Q. What research is available on the ratio of direct to indirect time for clinical staff? What are the industry norms?

A. I'm afraid I'm not quite sure what "clinical staff" or "industry" you have in mind, but I'll assume that you are asking about medical and mental health staff. There was not much in the literature that I found, using the search terms "direct time" or "indirect time". However, I did find one Japanese study (Lee et al, Taehan Kanho 1993 Nov-Dec;32(5):66-77) that might bear on your question.

The purpose of this study was to develop a new nursing unit to meet changing health care needs, enhance patients' satisfaction and nurses' job satisfaction, and to guarantee quality nursing care. One medical unit was selected as a unit for quality care, and another as a control unit. To evaluate the effectiveness of the model unit, direct/indirect nursing care hours, patients' satisfaction to nursing care, nurses' job satisfaction, and quality care index were measured.

Direct/indirect nursing care hours were compared with that of the control unit, and patients' and nurses' satisfaction and quality care index were measured before and after operating model unit and compared with each other.

The results of the study were as follows; 1. In the model unit mean direct nursing care hours per each shift was 146.88 minutes and indirect nursing care hours was 354.72 minutes. The ratio of the direct nursing care hour to indirect nursing hour was 29.6:70.4 and that of the control unit was 26.9:73.1.

Direct nursing care hours in the model unit were longer than in that of the control unit, but the difference was not significant. Patients' satisfaction to nursing care was increased significantly after operating the model unit (T = -3.48, P = 0.002). I hope this is the kind of information you are seeking.

August 2003

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