Clarifying workforce flexibility from a division of labor perspective: a mixed methods study of an emergency department team.

Human Resources for Health
Sarah WiseMichael Roche

Abstract

The need for greater flexibility is often used to justify reforms that redistribute tasks through the workforce. However, "flexibility" is never defined or empirically examined. This study explores the nature of flexibility in a team of emergency doctors, nurse practitioners (NPs), and registered nurses (RNs), with the aim of clarifying the concept of workforce flexibility. Taking a holistic perspective on the team's division of labor, it measures task distribution to establish the extent of multiskilling and role overlap, and explores the behaviors and organizational conditions that drive flexibly. The explanatory sequential mixed methods study was set in the Fast Track area of a metropolitan emergency department (ED) in Sydney, Australia. In phase 1, an observational time study measured the tasks undertaken by each role (151 h), compared as a proportion of time (Kruskal Wallis, Mann-Whitney U), and frequency (Pearson chi-square). The time study was augmented with qualitative field notes. In phase 2, 19 semi-structured interviews sought to explain the phase 1 observations and were analyzed thematically. The roles were occupationally specialized: "Assessment and Diagnosis" tasks consumed the largest proportion of doctors' (51.1...Continue Reading

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Citations

Jul 13, 2021·Journal of Health Services Research & Policy·Sarah WiseMichael Roche

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Methods Mentioned

BETA
X-ray

Software Mentioned

Work Observation Method by Activity Timing ” ( WOMBAT )
NVivo
GPower

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