Using real-time location devices (RTLD) to quantify off-unit adult intensive care registrar workload: a 1-year tertiary NHS hospital prospective observational study

UK national guidelines state deteriorating or at risk hospital ward patients should receive care from trained critical care outreach personnel. In most tertiary hospitals this involves a team led by an Intensive Care Unit (ICU) registrar. The ICU registrar must also review patients referred for possible ICU admission. These two responsibilities require work away from the ICU. To our knowledge the burden of this work has not been described, despite its importance in ICU workforce management and patient safety. A 12-month, prospective, observational study was carried out. The primary outcome measure was ICU registrar time spent on and off-unit. The study participants were senior and junior registrars on the rota of the 16 bed, Adult Intensive Care Unit at the John Radcliffe Hospital in Oxford. To measure their work patterns, this study used AeroScout ‘T2’ Real Time Location Device (RTLD) tags (Stanley Healthcare, Swindon). In our hospital, senior and junior ICU registrars spend roughly one-fifth of their time off-unit, half of which is spent in ED. This workload combines to leave the unit unattended at night up to 10% of the time. RTLDs provide a reliable, automated method for quantifying ICU registrar off-unit work patterns. This method may be adopted for quantifying other clinical staff work patterns in suitably equipped hospital environments.