Op-Time-izing Nursing Workflow and Workload with Human Factors Engineering
- National Database of Nursing Quality Indicators (NDNQI©) for a health care system revealed a significant decline in 2012 in nurse (RN) ratings of: job enjoyment, staffing, and perceptions of the environment while maintaining steady RN-to-patient ratios of 1:5 for Medical/Surgical (M/S) units and 1:2 for Intensive Care Units (ICU).
- This negative shift in satisfaction indicated that, despite a comparable patient load, RNs felt more burdened than in previous years.
- In order to identify and resolve these issues, a human factors and systems engineering framework was utilized at one hospital of the health care system for two pilot units, one M/S and one ICU, via a multidisciplinary team following a Plan Do Check Act (PDCA) cycle methodology.
Nursing efficiency was to be improved by reducing the time spent on medication management tasks by 10% per nurse per shift from March 2013 through March 2014 (baseline was 397.70 minutes for M/S and 378.34 minutes for ICU).
This was to be accomplished by a multidisciplinary team approach utilizing human factors and systems engineering methods including the elimination of non-value added tasks and redesign of the work system.
- Work system audit conducted by engineers
- Tools developed to reduce interruptions
- Unit secretary probing questions handout created
- Various checklists implemented and utilized
- Tip sheets developed for Order Message Manager (OMM)
- Work efficiencies implemented
Due to the success of the interventions, they were packaged into a usable toolkit and spread to other facilities. New inpatient room designs were adopted and infrastructure was remodeled to increase efficiency.