Workload measurement study to develop staffing guidelines for the clinical inpatient dietitian.

A study was done to develop staffing guidelines for the inpatient clinical dietitian based on the Victoria General Hospital Dietary Department's philosophy of nutritional care. The objectives were to identify the major activities being performed by the dietitian, estimate the average amount of time spent on each activity, determine the number of dietitian consults, determine the time required per patient consult, and establish indicators for workload, performance and productivity. All activities were coded for easy record keeping and tabulation, and the D-unit (5 minutes of a dietitian's time) was used as the unit of time measurement. The results showed that the dietitians were spending 44% of time on direct patient care, 20% on patient care support activities, 1% intradepartmental activities, 6% teaching (other than patients), 4% community, 3% on research and special projects, and 7% doing other tasks. Using the % of direct patient care time available, the % of patients requiring nutritional support, and the patient turnover rate, it was possible to develop a formula for the number of dietitians required to provide nutritional care based on the department's philosophy.