MEASUREMENT SYSTEMS IN PRINCIPLE AND IN PRACTICE - THE EXAMPLE OF NURSING WORKLOAD

There has been a rapid development of measurement systems in the healt h services in the United Kingdom (UK) over recent years, not always ma tched by a thorough understanding of the phenomenon being measured and rarely based on any assessment of reliability or validity. A particul arly flagrant example of this process is the development of nursing wo rkload measurement systems (NWMS). The estimates from four NWMS were e xamined. They were substantially different from each other for no obvi ous reason, and the difference between any of the estimates and the ac tual nursing hours worked could not be explained in terms of any other aspect of the nursing process. There is no evidence that the NWMS dep loyed in the UK are anything more than an expensive numbers game; with out this kind of investigation of how they actually work in practice, it would be prudent to be wary about any of the measurement systems wh ich have been proposed. Yet many of the measurement systems used in ot her sectors of the health service are equally untested.