INSIGHT The results of a pilot time-and-motion study in three Australian hospitals: Where do we spend our time? Marianna MILOSAVLJEVIC, 1 Peter WILLIAMS, 2 Geraldine PEREZ 2 and Tegan DALLA 2 1 Illawarra Shoalhaven Local Hospital Network, and 2 Nutrition and Dietetics, School of Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia Abstract Aim: To quantify the time nine dietitians spend on different tasks in the inpatient setting and to describe the main dietetic goals for the patients managed. Methods: We used a direct non-participatory observational method and observed hospital dietitians during a typical work shift. The data were then sorted into six categories. Results: A total of 286 hours and 45 minutes was observed across two collection time periods. On average the dietitians spent 18.3% in direct patient contact, 40.4% in indirect patient support activities, 13.5% in administrative tasks, 4.5% in research and education and 3.8% in travel and miscellaneous tasks. Dietetic goals of patients seen during this time, as identified by the dietitians were; to increase energy intake (48%), decrease energy intake (3%), improve dietary knowledge(15%), to improve or manage clinical symptoms (7%) and to meet enteral or parental requirements(11%). Conclusion: Knowing how the dietitians in the present study spend their time affords an opportunity to reflect on how these tasks contribute to the overall goals of the department. Furthermore, it provides baseline data for additional research into the area of dietetic work activities, which could be evaluated across a wider range of services and hospitals. Key words: clinical nutrition and dietetics, health service, practice, workforce. Introduction It has been suggested that the work context shapes dietetic practice; however, what hospital dietitians do in a typical day has received little attention. 1 The profession of dietetics was born in the hospital environment 2,3 and the hospital sector continues to provide employment for a large propor- tion of the workforce in Australia, 4 the UK and USA. 5,6 The few studies that have examined work practices of hospital dietitians have investigated the area using a variety of methods including simple descriptions of time investment across a range of activities, to an extensive analysis of work patterns to produce an algorithm to assist managers in predicting staffing requirements. 7,8 This pilot study is the first direct observational study examining work activities of hospital dietitians and so may be of interest to dietitians and managers. As a profession dietetics has grown and extended across a broad range of work settings; however, a significant number of dietitians still work within the hospital setting and one could argue hospital dietetics remains an integral part of the profession’s identity. There have been some major changes to the role of hospitals over the last 20 years; from a place of convalescence to one of diagnosis and short-term care. In part, these changes are driven by the increasing acuity or level of care required, the ageing population and the increased health needs of this cohort. 9 It is important that dietitians continue to review how they can best provide their expertise in the hospital setting as alternate models of care have burgeoned in the face of changing hospital focus. 10 Therefore, it is timely to review where dietitians in hospitals invest their time and compare these activities with the type of dietetic interventions provided to patients. The aim of this small observational study was to measure how a group of hospital dietitians, working across a range of ward areas, spend their time and describe the type of dietetic goals provided to patients. M. Milosavljevic, MBA, APD, Head of Nutrition Services P. Williams, PhD, FDAA, Associate Professor G. Perez, Third Year BSc (Nutrition and Dietetics) Student T. Dalla, Fourth Year (Nutrition and Dietetics) Student Correspondence: M. Milosavljevic, Illawarra Shoalhaven Local Hospital District, Wollongong Hospital, Crown Street, Wollongong, NSW 2500, Australia. Email: marianna.nilosavljevic@sesiahs.health.nsw.gov.au Accepted March 2011 Nutrition & Dietetics 2011; 68: 185–188 DOI: 10.1111/j.1747-0080.2011.01526.x © 2011 The Authors Nutrition & Dietetics © 2011 Dietitians Association of Australia 185