A Quantitative Study of Work Flow in a Dental Clinic

Understanding the workflow is an important task for designing, implementing, and evaluating any clinical information system. How to evaluate workflow quantitatively is a challenging task. Objective: The objective of this project is to develop a systematic method to evaluate and quantitize workflow of a dental clinic. Methods: Five dentists, five dental assistants and five administrative personnel were observed during their daily working activity for a whole shift in UTDB Houston. All data were collected in one tablet PC. The functional framework coding system was employed to code the whole work flow. The different tasks based on the functional frame work were categorized into different categories. Two coders were trained to use MacShapa to code the workflow. Data was analyzed by SPSS 10.0. Results: The observation was totally 1590 minutes. The average observation time is 160.1 Minutes per subject. (Range 114-220 minutes; SD=34.72) Two coders were tested in their inter-rater reliability; the inter-rater reliability is very high. (Cohen's Kappa=0.90) The average task number for a shift is 53, the range of task is very wide (min 24, max 104 tasks). In the function category part, category 6 (42.47) is much higher than category 3 (7.76), category 4 (1.16) or category 1(1.67). That means most of operation performed in the clinical routine are not supported by EDR nor considered by the user. Use paper chart (13.03) is much higher than use EDR (3.87); it shows paper chart still been used much more often used. There are significant difference in following predicates among dentist, assistant and administrative personnel: frequency of administrative work, clinical work, use of EDR,and use of paper chart (p< 0.05, ANOVA) Conclusion: By utilizing this new method, which combined qualitative research method and functional frame work, we could quantitizing the workflow of dental clinic. Thus a better understand and evaluation can be performed.