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Measurement systems in principle and in practice: the example of nursing workload
R A Carr-Hill1, S Jenkins-Clarke
1Centre for Health Economics, University of York, England.
Journal of Advanced Nursing
|August 1, 1995
Summary
Nursing workload measurement systems (NWMS) in the UK lack validity and reliability. These systems provide inconsistent estimates, proving to be an expensive numbers game without clear practical application.
Area of Science:
- Healthcare Management
- Nursing Informatics
- Health Services Research
Background:
- Rapid development of health service measurement systems in the UK.
- Lack of understanding of phenomena being measured and assessment of reliability/validity.
- Nursing workload measurement systems (NWMS) as a key example.
Purpose of the Study:
- To examine the validity and reliability of existing NWMS in the UK.
- To assess the discrepancy between NWMS estimates and actual nursing hours.
- To evaluate the practical utility of NWMS in healthcare settings.
Main Methods:
- Analysis of estimates from four different NWMS.
- Comparison of NWMS outputs with actual nursing hours worked.
- Qualitative assessment of the nursing process in relation to measurement.
Main Results:
- Substantial and unexplained differences between estimates from various NWMS.
- Inability to correlate NWMS estimates with actual nursing hours or nursing process aspects.
- Evidence suggesting NWMS function as an 'expensive numbers game'.
Conclusions:
- Current NWMS in the UK lack demonstrated reliability and validity.
- Caution is advised regarding proposed measurement systems without practical validation.
- Many health service measurement systems remain untested and potentially unreliable.
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