The Paper Time Study Worksheet is a tool to help hospitals assess how nurses spend time on the unit during a shift and identify obvious inefficiencies and waste in processes. The paper method enables hospital units to customize the data collection form to collect additional data on specific problem areas, such as medication administration, converting from manual to electronic nursing care documentation.

The Paper Time Study Worksheet was tested and is now used widely by hospitals participating in the Institute for Healthcare Improvement's Learning and Innovation Community on Taking Action to Transform Care at the Bedside. It is modeled after the personal digital assistant (PDA) called the Time Study RN™ developed by Rapid Modeling Corporation.

Download the tool and enter collected data into the worksheet.

Data Collection Methods:

Assign an observer to follow a nurse and record nursing activity at a designated rate, such as every five minutes. Observations may be customized for each unit. Three examples of how to accomplish this are as follows:

• Observe a nurse for an hour per day, recording observations every five minutes. Rotate the hour each successive day until all 24 hours are observed over a month.
• Observe a nurse for four hours, collecting data every five minutes, and repeat six times a month until 24 hours are covered. 
• Observe an entire shift. 

After manual data collection the observer should meet with the nurse and improvement team to review opportunities to remove waste and inefficiencies.