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ED healthcare professionals and their notions of productivity
  1. Fiona Moffatt1,
  2. Stephen Timmons2,
  3. Frank Coffey3
  1. 1Division of Physiotherapy Education and Rehabilitation Sciences, The University of Nottingham, Clinical Sciences Building, City Hospital Campus, Nottingham, UK
  2. 2Centre for Health Innovation, Leadership and Learning, Nottingham University Business School, Nottingham, UK
  3. 3Emergency Department, Nottingham University Hospitals NHS Trust, Nottingham, UK
  1. Correspondence to Fiona Moffatt, Division of Physiotherapy Education and Rehabilitation Sciences, The University of Nottingham, Clinical Sciences Building, City Hospital Campus, Rm B80, Nottingham NG5 1PB, UK; fiona.moffatt{at}


Objective The combination of constrained resources, patient complexity and rapidly increasing demand has meant that healthcare productivity constitutes a significant problem for emergency medicine. However, healthcare productivity remains a contentious issue, with some criticising the level of professional engagement. This paper will propose that productivity improvements in healthcare could occur (and be sustained) if professionals' perceptions and views of productivity were better understood.

Methods An 8-month ethnographic study was conducted in a large UK ED, using semistructured interviews with healthcare professionals (HCPs) (n=26), a focus group and observation. Thematic analysis of the data was undertaken based on an interpretivist philosophy.

Results The data demonstrate that HCPs accept productivity improvement as part of their contemporary professional role. In particular, their understanding of productivity is focused around five key domains: the patient; the professional; the culture; the process of work and the economic.

Conclusions By exploring how these HCPs experienced and made sense of productivity improvement and productive healthcare, the data reveals how HCPs may reconcile a culture of caring with one of efficiency. Understanding healthcare productivity from this perspective has potential implications for service improvement design and performance measurement.

  • qualitative research
  • efficiency
  • emergency care systems, emergency departments

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  • Twitter Follow Fiona Moffatt at @fimo18

  • Contributors All authors contributed equally to this submission.

  • Funding Foundation for the Sociology of Health and Illness.

  • Competing interests None declared.

  • Ethics approval University of Nottingham Medical School Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.