Administrative Workload in the Intensive Care Unit

Study Overview
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Brief Summary
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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.

Detailed Description
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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: Login time in the electronic patient data management system during fourteen consecutive days in the Intensive Care Unit and the Medium Care Unit Timing of activities of physicians and nurses with a work sampling method during five consecutive day shifts in the Intensive Care Unit

Official Title
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Administrative Workload in the Intensive Care Unit (AWIC Study)

Conditions
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Critical Illness

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Admission to the Intensive Care Unit during one of the two study periods Exclusion Criteria: Not applicable
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients admitted during measurement 1<br>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<br>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 | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | 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 | 

Secondary Outcome Measures

| Outcome Measure | 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 | The amount of time spent on direct care during dayshifts measured with a work sampling methode | 9 hours a day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Administrative workload, Patient data management system, Intensive Care Unit, Work sampling method, Nursing Activity Score