had lower odds of involving patient related tasks than physiotherapy (OR 0.37, 95%CI 0.16 to 0.85, P = 0.02).ConclusionAHAs may be underutilised in community settings, and by podiatrists and psychologists. These areas may be targeted to understand appropriateness of task delegation to optimise AHAs’ role in providing patient care.

Time Motion Studies for Conduct of Population Monitoring During Functional Radiological Exercises at Community Reception Centers.

The objectives of this study were to: validate current capacity estimates for radiological emergency response by collecting time motion observations from stations that would be used for screening and decontaminating populations, and use collected times to evaluate potential impact on current throughput calculations. Time observations were collected at 11 functional radiation exercises across the country and aggregated for analysis for population monitoring activities, including contamination screening, decontamination, and registration. Collected times were compared to published estimates in current planning guidance, and evaluated to determine the suitability of using exercise observations to estimate throughput capacity. 2532-time observations were collected from 11 functional exercises. Of those, 2380 were validated and used for analysis. Contamination screening times varied greatly from current guidance, ranging from 19% below to 267% above existing estimates. Measurements indicate that capacity to perform contamination screening is significantly overestimated when using current estimates of service times and calculations when compared to observed aggregate service times. Aggregate service time data presented in this study can be used to yield a more realistic estimate of capacity to respond to a radiation event.

Effect of Increased Interprofessional Familiarity on Team Performance, Communication, and Psychological Safety on Inpatient Medical Teams

In large academic centers, medical residents work on multiple clinical floors with transient interactions with nursing colleagues. Although teamwork is critical in delivering high-quality medical care, little research has evaluated the effect of interprofessional familiarity on inpatient team performance. To determine the effectiveness of increased familiarity between medical residents and nurses on team performance, psychological safety, and communication. A 12-month randomized clinical trial in an inpatient general medical service at a large academic medical center was completed from June 25, 2019, to June 24, 2020. Participants included 33 postgraduate year (PGY)-1 residents in an internal medicine residency program and 91 general medicine nurses. Fifteen PGY-1 residents were randomized to complete all 16 weeks of their general medicine inpatient time on 1 medical nursing floor (intervention group with 43 nurses). Eighteen PGY-1 residents completed 16 weeks on 4 different general medical floors as per usual care (control group with 48 nurses). The primary outcome was an assessment of team performance in physician-nurse simulation scenarios completed at 6 and 12 months. Interprofessional communication was assessed via a time-motion study of both work rounds and individual resident clinical work. Psychological safety and teamwork culture were assessed via surveys of both residents and nurses at multiple time points. Of the intervention and control PGY-1 residents, 8 of 15 (54%) and 8 of 18 (44%) were women, respectively. Of the nurses in the intervention and control groups with information available, 37 of 40 (93%) and 34 of 38 (90%) were women, respectively, and more than 70% had less than 10 years of clinical experience. There was no difference in overall team performance during the first simulation. At the 12-month simulation, the intervention teams received a higher mean overall score in leadership and management (mean [SD], 2.47 [0.53] vs 2.17 [0.39]; P = .045, Cohen d = 0.65) and on individually rated items were more likely to work as 1 unit (100% vs 62%; P = .003), negotiate with the patient (61% vs 10%; P = .001), support other team members (61% vs 24%; P = .02), and communicate as a team (56% vs 19%; P = .02). The intervention teams were more successful in achieving the correct simulation case outcome of negotiating a specific insulin dose with the patient (67% vs 14%; P = .001). Time-motion analysis noted intervention teams were more likely to have a nurse present on work rounds (47% vs 28%; P = .03). At 6 months, nurses in the intervention group were more likely to report their relationship with PGY-1 residents to be excellent to outstanding (74% vs 40%; P = .003), feel that the input of all clinical practitioners was valued (95% vs 53%; P < .001), and say that feedback between practitioners was delivered in a way to promote positive interactions (90% vs 60%; P = .003). These differences diminished at the 12-month survey. In this randomized clinical trial, increased familiarity between nurses and residents promoted more rapid improvement of nursing perception of team relationships and, over time, led to higher team performance on complex cognitive tasks in medical simulations. Medical centers should consider team familiarity as a potential metric to improve physician-nursing teamwork and patient care. ClinicalTrials.gov Identifier: NCT05213117.

The Purpose of Time-Motion Studies (TMSs) in Healthcare: A Literature Review

By utilizing time study methodologies, one can ascertain how long it takes a skilled person to complete a task with a specific level of quality. Time study aids in the selection of different job execution options as well asin the determination of the workforce required for a certain task, and thus assist in increasing manpower efficiency. It also aids in the acquisition of plants and machinery. By elaborating on the definition of "time-motion studies" (TMSs) as it is used in the biomedical literature and presenting justification based on full knowledge of that definition,this work aims to contribute to the standardization of TMSs. In TMSs, which is a type of quantitative data gathering, an outside observer records the motions and time necessary to complete an activity, together with an analysis aimed at increasing productivity.This papersuggests that, according to the researchers, the term is used to designate a range of investigations, the gathering and/or analysis of the length of one or more occurrences. A detailed analysis of all the available literature is done in this paper to get knowledge about TMS and its use in healthcare. Also, a comprehensive overview ofmany methodologies applied in works that are classed or referred to as TMSs is provided in this paper. Time motion investigations were first introduced in industrial engineering at the beginning of the twentieth century. Since then, they have been extensively employed by biological researchers, and because there is currently interest in parts of clinical workflow, they have attracted attention. However, combining the findings from different studies has proven challenging because there is a lot of variation in how techniques are used and reported. Although efforts have been made to uniformly publish these data and outcomes, there is still confusion about what TMSs are. A shared understanding of time and motion (TAM) research, as well as a proper acknowledgment of the various approaches it comprises, is a critical step toward standardization and validation. In this review paper literature analysis is done to discover what is known as TMSs to achieve the mentioned purpose.

A Time-Motion Analysis of An Urban Immunization Facility in The Konkan Region of India

Context/Background: Time motion studies involve the collection of data regarding the amount of time necessary to perform a specific movement or task by individuals or groups of people. Thus, hospital administrators can determine how much time is needed to execute that activity and whether the time is used efficiently and whether there is any possibility of improvement. Aims/Objectives: To study the operational efficiency of an immunization clinic attached to the urban health training centre. To assess the perception of patients regarding the health service delivery in the immunization OPD. Methodology: It was an observational study carried out in the immunization clinic of an urban health training center attached to a tertiary medical college, in the Konkan region of India for over 6 months. About 300 patients were included in the study. Results: According to 23.34% of study participants, the total time was too long. 24% of study participants were not satisfied with the total time taken while 48.33% of study participants were satisfied with the total time. Conclusions: Management of time at various levels of the healthcare system is a need for the hour and necessary remedial actions should be initiated for optimal functioning of the healthcare system.

Pengukuran Waktu Kerja Dengan Metode Time Motion Study Untuk Meningkatkan Produktivitas Kerja Produksi Greenware (Studi kasus : PT XYZ)

This study aims to determine the working time in order to increase productivity in greenware production in the formation section, the productivity of workers that will be calculated in this final project is the productivity of workers in the formation section in greenware production because the results of the production process every day are different and still exist,which has not reached its production target. The calculation of productivity is carried out using the time and study method, after obtaining the working time used to carry out the production process, then a new work method is applied to increase productivity results and a comparison is made before and after the implementation of the new work method, After applying the time motion study method to production Greenware in the formation section is known for the productivity results obtained, which are 121,350. After measuring working time using a time study and implementing the proposed improvement, the productivity results increased for the initial productivity results from 121.350 to 134.100, or an increase of 10.5%. Keywords: Working Time, Productivity,production targets, time and study, standard time.