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Using the time and motion method to study clinical work processes and workflow: methodological inconsistencies and a call for standardized research.

TitleUsing the time and motion method to study clinical work processes and workflow: methodological inconsistencies and a call for standardized research.
Publication TypeJournal Article
Year of Publication2011
AuthorsZheng, K, Guo, MH, Hanauer, DA
JournalJ Am Med Inform Assoc
Volume18
Issue5
Pagination704-10
Date Published2011 Sep-Oct
ISSN1527-974X
KeywordsChecklist, Data Collection, Health Plan Implementation, Humans, Medical Informatics, Reference Standards, Time and Motion Studies, Workflow
Abstract

OBJECTIVE: To identify ways for improving the consistency of design, conduct, and results reporting of time and motion (T&M) research in health informatics.MATERIALS AND METHODS: We analyzed the commonalities and divergences of empirical studies published 1990-2010 that have applied the T&M approach to examine the impact of health IT implementation on clinical work processes and workflow. The analysis led to the development of a suggested 'checklist' intended to help future T&M research produce compatible and comparable results. We call this checklist STAMP (Suggested Time And Motion Procedures).RESULTS: STAMP outlines a minimum set of 29 data/ information elements organized into eight key areas, plus three supplemental elements contained in an 'Ancillary Data' area, that researchers may consider collecting and reporting in their future T&M endeavors.DISCUSSION: T&M is generally regarded as the most reliable approach for assessing the impact of health IT implementation on clinical work. However, there exist considerable inconsistencies in how previous T&M studies were conducted and/or how their results were reported, many of which do not seem necessary yet can have a significant impact on quality of research and generalisability of results. Therefore, we deem it is time to call for standards that can help improve the consistency of T&M research in health informatics. This study represents an initial attempt.CONCLUSION: We developed a suggested checklist to improve the methodological and results reporting consistency of T&M research, so that meaningful insights can be derived from across-study synthesis and health informatics, as a field, will be able to accumulate knowledge from these studies.

DOI10.1136/amiajnl-2011-000083
Alternate JournalJ Am Med Inform Assoc
PubMed ID21527407
PubMed Central IDPMC3168304
Grant ListUL1RR024986 / RR / NCRR NIH HHS / United States
People: 
David Hanauer
University of Michigan Rogel Cancer Center at North Campus Research Complex
1600 Huron Parkway, Bldg 100, Rm 1004 
Mailing Address: 2800 Plymouth Rd, NCRC 100-1004
Ann Arbor, MI 48109-2800 

Research reported in this publication was supported by the National Cancer Institutes of
Health under Award Number P30CA046592. The content is solely the responsibility
of the authors and does not necessarily represent the official views of the
National Institutes of Health.

Research reported in this publication was supported by the National Cancer Institutes of
Health under Award Number P30CA046592 by the use of the following Cancer Center
Shared Resource(s): Biostatistics, Analytics & Bioinformatics; Flow Cytometry;
Transgenic Animal Models; Tissue and Molecular Pathology; Structure & Drug
Screening; Cell & Tissue Imaging; Experimental Irradiation; Preclinical
Imaging & Computational Analysis; Health Communications; Immune Monitoring;
Pharmacokinetics)

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