PNS204 A Self-Reporting Approach to Healthcare Time and Motion Studies for Budget IMPACT Models in Routine Cataract Surgery

Abstract Background Antiretroviral therapy (ART) is effective at reducing HIV-associated morbidity, mortality, and transmission, but 20 million people who meet WHO eligibility criteria for ART are not in care. While decentralized care is a promising strategy to expand ART access, the costs of implementing a community-based model on a large scale remain unknown. Methods The DO-ART study is a randomized trial of community- vs. clinic-centered ART delivery in South Africa and Uganda using 12-month viral suppression as the primary outcome. We evaluated the costs of home-based ART initiation and refill in southwest Uganda using time-and-motion studies, staff interviews, and budgetary analysis. Costs categories included medications, supplies, personnel, building and utilities, start-up, vehicles, and community mobilization. We used a programmatic perspective with a 3% discount rate and removed research-associated costs. Results The largest cost categories included medications, supplies, and salaries, constituting 41%, 27%, and 17% of the total cost, respectively. Time-and-motion studies revealed that each outreach worker could serve an average of three patients per day in a fully decentralized model. In a scenario of providing home-based ART to 1400 patients aross seven sub-counties, the yearly per-patient cost was estimated to be $304 (2016 USD), which is similar to literature reports of the costs of facility-based ART provision. Conclusion These estimates suggest that home-based ART may be a realistic delivery option, especially if it is found to be effective at improving viral suppression. Further research is needed to evaluate how this intervention can most efficiently scale to provide widespread ART access over a large geographic area. Disclosures All authors: No reported disclosures.

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Time and Motion Studies - P. Dorey: British Politics since 1945, Blackwell, 1995, 378 pp., hardback £40.00, paperback £11.99. - R. Pyper and L. Robins: Governing the UK in the 1990s, Macmillan, 1995, 293 pp., hardback £37.50, paperback £11.99.

Government and Opposition ◽

10.1017/s0017257x00005704 ◽

1996 ◽

Vol 31 (1) ◽

pp. 127-130

Author(s):

Peter Madgwick

Keyword(s):

British Politics ◽

Time And Motion Studies ◽

Time And Motion ◽

Motion Studies ◽

The Uk

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Time and motion studies of National Health Service cataract theatre lists to determine strategies to improve efficiency

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-310452 ◽

2017 ◽

Vol 102 (9) ◽

pp. 1259-1267 ◽

Cited By ~ 5

Author(s):

Harry W Roberts ◽

James Myerscough ◽

Simone Borsci ◽

Melody Ni ◽

David P S O’Brart

Keyword(s):

National Health Service ◽

Linear Regression ◽

Health Service ◽

Multiple Linear Regression ◽

National Health ◽

Multiple Linear Regression Model ◽

High Volume ◽

Time And Motion Studies ◽

Time And Motion ◽

Motion Studies

AimTo provide a quantitative assessment of cataract theatre lists focusing on productivity and staffing levels/tasks using time and motion studies.MethodsNational Health Service (NHS) cataract theatre lists were prospectively observed in five different institutions (four NHS hospitals and one private hospital). Individual tasks and their timings of every member of staff were recorded. Multiple linear regression analyses were performed to investigate possible associations between individual timings and tasks.Results140 operations were studied over 18 theatre sessions. The median number of scheduled cataract operations was 7 (range: 5–14). The average duration of an operation was 10.3 min±(SD 4.11 min). The average time to complete one case including patient turnaround was 19.97 min (SD 8.77 min). The proportion of the surgeons’ time occupied on total duties or operating ranged from 65.2% to 76.1% and from 42.4% to 56.7%, respectively. The correlations of the surgical time to patient time in theatre was R2=0.95. A multiple linear regression model found a significant association (F(3,111)=32.86, P<0.001) with R2=0.47 between the duration of one operation and the number of allied healthcare professionals (AHPs), the number of AHP key tasks and the time taken to perform these key tasks by the AHPs.ConclusionsSignificant variability in the number of cases performed and the efficiency of patient flow were found between different institutions. Time and motion studies identified requirements for high-volume models and factors relating to performance. Supporting the surgeon with sufficient AHPs and tasks performed by AHPs could improve surgical efficiency up to approximately double productivity over conventional theatre models.

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Time and motion studies of medical imaging workstations

10.1117/12.59506 ◽

1992 ◽

Cited By ~ 1

Author(s):

Michael W. Vannier ◽

Ronald K. Walkup ◽

Thomas K. Pilgram ◽

Charles F. Hildebolt ◽

Wolfgang Rueger

Keyword(s):

Medical Imaging ◽

Time And Motion Studies ◽

Time And Motion ◽

Motion Studies

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Ergonomic Time and Motion Studies of Aircraft De-icing Work

Journal of Ergonomics ◽

10.4172/2165-7556.1000204 ◽

2017 ◽

Vol 07 (04) ◽

Author(s):

Kurt Landau ◽

Sylvie Nadeau ◽

Tiphaine Le Floch ◽

Francois Morency

Keyword(s):

Time And Motion Studies ◽

Time And Motion ◽

Motion Studies

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Frederick Taylor and Frank Gilbreth: Competition in Scientific Management

The Business History Review ◽

10.2307/3111727 ◽

1957 ◽

Vol 31 (1) ◽

pp. 23-34 ◽

Cited By ~ 16

Author(s):

Milton J. Nadworny

Keyword(s):

Scientific Management ◽

Time And Motion Studies ◽

Wage Rates ◽

Time And Motion ◽

Motion Studies

The vital task of measuring jobs in order to establish equitable incentive wage rates is usually accomplished by a combination of techniques involving both time and motion studies. Yet for many years a highly personal competition between leading exponents of each type of study prevented a union of techniques from taking place. In the early days of the scientific management movement, Frank Gilbreth was a fierce admirer of Frederick W. Taylor, but Taylor and his disciples rejected Gilbreth, whose micromotion techniques came into competition with the Taylorites' stop watches. Thereby scientific management was split into two antagonistic camps and the course of the movement decisively influenced.

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Bucking Logs to Cable Yarder Capacity Can Decrease Yarding Costs and Minimize Wood Wastage

Southern Journal of Applied Forestry ◽

10.1093/sjaf/10.3.180 ◽

1986 ◽

Vol 10 (3) ◽

pp. 180-183

Author(s):

Chris B. LeDoux

Keyword(s):

Simulation Model ◽

Production Rates ◽

Forest Model ◽

Time And Motion Studies ◽

Piece Size ◽

Time And Motion ◽

Cable Yarding ◽

Motion Studies

Abstract Data from selected time and motion studies and a forest model plot, used in a simulation model, show that logging managers planning felling, bucking, and limbing for a cable yarding operation must consider the effect of alternate bucking rules on wood wastage, yarding production rates and cost, the number of chokers to fly and total logging costs. Results emphasize the need to consider initial logging activities in terms of effects on cable yarding system efficiencies and wood wastage. Results also emphasize the need to match payload (piece size) to cable yarder capacity. Results suggest that cable yarding costs can be decreased by 20 to 32% by simply bucking logs to yarder capacity. South. J. Appl. For. 10:180-183, Aug. 1986.

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Time and Motion Studies of Manual Harvesting Methods for Oil Palm Fruit Bunches: A Malaysian Case Study

Jurnal Teknologi ◽

10.11113/jt.v74.4555 ◽

2015 ◽

Vol 74 (3) ◽

Author(s):

Nizaroyani Saibani ◽

Ariff Azly Muhamed ◽

Mohd Faizal Maliami ◽

Rasyidah Ahmad

Keyword(s):

Palm Oil ◽

Oil Palm ◽

Time Study ◽

Time Data ◽

Palm Fruit ◽

Time And Motion Studies ◽

Time And Motion ◽

Harvesting Technique ◽

Motion Studies ◽

Harvesting Process

In optimizing the yield of oil palm fruit bunches collection, the mechanization of the collection process is very important. However, before the analysis of the cost benefits of any mechanization development can be utilized, this study has to be carried out. Time and Motion Studies (TMS) is used to identify and measure the efficiency of the oil palm fruit bunches’ manual harvesting technique. The Direct Time Study Technique has been selected to determine and record the time taken by the harvester to harvest the oil palm fruit bunches, where the tool used in this technique is a stopwatch, alongside the Time Study Observation Sheet. Meanwhile, to examine the motions used by the harvester in the harvesting process, the Therblig’s Motion Principle is applied to identify effective and non- effective motions. A field work study has been conducted by monitoring two harvesters and all the real time data is recorded in the time study observation sheet and analyzed to get a value of Normal Time (NT) and also Standard Time (ST) for each work element involved in the manual harvesting process of palm oil. There are seven work elements that have been identified to have been used by the harvester to complete the process, the first element is searching for the mature palm oil tree (NT= 40.73 seconds), the second element is adjusting the Aluminium Pole and Knife (APK) cutter (NT= 23.36 seconds), the third element is cutting the oil palm’s frond (NT= 51.30 seconds), the fourth element is cutting the mature oil palm’s bunches (NT= 60.26 seconds), the fifth element is collecting the oil palm’s frond that has been cut (NT= 21.69 seconds), the sixth element is putting the oil palm’s bunches that have been cut into the wheel barrow (NT= 34.25 seconds) and the seventh element is collecting the loose oil palm fruits or called fruitlets (NT= 77.49 seconds). The study also categorized a few non-effective work elements carried out during the manual harvesting process. The elements are: searching for the oil palm trees that have mature oil palm bunches, adjusting the APK cutter and also collecting the loose oil palm fruitlets off the ground.

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Activity-Based Costing (ABC) and Time-Driven Activity-Based Costing (TDABC): Applicable Methods for University Libraries?

Evidence Based Library and Information Practice ◽

10.18438/b8gg8z ◽

2011 ◽

Vol 6 (4) ◽

pp. 107 ◽

Cited By ~ 6

Author(s):

Kate-Riin Kont ◽

Signe Jantson

Keyword(s):

Cost Accounting ◽

Library Services ◽

Activity Based Costing ◽

University Libraries ◽

Natural Evolution ◽

Time And Motion Studies ◽

Time And Motion ◽

History Of ◽

Motion Studies ◽

Abc Method

Objective – This article provides an overview of how university libraries research and adapt new cost accounting models, such as “activity-based costing” (ABC) and “time-driven activity-based costing” (TDABC), focusing on the strengths and weaknesses of both methods to determine which of these two is suitable for application in university libraries. Methods – This paper reviews and summarizes the literature on cost accounting and costing practices of university libraries. A brief overview of the history of cost accounting, costing, and time and motion studies in libraries is also provided. The ABC and the TDABC method, designed as a revised and easier version of the ABC by Kaplan and Anderson (Kaplan & Anderson 2004) at the beginning of the 21st century, as well as the adoption and adaptation of these methods by university libraries are described, and their strengths and weaknesses, as well as their suitability for university libraries, are analyzed. Results – Cost accounting and costing studies in libraries have a long history, the first of these dating back to 1877. The development of cost accounting and time and motion studies can be seen as a natural evolution of techniques which were created to solve management problems. The ABC method is the best-known management accounting innovation of the last 20 years, and is already widely used in university libraries around the world. However, setting up an ABC system can be very costly, and the system needs to be regularly updated, which further increases its costs. The TDABC system can not only be implemented more quickly (and thus more cheaply), but also can be updated more easily than the traditional ABC, which makes the TDABC the more suitable method for university libraries. Conclusion – Both methods are suitable for university libraries. However, the ABC method can only be implemented in collaboration with an accounting department. The TDABC method can be tested and implemented by separate departments, and thus can contribute to the provision of better and more effective library services at lower costs. However, the involvement of experts in costing and accounting is recommended.

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