No more tears: An adaptable tool for measuring workloads without inflicting a time study or new information technology on staff

In the effort to reduce District Public Health Nurses (PHNs) workloads, the administration of the Los Angeles County Department of Public Health needed to measure the relative contribution of common activities to overall District PHN workload in order to identify tasks for streamlining. District PHNs are frontline staff working directly in neighborhoods investigating communicable diseases, performing home visits, interviewing patients, and participating in community outreach. However, the amount of variation among staff in the time spent on common work tasks and the relative contribution of each domain of work (e.g. home visits) to overall workload was not known. Without an existing system to measure time spent on tasks, the challenge was meeting Administration's needs to characterize workload in a timely manner. The solution was an on-line administered survey that asked District PHNs to self-report percent of time spent on common tasks in each work domain over the typical time frame in which that work domain is performed (e.g. percent of time in a typical week spent on home visitation). The workload survey tool is adaptable to various workforces, particularly for fieldwork staff, but does begin with a deep qualitative understanding of the major tasks that make up workload. The District PHN Workload Survey can provide health administrators with a relatively quick overview of workload for their staff and is less disruptive than time studies and information technology approaches. The survey also has applicability in situations where it may be desirable to measure the effects of an intervention upon workload.