The Impact of Hospital Design on Time Spent on Nursing Tasks: A Time Motion Study

Abstract

ObjectivesTo explore the time spent on nursing tasks and the extent of multitasking in a hospital with multi-bedded rooms compared to single-occupancy rooms.BackgroundSingle-occupancy patient rooms in hospitals have become popular because of the privacy they offer. However, little is known about the impact of different hospital designs on time spent performing on nursing tasks.MethodsA before-after time motion study was conducted in a former hospital which featured multi-bedded rooms and a new hospital with 100% single-occupancy rooms. Trained observers shadowed nurses during day and evening shifts using an online shadow application distinguishing eleven main categories of nursing tasks (e.g., direct patient care, indirect care, and professional communication). Data was analyzed using descriptive statistics. Tasks performed concurrently (multitasking) are described in terms of (overlapping) duration and frequency.ResultsIn total, 60 and 107 nurses were shadowed for 225 and 450 hours in the former and new hospital, respectively. The top three tasks on which nurses spent most the time in the former and new hospital concerned: direct care 40% versus 40%, training and supervision 27% versus 25%, communication 25% versus 25%, respectively. In the former hospital, nurses performed on average 32.8% of their time on multitasking versus 34.8% in the new hospital.ConclusionsContrary to our expectations, the 100% single-occupancy rooms hospital design hardly affected nursing time spent in nursing tasks and multi-tasking compared to a multi-bedded patient rooms setting.

Keywords: acute care; policy; research in practice; work organization; workforce issues.

Figure 1.

Schematic examples of metrics. The green bars show the tasks performed. The dark blue line represents the corresponding level of multitasking.

Figure 2.

Proportion of time spent on nursing tasks on average per session. Red whiskers are the 95% confidence interval of the average time spent on nursing task on average per session.