TY - JOUR
T1 - Clinical work intensity among physician specialties
T2 - How might we assess it?: What do we find?
AU - Horner, Ronnie D.
AU - Szaflarski, Jerzy P.
AU - Jacobson, C. Jeffrey
AU - Elder, Nancy
AU - Bolon, Shannon
AU - Matthews, Gerald
AU - Ying, Jun
AU - Meganathan, Karthikeyan
AU - Raphaelson, Marc
PY - 2011/1
Y1 - 2011/1
N2 - Background: The level of work intensity associated with patient encounters has implications for quality of care, patient safety, practice management, and reimbursement. The utility of available instruments for clinical work intensity assessment is unknown. Objective: We assessed, in the clinical setting, the performance of existing measures of work intensity that are valid for nonclinical contexts. Research design: A cross-sectional, multimeasure design involving work intensity assessments for the last patient encounter and for an entire half-day clinic session. Subjects: A convenience sample of 14 providers from the following 4 specialties: family medicine, general internal medicine, neurology, and surgery. Measures: Perceived clinical work intensity was measured by the following 3 instruments: National Aeronautic and Space Administration-Task Load Index, Subjective Workload Assessment Technique, and Multiple Resources Questionnaire; stress was measured by the Dundee Stress State Questionnaire. Convergent validity was assessed by correlation among the instruments. Results: For the last patient encounter, there was a moderate to high correlation between the work intensity instruments' scores (Pearson's r ranged from 0.41 to 0.73) and low to moderate correlation with the distress subscale of the Dundee Stress State Questionnaire (Pearson's r ranged from -0.11 to 0.46), reflecting their stress dimension. Provider personality was associated with reported levels of work intensity and stress. Similar results were obtained when the entire clinic session was the unit of reference. Conclusion: Existing measures of work intensity and stress appear to be valid for use in the clinical setting to generate evidence on perceived intensity and stress experienced by providers in the performance of medical services.
AB - Background: The level of work intensity associated with patient encounters has implications for quality of care, patient safety, practice management, and reimbursement. The utility of available instruments for clinical work intensity assessment is unknown. Objective: We assessed, in the clinical setting, the performance of existing measures of work intensity that are valid for nonclinical contexts. Research design: A cross-sectional, multimeasure design involving work intensity assessments for the last patient encounter and for an entire half-day clinic session. Subjects: A convenience sample of 14 providers from the following 4 specialties: family medicine, general internal medicine, neurology, and surgery. Measures: Perceived clinical work intensity was measured by the following 3 instruments: National Aeronautic and Space Administration-Task Load Index, Subjective Workload Assessment Technique, and Multiple Resources Questionnaire; stress was measured by the Dundee Stress State Questionnaire. Convergent validity was assessed by correlation among the instruments. Results: For the last patient encounter, there was a moderate to high correlation between the work intensity instruments' scores (Pearson's r ranged from 0.41 to 0.73) and low to moderate correlation with the distress subscale of the Dundee Stress State Questionnaire (Pearson's r ranged from -0.11 to 0.46), reflecting their stress dimension. Provider personality was associated with reported levels of work intensity and stress. Similar results were obtained when the entire clinic session was the unit of reference. Conclusion: Existing measures of work intensity and stress appear to be valid for use in the clinical setting to generate evidence on perceived intensity and stress experienced by providers in the performance of medical services.
KW - DSSQ
KW - MRQ
KW - NASA-TLX
KW - SWAT
KW - medical specialties
KW - personal health services
KW - stress
KW - workload
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UR - http://www.scopus.com/inward/citedby.url?scp=78650706302&partnerID=8YFLogxK
U2 - 10.1097/MLR.0b013e3181f3801f
DO - 10.1097/MLR.0b013e3181f3801f
M3 - Article
C2 - 21063227
AN - SCOPUS:78650706302
SN - 0025-7079
VL - 49
SP - 108
EP - 113
JO - Medical Care
JF - Medical Care
IS - 1
ER -