Inpatient clinician workload: a scoping review protocol to understand the definition, measurement and impact of non-procedural clinician workloads

Abstract

IntroductionClinicians that care for hospitalised patients face unprecedented work conditions with exposure to highly infectious disease, exceedingly high patient numbers, and unpredictable work demands, all of which have resulted in increases in stress and burnout. Preliminary studies suggest that increasing workloads negatively affect inpatient clinician well-being and may negatively affect job performance; yet high workloads may be prioritised secondary to financial drivers or from workforce shortages. Despite this, the correlation between workload and these negative outcomes has not been fully quantified. Additionally, there are no clear measures for inpatient clinician workload and no standards to define ideal workloads. Using the protocol described here, we will perform a scoping review of the literature to generate a comprehensive understanding of how clinician workload of medical patients is currently defined, measured in clinical settings and its impact on the workforce, patients and institutional outcomes.Methods and analysisWe will follow the methodology outlined by Joanna Briggs Institute and Arksey and O’Malley to conduct a comprehensive search of major electronic databases including Ovid Medline (PubMed), Embase (Embase.com), PsycINFO, ProQuest Dissertations and Google Scholar. All relevant published peer-reviewed and dissertaion grey literature will be included. Data will be extracted using a standardised form to capture key article information. Results will be presented in a descriptive narrative format.Ethics and disseminationThis review does not require ethics approval though all included studies will be screened to ensure appropriate approval. The synthesis of this literature will provide a better understanding of the current state of work for inpatient clinicians, associated outcomes, and will identify gaps in the literature. These findings will be used in conjunction with an expert Delphi panel to identify measures of inpatient clinician workload to then guide the development of a novel workforce mobile application to actively track clinician work. We aim to lay the groundwork for future workforce studies to understand the optimal workloads that drive key outcomes for clinicians, patients and institutions.

The development and pilot of a novel mobile application to assess clinician perception of workload and work environment

“…In phase 1 of the discover and define stage, we sought to understand the concepts and processes associated with capturing workloads in near real time from hospitalists via a mobile application, utilizing both a scoping review process and Delphi panel to generate ideas to measure workloads and work environments. 4,9 This work, alongside the clinical experience and background of the research team, informed the rudimentary concept for the GW App. Research team members actively collaborated with the developers to determine the early prototype platform functionality (Android and iOS), ease of use, interface attractiveness, push notification functionality, biometric data collection, data storage, data retrieval, and the process to modify and push new questions to users.…”

“…In phase 1 of the discover and define stage, we sought to understand the concepts and processes associated with capturing workloads in near real time from hospitalists via a mobile application, utilizing both a scoping review process and Delphi panel to generate ideas to measure workloads and work environments 4,9 . This work, alongside the clinical experience and background of the research team, informed the rudimentary concept for the GW App.…”