Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jul 6;18(1):529.
doi: 10.1186/s12913-018-3350-0.

The goldilocks effect: the rhythms and pace of hospital life

Jeffrey Braithwaite  1 , Louise A Ellis  2 , Kate Churruca  2 , Janet C Long  2
Affiliations

The goldilocks effect: the rhythms and pace of hospital life

Jeffrey Braithwaite et al. BMC Health Serv Res. .

Abstract

Background: While we have made gains in understanding cultures in hospitals and their effects on outcomes of care, little work has investigated how the pace of work in hospitals is associated with staff satisfaction and patient outcomes. In an era of efficiency, as speed accelerates, this requires examination.

Discussion: Older studies of pace in cities found that faster lifestyles were linked to increased coronary heart disease and smoking rates, yet better subjective well-being. In this debate we propose the Goldilocks hypothesis: acute care workplaces operating at slow speeds are associated with factors such as increased wait lists, poor performance and costly care; those that are too fast risk staff exhaustion, burnout, missed care and patient dissatisfaction. We hypothesise that hospitals are best positioned by being in the Goldilocks zone, the sweet spot of optimal pace.

Conclusion: Testing this hypothesis requires a careful study of hospitals, comparing their pace in wards and departments with measures of performance and patient outcomes.

Keywords: Busy-ness; Complexity; Efficiency; Optimal hospital performance; Pace of life; Patient outcomes; Staff satisfaction.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Underlying theoretical model
Fig. 2
Fig. 2
The pace normal distribution curve
Fig. 3
Fig. 3
3D surface plot of performance, complexity and speed
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Bornstein M. The pace of life: revisited. Int J Psychol. 1979;14(1–4):83–90. doi: 10.1080/00207597908246715. - DOI
    1. Milgram S. The experience of living in cities. Science. 1970;167(3924):1461–1468. doi: 10.1126/science.167.3924.1461. - DOI - PubMed
    1. Levine RV, Norenzayan A. The pace of life in 31 countries. J Cross-Cult Psychol. 1999;30(2):178–205. doi: 10.1177/0022022199030002003. - DOI
    1. Levine R. A geography of busyness. Soc Res. 2005;72(2):355–370.
    1. Braithwaite J, Herkes J, Ludlow K, Testa L, Lamprell G. Association between organisational and workplace cultures, and patient outcomes: systematic review. BMJ Open. 2017;7:e017708. doi: 10.1136/bmjopen-2017-017708. - DOI - PMC - PubMed

Publication types

LinkOut - more resources