Using Time Trackers to Understand Staff Capacity to Improve Flow

By Candace Sinclair, Improvement Advisor 

In this 5-minute read, learn how the Integrated Learning Disability Service (ILDS) team in City and Hackney have used time trackers as a tool to better understand staff capacity. 

The ILDS in City and Hackney have been working on an Optimising Flow project to reduce the time it takes for service users to receive an intervention after an assessment has been completed. Led by Dr Laura Checkley, Consultant Psychiatrist, the project team is multi-disciplinary to represent the membership of the service and includes specialist Social Workers, Psychiatrists, Psychologists, Physiotherapists, Occupational Therapists, Speech and Language Therapists and Specialist Community Nurses. 

As participants on the Optimising Flow, Demand and Capacity programme the team have been following the ELFT QI method to address the flow issues within their service. In order to fully understand the problem, the team have been using process maps (also known as flow diagrams), service user/carer questionnaires and staff questionnaires.  

Through the staff questionnaires it became apparent that staff felt they were spending less and less time with service users and that this had an impact on the quality of care they could provide and their sense of fulfilment within their job. 

In order to address the capacity issues within the service, the team realised that they had to understand how staff’s time was being taken up. As a group they discussed and developed an electronic time tracker sheet (see Figure 1.) that would be appropriate for each of the disciplines and would provide a 2–week window into the time staff were spending on each category. 

Figure 1. Example of the time tracker sheet used by the ILDS team  

Once the template was ready, Dr Checkley shared it at the ILDS monthly team meeting, spending time to explain the purpose and to emphasise that the information was for improvement and not for judgement or for performance reasons. Dr Checkley felt it was important to ease any concerns so that the staff felt safe to complete the forms honestly. During the meeting staff also had an opportunity to share any thoughts on the template itself and agreed that 15-minute increments would be better than the proposed 30-minutes to capture the broader use of their time. 

The project team were predicting some resistance to the task from staff already at capacity, but no one objected and despite a busy annual leave period, a good number of staff completed the trackers (29 out of 48). 

Key learning: 

Dr Laura Checkley and Kirsty Haberland, Lead Occupational Therapist and QI project member have summarised some of the key learning they have had and advice they would give to anyone thinking of doing time trackers: 

• When asking staff to complete time trackers, make sure to have clear expectations, explain the purpose and spend time building trust with staff so that they feel comfortable to be honest. 
• In conversations with line managers, staff have already shared that the time trackers are a good reflection tool and can help them understand how they are spending your day. 
• Avoid calling them time audits as that has assurance/performance connotations.  

• Spend time on developing the trackers so that everyone is using the same template with uniform categories and clear definitions for each. 

Next Steps: 

The project team are working with their Improvement Advisor to collate the information from the time tracker sheets completed to date and to put the information into a Pareto Chart in order to identify the “vital few” areas to focus on first.  See (Figure 2) below.

Figure 2. ILDS OT Time Tracker Pareto Chart

The work Hackney ILDS did on their pathway in 2021 has recently been published in the British Medical Journal Open Quality. Click here to read all about it.