Subtle cues: Qualitative elicitation of signs of capacity strain in the hospital workplace

Dana M Womack; Nancy N Vuckovic; Linsey M Steege; Deborah H Eldredge; Michelle R Hribar; Paul N Gorman

doi:10.1016/j.apergo.2019.102893

Subtle cues: Qualitative elicitation of signs of capacity strain in the hospital workplace

Appl Ergon. 2019 Nov:81:102893. doi: 10.1016/j.apergo.2019.102893. Epub 2019 Jul 11.

Authors

Dana M Womack¹, Nancy N Vuckovic², Linsey M Steege³, Deborah H Eldredge⁴, Michelle R Hribar⁵, Paul N Gorman⁶

Affiliations

¹ Oregon Health & Science University, Department of Medical Informatics & Clinical Epidemiology, 3181 S.W. Sam Jackson Park Rd, Portland, OR, 97239-3098, USA. Electronic address: womacda@ohsu.edu.
² Cambia Health Solutions, 100 SW Market St, Portland, OR, 97201, USA.
³ University of Wisconsin - Madison, School of Nursing, 701 Highland Avenue, Madison, WI, 53705, USA.
⁴ Oregon Health & Science University Hospital, 3181 S.W. Sam Jackson Park Rd, Portland, OR, 97239-3098, USA.
⁵ Oregon Health & Science University, Department of Medical Informatics & Clinical Epidemiology, 3181 S.W. Sam Jackson Park Rd, Portland, OR, 97239-3098, USA.
⁶ Oregon Health & Science University, Department of Medical Informatics & Clinical Epidemiology, 3181 S.W. Sam Jackson Park Rd, Portland, OR, 97239-3098, USA; Oregon Health & Science University Hospital, 3181 S.W. Sam Jackson Park Rd, Portland, OR, 97239-3098, USA.

Abstract

Through everyday care experiences, nurses develop expertise in recognition of capacity strain in hospital workplaces. Through qualitative interview, experienced nurses identify common activity changes and adaptive work strategies that may signal an imbalance between patient demand and service supply at the bedside. Activity change examples include nurse helping behaviors across patient assignments, increased volume of nurse calls from patient rooms, and decreased presence of staff at the nurses' station. Adaptive work strategies encompass actions taken to recruit resources, move work in time, reduce work demands, or reduce thoroughness of task performance. Nurses' knowledge of perceptible signs of strain provides a foundation for future exploration and development of real-time indicators of capacity strain in hospital-based work systems.

Keywords: Capacity strain; Nursing; Socio-technical systems; Strategies; Workload.

MeSH terms

Adult
Attitude of Health Personnel*
Cues
Female
Humans
Job Satisfaction
Male
Middle Aged
Nurse's Role
Nursing Staff, Hospital / psychology*
Occupational Stress / diagnosis*
Occupational Stress / psychology
Qualitative Research
Work Capacity Evaluation
Workload / psychology*
Workplace / psychology*

Abstract

MeSH terms

Grants and funding