The patient encounter index: a novel method of measuring clinical workload in a paediatric cardiology service

Area of Science:

• Cardiology
• Healthcare Management
• Health Services Research

Background:

• Technological advancements in paediatric cardiology have expanded clinical services, leading to increased clinician workload.
• Growing workloads present significant workflow and staffing challenges within paediatric cardiology departments.
• Addressing these issues is crucial for maintaining optimal patient outcomes and service delivery.

Purpose of the Study:

• To develop and implement a novel tool, the patient encounter index, for quantifying clinical workload in paediatric cardiology.
• To assess the clinical workload of a specific paediatric cardiology service in Cape Town, South Africa.
• To provide data-driven insights for resource allocation and workflow improvement.

Main Methods:

• A prospective cross-sectional study design was employed.
• The patient encounter index was developed, defined as the ratio of measured clinical work duration to total available work time.
• Time-and-motion sampling was used over a 10-day period to collect clinical workload data.

Main Results:

• The median patient encounter index for the Western Cape Paediatric Cardiac Service was 0.81.
• This indicates that 81% of total contractual working time was dedicated to clinical activities.
• The index ranged from 0.19 to 1.09, demonstrating variability and high overall workload.

Conclusions:

• The patient encounter index is a viable tool for prospectively quantifying clinical workload in paediatric cardiology.
• The study demonstrated an excessive workload within the Cape Town paediatric cardiology service.
• The findings support the need for improved resource allocation and workflow management to enhance service efficiency and patient care.