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Standardized Workload Assessment Metric for Pediatric Emergency Departments (SWAMPED): Multicenter Derivation and
Garth Meckler1,2, Jeffrey N Bone2,3, Tania Principi4
1Department of Pediatrics, Pediatric Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Summary
The Standardized Workload Assessment Metric for Pediatric Emergency Departments (SWAMPED) reliably quantifies physician workload at the task level. This metric is sensitive to clinical context and provides a foundation for improving care quality and clinician well-being.
Area of Science:
- Medical research
- Health systems science
- Occupational health
Background:
- Physician workload in pediatric emergency departments (PEDs) impacts patient safety and care quality.
- Current workload measures (e.g., visit volume) are insufficient proxies for cognitive and contextual demands.
- The Standardized Workload Assessment Metric for Pediatric Emergency Departments (SWAMPED) was developed to address these limitations.
Purpose of the Study:
- To derive workload estimates using the SWAMPED tool.
- To evaluate the reliability, precision, and contextual responsiveness of SWAMPED.
- To enable quantitative assessment of physician workload at the task level.
Main Methods:
- A multicenter cross-sectional study involving PED physicians from tertiary children's hospitals.
- Physicians used the NASA Task Load Index to score 46 care components.
- Interrater agreement, score distributions, and effects of extrinsic modifiers were analyzed.
Main Results:
- Good interrater agreement (ICC: 0.69) was observed across care components.
- Workload scores varied significantly across components (range 22.1-99.5) with high precision.
- Extrinsic modifiers increased workload, while intrinsic physician characteristics did not.
Conclusions:
- SWAMPED provides reliable and precise task-specific workload estimates.
- The metric is sensitive to clinically relevant contextual modifiers.
- SWAMPED offers a foundation for research on workload's impact on clinical outcomes and health system planning.
