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At least 19 recordsLinked to original sources
PubMed1993

What is a reasonable orthopaedic surgical workload? An analysis of elective and trauma workloads using two different complexity scoring systems.

A 1-year prospective study of all surgical activity was undertaken by the Orthopaedic Unit using two weighting systems for operative complexity: the Intermediate Equivalent (IE) and the Operative Complexity Score (OCS). The objectives were to define the difference between caseload and workload, and to formulate a reasonable workload for an operating session and a reasonable annual workload for a consultant team. In both elective and trauma surgery the BUPA complex, major+ and major operations represented 50 per cent of the caseload but accounted for approximately 68 per cent of the workload. The BUPA minor and intermediate procedures representing the remaining 50 per cent of the caseload accounted for only 32 per cent of the workload. The number of hours required to undertake all the complex, major+ and major operations was approximately twice that required for the number of minor and intermediate procedures. Despite the marked variation in case mix, the workload achieved by the six teams in the same number of sessions was remarkably similar. On the basis of two consultant and one registrar elective lists per week, a total of 705 IEs (1795 OCS units) could be undertaken by each team in 1 year. An average of 458 IEs (1086 OCS units) of trauma surgery were undertaken by each team. Caseload is a poor performance indicator of surgical activity. This study supports the concept of 3.5-4.0 IEs as reasonable workload for an orthopaedic elective operating session, and 900 IEs (2200 OCS units) as a reasonable annual workload for an orthopaedic team.

England↗
PubMed1994

The role of clinical workload and satisfaction with workload in rural primary care physician retention.

OBJECTIVE: To examine the relationship between clinical workload and workload satisfaction in rural primary care physician retention. DESIGN: Data from a survey, "Practice Patterns of Young Physicians, 1987: United States," were analyzed. PARTICIPANTS: Data on rural primary care (general or family practice, general internal medicine, or pediatrics) physicians working full time (> 35 h/wk) in clinical care were analyzed (n = 373). MAIN OUTCOME MEASURES: Self-reported likelihood of leaving the current practice within the next 2 years. RESULTS: Twenty-five percent of the physicians indicated that they were somewhat or very likely to leave the practice within the next 2 years. The modal reason for the likelihood of leaving was working too many hours (21%). Forty-nine percent of the respondents were dissatisfied with their workload. Those who were dissatisfied with their workload reported a greater likelihood of leaving (P = .0005). However, a quantitative measure of workload was not significantly related to the likelihood of leaving. The results of a multiple regression indicated that employees and those dissatisfied with their workload were most likely to leave the practice within the next 2 years. CONCLUSIONS: Satisfaction with clinical workload is an important factor in the likelihood of retaining rural primary care physicians.

Adult↗
PubMed2006

Radiologist workloads in teaching hospital departments: measuring the workload.

This article proposes a practical method for measuring staff radiologist workloads (clinical productivity) in teaching hospital departments of radiology in Australia. It reviews the Australian background to this, including the Royal Australian and New Zealand College of Radiologists (RANZCR) Education Board accreditation guidelines and the development of the RANZCR practice costing model. It reviews overseas methods of radiologist workload measurement and trends in radiologist workloads both in Australia and overseas. It proposes a practical and simple workload measuring method based on relative value units derived from the RANZCR model. Using a previous national workload survey in teaching hospitals, it proposes initial workload benchmarks when using this method. Strengths and weaknesses of this method and alternatives are reviewed, and a number of proposals for Australian teaching radiology departments are put forward to advance the issue of radiologist workloads in a disciplined manner.

Australia↗
PubMed1990

Caseload or workload? Scoring complexity of operative procedures as a means of analysing workload.

OBJECTIVE: To present a more realistic assessment of surgical workload than that provided by a case count. DESIGN: Prospective study of all the operative procedures performed in one year, classified according to the British United Provident Association's schedule of procedures and scored by the "intermediate equivalent" value (taking the recommended fee value of an intermediate operation as 1.0) compared with the number of operations performed. SETTING: General surgical unit of Taunton and Somerset Hospital, comparing four consultant surgeons and their teams. PATIENTS: Inpatients and day patients admitted under the care of general surgeons during 1989. MAIN OUTCOME MEASURE: Difference between the apparent workload represented by simple case counting (caseload) and the actual workload represented by calculation of the total "intermediate equivalent" value. RESULTS: The workload assessed in terms of intermediate equivalent values was greater than that suggested by case counting for complex operations (12% v 4%), operations at the district hospital (82% v 74%), and operations performed by consultants (53% v 35%) and was lower for minor operations (20% v 42%), operations at the community hospitals (18% v 26%), and operations performed by surgeons in training grades and clinical assistants (47% v 66%). CONCLUSIONS: The use of the intermediate equivalent values as an indicator of complexity allows a more realistic assessment of the operative workload than a simple case count of the number of different operations and is recommended for comparing workload in different hospitals and departments.

England↗
PubMed2005

The Integrated Workload Scale (IWS): a new self-report tool to assess railway signaller workload.

Network Rail, who own the railway infrastructure in the UK, have been interested in the assessment of mental workload (MWL) of signallers and control staff for some years. A new model of MWL has been proposed within which to develop a suite of new MWL analytical and empirical assessment tools. One of these is the Integrated Workload Scale (IWS), developed and tested for signallers. This paper describes the development of the IWS and its subsequent testing within two full-scale simulator trials with an NX (entry/exit) panel and an Integrated Electrical Control Centre (IECC) system, and then in the field at signal boxes. The IWS has proven to be a valuable measure of individually experienced peaks and troughs in workload over a period of time or within a particular set of scenarios. It is acceptable to signallers and maps well onto assessments of expected workload on the basis of timeline analysis and subject matter expert commentaries.

Humans↗
PubMed1992

[Workload in software development work. A consideration based on work-characteristics and analysis on workload factors of each working group].

To clarify workload factors in software developing work, we designed questionnaires composed of questions of work-content based on the interview survey. For the analysis of workload, Cumulative Fatigue Symptom Index (CFSI) and the stress-rating-method by 7-likert-scale were used. With the cooperation of the Japanese Software Engineers' Association (SEA) responses were obtained from 270 out of 1,100 members and from 553 non-member software engineers in 18 companies in Japan. The CFSI score obtained was higher than those of other groups of other industries obtained in our previous studies. The stress-rating showed that "time-pressure," "too much amount of work, and "ambiguity in job specification" were the highest stressors. The work groups were categorized by the results of CFSI profile into 4 types. The results of stress-ratings were significantly different between the 4 type groups. Based on the multiple comparison analysis, the workload factors of each group could be specified. Out of the foregoing 4 types, the work groups which showed the deviation in F1B (depression) in CFSI and the work groups which showed high scores in every category in CFSI were higher in "ambiguity of specification" in stress-ratings. This result indicates that "ambiguity in specification" is a significant stressor in software engineers. This stressor is caused by the complicated communication process between users and engineers and by the shortage of tools or rules in this process. This stressor is considered to be the most typical workload which characterizes the software developing work.

Adult↗
PubMed1993

Correlation of employees' perception of workload with workload indicators.

In this study, the measurement of perception of pharmacists' workload did not correlate well with any workload indicators studied. Generally, census on the study date correlated well for pharmacy technicians working in various areas of the pharmacy. If it is agreed that perception of workload is the real measure of activity--that is, how busy the employees believe it is--then the indicators used in this study are not useful. Similar research using other indicators is warranted.

Analysis of Variance↗
PubMed2002

Proactive management of histopathology workloads: analysis of the UK Royal College of Pathologists' recommendations on specimens of limited or no clinical value on the workload of a teaching hospital gastrointestinal pathology service.

AIMS: To investigate the effect on the workload of a gastrointestinal pathology service of implementing the recommendations of the Royal College of Pathologists' (RCPath) working party on specimens of limited or no clinical value (LONCV). METHODS: All endoscopic gastrointestinal pathology reports for the first three months of 2001 at a large teaching hospital were reviewed against the RCPath recommendations. Specimens in the category of LONCV were recorded and the final histopathology diagnosis noted. RESULTS: The biopsies in the LONCV category were 30% of oesophageal, 61% of gastric, 0.5% of duodenal, and 7% of colorectal origin. CONCLUSIONS: Implementing the RCPath recommendations would reduce the number of requests for the examination of gastrointestinal endoscopic specimens by 3500 specimens each year in this department. None of the specimens in the LONCV category showed an abnormality that could not have been detected by a more efficient and less invasive method. In the UK, where there is a severe shortage of trained histopathologists, the implementation of these recommendations would ensure that these scarce resources are not misused.

Biopsy↗
PubMed2000

[The workload of computer system engineers and mental health].

The nature of labor in Japan is changing from work which is physically demanding to work in which mental activity requiring intellectual and psychological ability results in production. The author studied and analyzed the type of workload experienced by system engineers in informatics. The results of a health study of 2,396 system design engineers in informatics at our company were analyzed (only data on 2,169 males were analyzed). Workload related to the 'quality', or type of work done ('Workload of quality') was felt by 63.5%, with 36.0% feeling workload related to the amount of work ('Workload of quantity'). A very large number of workers felt workload related to the quality, or type of work rather than to the amount of work. The relationship between emotional health indices and workload showed insomnia in 25.5% of workers who felt a 'Workload of quality', and in 11.1% of those who did not feel such a workload. Similarly, depressive mood was seen in 40.3% of workers who felt a 'Workload of quality', and in 18.7% of workers who did not. Insomnia was seen in 42.8% of workers with a feeling of a 'Workload of quality', and in 26.3% of those without. The relationship between workload, related to the quality and quantity of work was also strong for other mental health indices. Workload related to the quality of work was particularly strong. Workload related to the quality or type or work comes from a myriad of factors including the variety of work required from workers in informatics, the still developing nature of the production process, and the rapid pace of technical progress with each type of work carrying a different set of factors. The ability and personality of each individual worker also plays an important role. The results of the survey showed the importance of carrying out occupational healthcare activities in health management from the standpoint of work related health hazards or "quality of work"; in other words, from the standpoint of work type, system operation and the individuality of the worker.

Adult↗
PubMed1997

The effect of electronic record keeping and transesophageal echocardiography on task distribution, workload, and vigilance during cardiac anesthesia.

BACKGROUND: Electronic anesthesia record keeping (EARK) systems increasingly are used in the operating room, but studies have only recently begun to investigate their effect on anesthesia task performance. Teak analysis, workload assessment, and vigilance assessment techniques were used to study senior residents providing anesthesia for coronary artery bypass graft (CABG) procedures. The impact on anesthesia residents' workload of the routine use of transesophageal echocardiography (TEE) also was examined. METHODS: Before each case, the record keeping system was randomly selected as either electronic (Distek ARKIVE; EARK) or traditional manual recording (MAN). Twenty CABG procedures (10 EARK and 10 MAN) were examined, with observation commencing with anesthetic induction and terminating on initiation of cardiopulmonary bypass. The activities of each resident, divided into 32 task categories (e.g., "laryngoscopy," "observe monitors," etc.), were recorded by a trained observer using a computer. The response latency to a randomly activated alarm light was used as a measure of vigilance ("vigilance latency"). Workload was rated by subject and observer at random 10- to 15-min intervals throughout the case. Data analysis included calculation of workload density (number of tasks/min multiplied by task-specific workload values) and task-links (relationship between sequential tasks). RESULTS: The two groups had a similar distribution of tasks before intubation. In only 4 of the 20 cases studied did any manual record keeping occur before intubation. After intubation, the EARK group spent less time record keeping and using the TEE but more time observing the monitors and conversing with the attending physician than the MAN group did. All subjects reported significantly higher workload scores before intubation compared with after intubation. Similarly, vigilance latency was greater before intubation compared with after intubation (57 vs. 31 s; P < 0.001). There were no significant differences between the two record keeping groups in subjective workload scores, workload density, or vigilance latency. During TEE use, vigilance latency was significantly longer, and workload density was greater than during other monitoring or recording tasks. CONCLUSIONS: This study provides an objective description of the task distribution and workload during the administration of anesthesia for cardiac surgery. Under the conditions of this study. EARK use modestly decreased the time spent record keeping during the postintubation prebypass period. However, there was no effect of EARK either on vigilance or several measures of workload. TEE use was associated with increased workload and possibly decreased vigilance.

Anesthesiology↗
PubMed1992

Influence of workload on the antihypertensive effect of exercise.

1. The relation between workload and the antihypertensive effect of exercise therapy in hypertensive patients, and the mechanism of that effect, were investigated. 2. Twenty-six patients participated in the study and were randomly assigned to 10 weeks of either low or high workload exercise. In the low workload group, 16 mild hypertensive patients were treated with bicycle ergometer exercise at approximately 50% of their maximum oxygen consumption (VO2max) for 60 min three times a week for 10 weeks. In the high workload group, 10 mild hypertensive patients exercised on the same schedule, but at approximately 75% of VO2max. 3. After 10 weeks of exercise, the low workload group had significantly lower systolic (9 mmHg), mean (6 mmHg) and diastolic (6 mmHg) blood pressures. In the high workload group, decreases in systolic (3 mmHg), mean (4 mmHg) and diastolic (5 mmHg) blood pressure were not statistically significant. 4. In the low workload group, changes in haemodynamic and humoral variables were not significant, except for a reduction in plasma norepinephrine at week 7. Cardiac index and plasma norepinephrine tended to decrease. In the high workload group, plasma norepinephrine and the renin-angiotensin system were transiently stimulated after 4 weeks of exercise. Stroke volume significantly increased (+26.4%) after 10 weeks of high workload exercise. 5. Based on these results and better patient compliance with the exercise programme in the low workload group than in the high workload group, low workload exercise therapy was recommended to mild hypertensive patients.

Adult↗
PubMed2004

Multiple measures of anesthesia workload during teaching and nonteaching cases.

UNLABELLED: In this study, we sought to examine several measures of anesthesia provider workload during different phases of anesthesia care and during teaching and nonteaching cases. Clinical work was assessed in real-time during 24 general anesthetics performed by consenting anesthesia providers. Workload was measured using physiological (provider heart rate), psychological (self-assessment and observer rating), and procedural (response latency to an alarm light and workload density) techniques. Clinicians' heart rates, observer and self-reported workload scores, and nonteaching workload density were consistently increased during anesthetic induction and emergence compared with maintenance. In nonteaching cases, workload density correlated with heart rate and with psychological workload. Workload density during teaching cases did not decrease during the induction and was significantly greater than during nonteaching cases. Alarm-light response latency (a measure of clinical vigilance) was significantly prolonged during the teaching compared with nonteaching cases. These results suggest that intraoperative teaching increases the workload of the clinician instructor and may reduce vigilance during anesthesia care. Additionally, multiple workload measures may provide a more comprehensive profile of the work demands of clinical cases. IMPLICATIONS: Psychological, physiological, and procedural workload measures during routine general anesthesia cases documented the increased work demands of induction and emergence. Intraoperative teaching increased workload and decreased vigilance, suggesting the need for caution when educating during patient care.

Anesthesia↗
PubMed1992

[Participation of mental workload in circulatory system reaction to occupational work].

The aim of the study was to determine the degree to which the heart rate during and after work of variable physical and mental load was affected by the mental workload of moderate intensity. The subjects were 150 women aged 17-57. 24-hour recordings of their heart rates during work, leisure and sleep were taken using the Medilog recording-analysing system. Mental workload was determined in two ways: by the AET method, which enabled objective evaluation of the load, and by a method which involved subjective evaluation of work requirements and the ability to cope with them. Using the multiple regression analysis, the degree to which concurrent elements of mental and physical workload an serve as predictors of heart rate during work, leisure and sleep. The results show that physical workload is the more essential factor affecting the reaction of the circulatory system under the circumstances of concurrent mental and physical workload. By extending the measurements to involve off-duty hours, it was possible to determine that the consequences of mental workload manifested also after the work. The prolonged effect of mental workload on the heart rate was evident only when the subjective method of workload estimation was used. This points to the individual character of mental workload. The findings indicate on one hand that the share of mental workload should not be neglected during evaluation of the effects of occupational workload on the physiological reactions and, on the other, that the heart rate measurement is a useful tool for indicating essential elements of workload.

Adolescent↗