The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts


Susan Gole1, Robert Chatburn1

Background: Some employees believe that non-ICU respiratory therapy workload is unfairly distributed, with the second shift least favorable despite our use of workload tracking (MediLinks, MediServe, Phoenix AZ) for assignments. The purpose of this study was to determine if workload distribution (work units per person) and a new metric, workrate (work units per hour per person), are different among the three shifts.

Measured workload consisted of scheduled treatments (standard times in minutes): small volume nebulizers (9), metered dose inhalers (6), positive expiratory pressure (10), bronchopulmonary hygiene (10), continuous positive airway pressure and bilevel positive airway pressure (8), and nasotracheal suctioning (8). Workload units were defined as the product of treatment volume and standard time/procedure. Our assignment target was 300 minutes per person per 8 hr shift. Workload "due times" were base on ordered frequency (e.g., Q4 at 04:00, 08:00, 12:00, 16:00, 20:00 and 24:00). Policy requires therapies to be completed 30 minutes before or after due times. Study data were collected over seven days at 07:00. Workload per person was calculated using scheduled and unscheduled treatments. Work rate (workload/hour) per person was defined as the cumulative scheduled workload at each due time. Workloads and workrates for day, evening, and night shifts were compared with One Way ANOVA. Vaues of p < 0.05 were considered statistically significant.

Mean daily workload/person was largest for the day shift (5.3 hr, p = 0.007); no differences were found for other pairwise comparisons (evening = 5.0 hr, night = 4.8 hr). Workrate did not differ among shifts (p = 0.686). However, Table 1 shows that due times of 08:00 and 20:00 had average workrates of 2.2 hrs/hr.

Day and evening shifts have some due times with unachievable workrates (based on a maximum workrate = 1.0 hr work/hr time per person). Our findings suggest that, to assure equal distribution of workload and the timeliness of delivered treatments, assignments should be based on workrate not workload