Designing for Resource-Efficient Manual Work Activities at Hospital Care Units

Abstract: Although Swedish healthcare needs to increase productivity to become able to meet demand projected for the future, public healthcare in Sweden currently shows a downward trend in productivity. The research presented in this licentiate thesis aims to improve the resource efficiency of manual work activities performed in Sweden’s hospital care units and, in turn, contribute to increased productivity in the nation’s healthcare. In that context, resource efficiency, defined in light of production engineering, refers to how efficiently activities are performed by resources in producing output. The thesis provides answers to three research questions regarding (i) how medication work in hospital care units should be improved to become more efficient; (ii) how work activities in care units should be identified, collected, and organised systematically; and (iii) how resource efficiency can be systematically improved for manual work activities in hospital care units. The framework of the thesis is based on design science research, and the methods used in the accompanying research included work design and work study analysis. Two projects conducted at Sahlgrenska University Hospital, a large public hospital in Sweden, constitute the empirical basis of the thesis. First, the Standard for Medication Work in Care Units project concerned how to design a solution to change the conditions for performing the work activity of preparing medication more efficiently. Its results include principles for designing medication rooms, configurations for designing work stations and kit storage, and ways to prioritise the placement of furnishings in medication rooms. Second, the Systematic Work Activity Mapping project concerned ways to design a solution for identifying and organising work activities in hospital care units. The results of this project include a systematic work activity mapping method, a systematic work activity mapping structure, a work activity denomination terminology, and a comprehensive list of work activities mapped in nine care units. The evolution of the field problems and design problems, the design of the interventions, the plan for their implementation, and the methods used to design the solutions are also discussed in the thesis. The chief result of the thesis is the series of four steps necessary to achieve improvements in resource efficiency of work activities as a means to increase productivity in the aggregate: systematic mapping of work activities, conducting a work sampling study, improving work methods, and realising the improvement. Suggestions for further research to contribute to resource efficiency and productivity in Sweden’s healthcare system conclude the thesis.