Systematic Mapping of Care Ward Activities – Towards a Standardized Activity Structure and Terminology of Hospital Activities

Other conference contribution, 2018

Introduction
The productivity needs to increase in public healthcare in Sweden, but it is actually decreasing. Previous research has pointed at great productivity increase potentials when specific activities are analysed using work study techniques. The same activities are performed at several places at a hospital. However, many activities are not performed in a standardized way. There is great potential to improve productivity by standardizing repetitive supporting activities. However, the most fundamental factor is missing: There is no standardized terminology for what to call all activities. For many direct patient activities, e.g. different treatments, there are official standards but for supporting activities, which constitute a large majority of the total work time, there are no standards.
Aim
The aim of the research is to develop a generalized structure and terminology for all hospital activities and develop a practical method for collecting activity data from all organizational units. In the first phase, the scope has been delimited to care ward activities.
Material and methods
The researchers have lead the design process in an R&D project at Sahlgrenska University Hospital, using a Design Science Research approach. The project has resulted in an activity structure, a terminology, and a method for data collection. The project was carried out through 22 workshops, by a multi-functional project team and involving nine different care wards representing different disciplines for validation.
Results
Based on pre-determined time system logic a hierarchical activity structure was developed consisting of six levels: Activity category, Activity, Activity variant, Building block, Sequence, and Element. The first three levels are specific and discrete and group and organize activities. The last three levels are generic, and in combination describe in increasing detail how to perform the specific activities.
Contributions
The primary contribution of this research is to hospital operations management through the generalized structure and the method for use at other hospitals. It also contributes to hospital operations since it is necessary to effectively improve standardized activities throughout a whole hospital. An activity structure is only the first step towards increased productivity in healthcare. The next step involves improvements and standardization of how activities are carried out.