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An alternative method for measuring workload.

An alternative method for measuring workload

We have introduced a highly accurate work measurement technique, long used by industry, to the laboratory field. It is a predetermined motion time system, and several departments in our 404-bed hospital find that it's an important tool for workload management.

The idea is that any job can be broken down into basic motions, which have associated times. Turning, bending, and picking up something and putting it down are examples.

The time each motion takes is known: Developers of the system we use timed the work activities of many hundreds of individuals, and independent experts when validated the measurements. All we have to do is outline a procedure in terms of the motions it requires and add up the predetermined times.

No stopwatches, no long series of repeated observations are needed to insure accuracy. So the system is considerably faster than a time study approach. It is also more reliable.

We will describe how the system works and consider several of its advantages in this article. In Part II next month, we will further illustrate its use and compare it to time study approaches, including the CAP workload recording method.

The first predetermined motion time system was developed in 1925. Numerous other systems followed, the most significant of them--Methods Time Measurement--emerging in the mid-1940s. Unlike the authors of previous systems, MTM's developers made their approach and backup data generally available. This opened the door to validation by industrial engineers and the academic community. The MTM system was first validated at Cornell University in 1950. Later exhaustive validation took place at the University of Michigan, from 1953 to 1973.

A family of MTM systems, all based on the original research data, have come out since 1948. Many are designed for particular kinds of work, such as MTM-M for activities using a microscope and MTM-V for machine shop activities. All of these systems are available to the public through the MTM Association, a nonprofit organization headquartered in Fair Lawn, N.J.

There are MTM association in 12 other countries. The one in Germany brought forth the system our hospital uses: MTM-UAS or simply UAS (universal analyzing system). Some of the characteristics that make UAS well suited to the laboratory are:

* Accuracy, Dr. Walton M. Hancock established a method for determining the accuracy of MTM-1 (the original system). That created a yardstick--the accuracy of other work measurement systems can be expressed within a percentage, plus or minus, of MTM-1. For jobs taking at least 5.27 minutes, there is 95 per cent confidence that the time standards produced by our UAS system will be within 5 per cent of MTM-1. We attain even greater accuracy with longer time standards.

* Reliability. Work measurement results obtained by individuals trained in the UAS system are consistent. Valid comparisons can be drawn when time standards for a lab procedure are developed by two different observers or in two different locations. If the standards differ by 10 per cent, you can expect the actual work content--the motions involved for each lab method or for varying batch sizes--to differ by that amount, too.

* Fast application. Our experience shows that an analyst who is developing a standard for work on a lab procedure will spend five to eight times the cycle time (the length of the work). Thus it will take only 25 to 40 minutes to develop a standard for an activity that requires 5 minutes of work, as opposed to the many repetitions that would be necessary in a time study. This estimate covers everything the analyst has to do--observe, take notes, think about the procedure, look up UAS times, and edit findings.

* Computer program. Analysis is reduced to four to six times the cycle time in our hospital because we use microcomputers to develop the standards and periodically update them as methods or work conditions change. For example, a series of activities that make up a tube-pouring task can be assigned a single code. Whenever an analyst comes across a procedure that requires tube pouring, he or she simply enters the code into the computer. The computer automatically inserts the tube-pouring data at the proper place in the standard that is being developed.

To date we have identified more than 160 common procedural elements. These elements are pieced together like building blocks to develop standards for higher-level procedures.

Our data base management software is the MTM Association's Adam program. Its $20,000 cost is more easily justified on an institutional basis than for the laboratory alone. Nursing, radiology, and respiratory therapy also use the computerized work measurement system in our hospital.

The UAS system can be put into a general-purpose data base management program at a lower cost. And many laboratories might conclude that manual application is the best alternative for them.

* Ease of use. MTM-UAS is so simple to understand and apply that 10 days of training will suffice to qualify a laboratory technologist. Eight of us from different departments received training at the hospital from an MTM Association instructor. The total cost was $8,000, but less expensive association courses are available at locations acros the country. The rate per person is $650 for a 56-hour course. The association also offers instructors' courses, so one representative from an institution can qualify to teach others the system.

* Laboratory-specific standards. The time standards we have developed are specific to our operation. They are based on our methods, are well documented, and are known to be correct. They can be modified, however, to meet the exact methods of another laboratory, for while no two laboratories are identical, they are often similar. Sharing in this manner can provide a superior work measurement product for each laboratory while minimizing time spent on development of standards.

Let us briefly see how the system works. Figure I shows both sides of a 6 x 8-inch UAS data card. All of the basic motiuons are listed. They are summarized by 29 sets of code letters (AA, AB, AC, PA, PB, etc.), which represent degrees of difficulty in performing the motions.

We will focus here on the most common activity, which is called get and place--picking up something from somewhere and putting it somewhere else. One example is getting a pencil from your pocket and placing the point on a piece of paper; another, getting a test tube from a box and placing it in a rack.

The time it takes to do these things is influenced by the four headings in the get and place section of the card: the weight of the object; the conditions of the get or how difficult it is to reach for an object and gain control if it; place accuracy or how difficult it is to move the object to a position and relinquish control; and distance range or how far you have to reach to either get or place the object. The card has one-word descriptions for differnt conditions of the get and for place accuracy:

In an "easy" get, you may only have to pick up one object that sits by itself; in a "difficult" get, you may first have to separate several objects lying close together before picking up one. Picking up several small objects in a pile is called a "handful."

A "loose" place involves either light pressure to get at the object or 1/4 to 1/16-inch tolerance. A "tight" place involves heavy pressure or less than 1/16-inch tolerance. An "approximate" place is everything else.

For reasons related to development of the system, times are expressed in TMUs or time measurement units. They are small--there are 100,000 TMUs in one hour, making 1 TMU equivalent to 0.036 seconds.

It takes 10 days of instruction to properly understand the UAS data card, but those are some of the highlights. In practice, the analyst seldom even uses the card. The 29 codes for get and place and other activities are applied from memory. The computer looks up all the times, freeing the analyst to concentrate on the work methods under examination.

Now we can apply get and place to the act of pouring a tube specimen. Let's say the sample tube is in a rack and the centrifuge tubes are in a nearby box. The technologist removes the sample tube from the rack, uncaps it, gets the centrifuge tube, pours, and places both tubes in the rack.

The first step is to get the tube from the rack and hold it in front of the technologist. The factors are: weight, less than 2 pounds; condition of get, easy; place accuracy, approximate; and distance range, 8 to 20 inches. The applicable code on the UAS data card in Figure I is AA2 (the 2 signifies the second distance heading, for 8 to 20 inches). That code tell us it takes 35 TMUs to get the tube from the rack.

Figure II gives times for all five of the steps that make up the pouring of a tube specimen. Note that the actual pouring time, step four, isn't taken from the UAS data card. Since the technologist does not have to move while pouring takes place, it's better to clock the step and record the time. Activities measured by stopwatch are encoded PT, which stands for process time.

Another point to note: There's no "get" aspect to placing the tubes in the rack--the technologist is already holding them after pouring. So a time for the final step is obtained from the bottom of the data card, in the activity section titled "place."

If you have followed get and place, you now know how the most complex element in the system works. You're ready for the example in next month's article--a work measurement analysis of Stat urinalysis.
COPYRIGHT 1986 Nelson Publishing
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1986 Gale, Cengage Learning. All rights reserved.

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Title Annotation:part 1
Author:Lindner, Carl A.; Helms, Ashley S.; Shaw, Brigitte
Publication:Medical Laboratory Observer
Date:May 1, 1986
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