Purpose Workload is a critical concept in the evaluation of performance and quality in healthcare systems, but its definition relies on the perspective (e.g. individual clinician-level vs unit-level workload) and type of available metrics (e.g. objective vs subjective measures). The purpose of this paper is to provide an overview of objective measures of workload associated with direct care delivery in tertiary healthcare settings, with a focus on measures that can be obtained from electronic records to inform operationalization of workload measurement. Design/methodology/approach Relevant papers published between January 2008 and July 2018 were identified through a search in Pubmed and Compendex databases using the Sample, Phenomenon of Interest, Design, Evaluation, Research Type framework. Identified measures were classified into four levels of workload: task, patient, clinician and unit. Findings Of 30 papers reviewed, 9 used task-level metrics, 14 used patient-level metrics, 7 used clinician-level metrics and 20 used unit-level metrics. Key objective measures of workload include: patient turnover (n=9), volume of patients (n=6), acuity (n=6), nurse-to-patient ratios (n=5) and direct care time (n=5). Several methods for operationalization of these metrics into measurement tools were identified. Originality/value This review highlights the key objective workload measures available in electronic records that can be utilized to develop an operational approach for quantifying workload. Insights gained from this review can inform the design of processes to track workload and mitigate the effects of increased workload on patient outcomes and clinician performance.

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The Sidwell Friends School S.M.A.R.T. Team (Students Modeling A Research Topic) has been working with the Nelson laboratory at the University of Maryland to design and produce accurate, three‐dimensional physical models of bacteriophage lysins using rapid prototyping (RP) technology. Lysins are bacterial cell wall hydrolases used by bacteriophage during progeny release. These enzymes in their pure form can be applied directly to Gram positive bacteria to quickly induce hypotonic lysis from without. This rapid activity shows promise as a novel antibacterial agent to both prevent and treat infections. Discussions with members of the Nelson laboratory allowed the students to design models of lysins to highlight their structural and functional characteristics. These designs were used to direct RP machines to build physical models of these enzymes. These physical models serve as “communication tools” used to enhance the understanding of lysins and their applications among the scientific and academic community. By contributing this tool to the Nelson laboratory research team, the students have the unique opportunity to experience and participate in the activities of a research laboratory. This work is supported by a grant awarded to Tim Herman by the NIH NCRR SEPA program and the HHMI Precollege Science Education Program.