Time-motion studies of physician assistants and nurse practitioners

The Resource-Based Relative Value Scale is widely used to measure healthcare provider productivity and to set payment standards, although its limitation is in its assessment of preservice and postservice work and other potentially non-revenuegenerating healthcare services, or service-valued activity (SVA). A time and motion study assessed PA and NP productivity in hospital and outpatient settings. Using personal digital assistants (PDAs), 19 providers identifi ed their location and activity each time the PDA randomly prompted them to input their activity. The data from the providers in multiple inpatient and outpatient settings were separated into revenue-generating services (RGSs) and SVAs. The inpatient PAs and NPs spent 62% of their time on RGSs and 35% on SVAs. Providers in the outpatient settings spent 59% of their time on RGSs and 38% on SVAs. This novel informationgathering system can be used to accurately document productivity, determine clinical practice patterns, and improve deployment strategies of healthcare providers.