Respiratory care work assignment based on work rate instead of work load

Area of Science:

• Healthcare Management
• Operations Research
• Clinical Workflow Optimization

Background:

• Previous work identified unachievable work rates (exceeding available labor) in 75% of scheduled times, despite presumed achievable workloads.
• Work rate, defined as work load per hour based on standard treatment times, was a newly identified management variable.

Purpose of the Study:

• To determine the optimal strategy for creating work assignments based on work rate.
• To investigate methods for balancing work assignments to prevent unachievable work rates.

Main Methods:

• A focus group utilized root-cause analysis to identify strategies for balancing work rate assignments.
• Employee surveys assessed willingness to adjust start times, and a 12-month period was analyzed for scheduled vs. unscheduled work ratios.
• A spreadsheet model evaluated the impact of shifting start times on work-rate distribution over a 24-hour period.

Main Results:

• A focus group suggested starting treatments one hour earlier; 13 of 24 surveyed clinicians were willing to do so.
• Scheduled work averaged 55% of the total workload, with significant variability across assignment areas (0-99%).
• Shifting treatment start times improved work rate distribution but did not eliminate instances where labor demand exceeded supply.

Conclusions:

• Assignments based solely on average workload result in unachievable work rates, leading to missed treatments and staff dissatisfaction.
• Staggering treatment times is an effective strategy for managing work rate peaks, though overall reduction is limited.
• Fair work assignment requires differentiating between scheduled and unscheduled work components.