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Managing time: the effects of personal goal setting on resource allocation strategy and task performance.

One key to understanding motivated behavior is examining the behavior of individuals as they work on multiple tasks under a time constraint. This article is an exploration of the influence of self-set goals on subsequent resource allocation to different tasks. Participants were given a variety of tasks from which they were to choose how to allocate their time and effort. Results indicated that the use of self-set goals structured the work pattern, with less switching between tasks relative to the work pattern of a group of participants who did not set goals. In addition, those who set goals reported less task-related cognitive interference, indicating that they were not as distracted while they worked. Participants who did not set goals, however, performed at a higher level on some of the tasks. It is suggested that self-set goals may often be chosen at an easily attainable level, creating a structured and focused work environment but not necessarily eliciting the motivational properties typically associated with goal setting.

Female↗

Clinical nurse specialist care managers' time commitments in a disease-management program for bipolar disorder.

OBJECTIVES: As part of a cost-effectiveness analysis for Department of Veterans Affairs Cooperative Studies Program #430, 'Reducing the Efficacy-Effectiveness Gap in Bipolar Disorder,' we conducted a time and motion study to quantify the time psychiatric clinical nurse specialist (CNS) care managers spent providing care for patients. METHODS: Clinical nurse specialist care managers completed activity logs in which they recorded time spent implementing the Bipolar Disorders Program (BDP) during a 1-week period in spring, summer, fall and winter over a 1-year period when caseloads were at steady state. Mean service time was estimated by use of univariate analysis of means and by multivariable regression analysis. RESULTS: On average CNS care managers spent 40% of their clinical time in activities that typically are reimbursed (e.g. clinic visits) and spent the remaining 60% of their time in activities that are typically unreimbursed. Total clinic time increased as the number of visits per day increased; however, this increase got smaller with each additional visit per day. CONCLUSIONS: As with other chronic illness management programs, CNS care managers expend a substantial portion of their clinical effort for the BDP in activities that are typically unreimbursed. Their activities have a fixed component per day as well as a component that systematically varies with the number of visits per day. These findings should be considered when costing out and disseminating psychiatric and other medical chronic illness management programs.

Bipolar Disorder↗

Microfiche vs. computerized Poisindex: the impact on time management.

A prospective study was conducted to compare access-to-information times using Poisindex on microfiche versus the computerized version. A time study was conducted in 2 separate phases in the Pittsburgh Poison Center by professional time management engineers who observed certified poison information specialists. The microfiche phase was completed as a portion of a more extensive time management study, and the phase to evaluate the computerized version was completed 9 months after the system had been implemented to insure standardized competency. Access time was defined as the length of time required for the initial information to appear on either the microfiche viewer or the CRT. The average access time for microfiche use was 37.2 sec compared to 18.0 sec for the computerized version, an improvement of 106%. Based upon an annual volume of approximately 40,000 cases, the 19.2 sec savings in access time results in a time savings of 213 hours per year. To generate time savings equivalent to a 0.5 FTE position, a reduction of 1.47 min/call in the overall processing time is necessary. However, the time savings may improve patient care through easier and more extensive access to information and may allow more time for thorough documentation.

Information Systems↗

Teaching mentally retarded adults to time-manage in a vocational setting.

Three retarded adults who had minimal ability to tell time were trained to "time-manage." Each was given a card with clock face representations on which the hands of the clock were drawn, representing each trainee's assigned lunch and break times. Instruction was given before work to perform each of the required behaviors when the "real" clock matched the clock faces. Praise was given following correct responses, and reprimands, instruction, and, in some instances, delay or omission of the scheduled activity followed incorrect responses. Pre-instruction and instructional feedback were then sequentially withdrawn. Results indicated that the package consisting of pre-instruction, instructional feedback, and picture cues was effective in producing independent time management responding. When the first two components were withdrawn, two trainees maintained high levels of correct responding. Correct responding decreased for one trainee when pre-instruction was withdrawn. Reintroduction and subsequent withdrawal of the components resulted in maintenance by this trainee. Little improvement in time-telling ability resulted.

Adult↗

A computerized faculty time-management system in an academic family medicine department.

The authors describe the development, implementation, and evaluation of a computerized faculty time-management system (FTMS) in the Department of Family Medicine at the University of North Carolina-Chapel Hill. The FTMS is presented as an integrated set of computerized spreadsheets used annually to allocate faculty time across all mission activities of the department. It was first implemented in 1996 and has been continuously developed since then. An iterative approach has been used to gain consensus among faculty about time resources needed for various tasks of all missions of the department. These time-resource assumptions are used in the computerized system. Faculty time is allocated annually by the department vice chair in negotiation with individual faculty, making sure that the activities planned do not exceed the work time each faculty member has available for the year. During this process, faculty preferences are balanced against department aggregate needs to meet mission commitments and obligations. The authors describe how the computerized FTMS is used for faculty time management and career development, department planning, budget planning, clinical scheduling, and mission cost accounting. They also describe barriers and potential abuses and the challenge of building an organizational culture willing to discuss faculty time openly and committed to developing a system perceived as fair and accurate. The spreadsheet file is available free from the authors for use in other departments.

Attitude↗

Multidetector-row helical CT: analysis of time management and workflow.

The purpose of this study was to evaluate time management and workflow for multidetector-row helical CT (MDCT). Time for patient and data handling of at total of 580 patients were evaluated at two different time periods (December 1999, August 2000), each for the following baseline measurements: (a) change of clothes/instruction; (b) patient placement on the CT table/i.v. catheter; (c) CT planning and programming; (d) CT data acquisition; (e) CT data reconstruction; (f) CT data storage/printing. All imaging was performed on a Somatom Volume Zoom (Siemens, Erlangen, Germany). Time measurements summarized for different CT protocols revealed the following: (a) 5:01 min (+/- 2.06 min); (b) 4:36 min (+/- 2.43 min); (c) 4:11 min (+/- 2.55 min); (d) 0:43 min (+/- 0.15 min); (e) 6:59 min (+/- 2.39 min); (f) 09:51 min (+/- 3.51 min). Planning and programming was most time-consuming for CT angiography, whereas chest and abdominal CT needed only 3:26 and 3:30 min, respectively. Reconstruction time was highest for HRCT (9:22 min) and CTA (9:03 min). Data storage/printing was most time-consuming for HRCT (13:02 min), followed by combined neck-chest-abdomen examinations (12:19 min). Comparing the two time periods, during which a software update was performed, a mean time reduction of 4:31 min per patient (15%, p<0.001) was achieved. Whereas CT data acquisition time is no longer a problem with MDCT, patient management, data reconstruction, and data storage are the most time-consuming parts. Well-trained technicians, state-of-the-art workstations, and fast networking are the most important factors to improve workflow.

Efficiency, Organizational↗

Time-management study of trauma resuscitation.

A prospective time-management analysis of trauma resuscitation (TR) of 431 patients arriving at a university trauma center documents timing and organization. Severity of injury, patient age, and potential airway injury were significant factors increasing the duration of TR up to a certain time (36 minutes). Moderately injured patients required less time (under 25 minutes). Patients needing emergent operations spent a minimal amount of time (20 minutes) in TR. Potential injuries involving the airway or cervical spine, or shock, added minutes. A review of the timing and organization of TR suggests the need for improvement in airway assessment and management. Patients with certain mechanisms of injury and elderly patients with blunt injuries required additional time in TR. With surgery faculty supervision and senior resident attendance, the month of resident experience had no effect on TR times. A timely and organized TR is critical to trauma care. TR times should be documented for quality assurance and ongoing review.

Adolescent↗