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

J Am Med Inform Assoc. Sep-Oct 2011;18(5):704-10. doi: 10.1136/amiajnl-2011-000083. Epub 2011 Apr 27.

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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Checklist*
  • Data Collection / methods
  • Data Collection / standards*
  • Health Plan Implementation / statistics & numerical data
  • Humans
  • Medical Informatics*
  • Reference Standards
  • Time and Motion Studies*
  • Workflow*