title: Work flow analysis: eliminating non-value-added work.
abstract: OBJECTIVE
  To evaluate the impact of implemented work environment changes on nursing and support staff roles.
  
  
  BACKGROUND
  In 1999, the authors identified key drivers of unnecessary work associated with the day-to-day delivery of patient care in their institution and implemented changes based on their results.
  
  
  METHODS
  Both quantitative and qualitative methods were used. Work sampling and focus groups were used to evaluate work flow. Activity categories were identified and clearly defined by advanced practice nurses. All compiled data were subsequently synthesized and cross-checked with the information acquired through independent, multidisciplinary validation studies.
  
  
  RESULTS
  There were significant changes (P <.0001) noted in overall distribution of observed activities for nurses and all support staff.
  
  
  CONCLUSIONS
  The significant changes noted in overall distribution of observed activities reflect the important adjustments made in both job descriptions and the environment to eliminate key drivers of unnecessary work in the delivery of patient care.
authors.affiliation: Health Care Research, Center for Professional Excellence, Lehigh Valley Hospital and Health Network, Cedar Crest Boulevard & 178, Allentown, PA 18104, USA. Terry.Capuano@lvh.com
authors.forename: Terry
authors.initials: T
authors.lastname: Capuano
authors.forename: Joanna
authors.initials: J
authors.lastname: Bokovoy
authors.forename: Deborah
authors.initials: D
authors.lastname: Halkins
authors.forename: Kim
authors.initials: K
authors.lastname: Hitchings
mesh_terms: D001291:Attitude of Health Personnel; D017598:Efficiency, Organizational; D006804:Ergonomics; D017144:Focus Groups; D006272:Health Facility Environment / Q000458:organization & administration; D006754:Hospital Restructuring / Q000458:organization & administration; D006801:Humans; D024802:Nurse's Role; D015401:Nursing Administration Research; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000523:psychology; D009936:Organizational Innovation; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration; D017060:Patient Satisfaction; D010414:Pennsylvania; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D013996:Time and Motion Studies; D017749:Total Quality Management / Q000458:organization & administration; D014941:Work Simplification; D016526:Workload; D017132:Workplace / Q000458:organization & administration* / Q000523:psychology