title: Using the time and motion method to study clinical work processes and workflow: methodological inconsistencies and a call for standardized research.
abstract: OBJECTIVE
  To identify ways for improving the consistency of design, conduct, and results reporting of time and motion (T&M) research in health informatics.
  
  
  METHODS
  We analyzed the commonalities and divergences of empirical studies published 1990-2010 that have applied the T&M approach to examine the impact of health IT implementation on clinical work processes and workflow. The analysis led to the development of a suggested 'checklist' intended to help future T&M research produce compatible and comparable results. We call this checklist STAMP (Suggested Time And Motion Procedures).
  
  
  RESULTS
  STAMP outlines a minimum set of 29 data/ information elements organized into eight key areas, plus three supplemental elements contained in an 'Ancillary Data' area, that researchers may consider collecting and reporting in their future T&M endeavors.
  
  
  CONCLUSIONS
  T&M is generally regarded as the most reliable approach for assessing the impact of health IT implementation on clinical work. However, there exist considerable inconsistencies in how previous T&M studies were conducted and/or how their results were reported, many of which do not seem necessary yet can have a significant impact on quality of research and generalisability of results. Therefore, we deem it is time to call for standards that can help improve the consistency of T&M research in health informatics. This study represents an initial attempt.
  
  
  CONCLUSIONS
  We developed a suggested checklist to improve the methodological and results reporting consistency of T&M research, so that meaningful insights can be derived from across-study synthesis and health informatics, as a field, will be able to accumulate knowledge from these studies.
authors.affiliation: School of Public Health, Department of Health Management and Policy, University of Michigan, Ann Arbor, Michigan 48109-2029, USA. kzheng@umich.edu
authors.forename: Kai
authors.initials: K
authors.lastname: Zheng
authors.forename: Michael H
authors.initials: MH
authors.lastname: Guo
authors.forename: David A
authors.initials: DA
authors.lastname: Hanauer
mesh_terms: D057189:Checklist; D003625:Data Collection / Q000379:methods / Q000592:standards*; D006284:Health Plan Implementation / Q000706:statistics & numerical data; D006801:Humans; D008490:Medical Informatics; D012015:Reference Standards; D013996:Time and Motion Studies; D057188:Workflow