First Get the Data, Then Do the Science!

382 www.pccmjournal.org April 2018 • Volume 19 • Number 4 ICUs, each of which could influence the proportion of time nurses and orderlies are able to spend on patient care (5). Importantly, the authors report a difference in the proportion of nurses with 5 or more years of experience in the study periods, with fewer experienced nurses in the latter period. Other workforce characteristics not reported but potentially relevant include the training backgrounds of the nursing and orderly staff. Hospitals with higher proportions of nurses educated at the baccalaureate or higher level demonstrate lower mortality and failure-to-rescue rates (6). Similarly, lower nurseto-patient ratios are associated with improved patient outcomes (7). Acuity-adjusted nursing ratios could conceivably influence the amount of time directed toward patient care each study period, although these data are not reported. While more than 150 hours were observed for 22 nurses and 14 orderlies, a larger cohort may be necessary to represent the individual nurse, orderly and patient circumstances that can influence the proportions of task times spent during a given shift. When resources allow, time-motion study provides rigorous benchmarks that can be tracked longitudinally to gauge system performance in response to such tweaks. Similar studies from other institutions are necessary to form a more generalized understanding of the impact of EMR implementation, mobile phones, changes to designated orderly tasks, and other system modifications on patient care.