The influence of client, staff and workflow characteristics on immunization clinic encounter time

Abstract

Using a conceptual framework derived from contingency theory and Verran and Shaw's (1986) Nursing Technology Model, this exploratory descriptive, comparative study examined the effect of clients' dominant language and degree of acculturation, staff's dominant language, and workflow variability on the time required to preconference clients at one immunization clinic in Southern Arizona. An investigator-developed tool was used to classify clients into three dominant language groups (English-only, Spanish-only, and bilingual), three levels of acculturation (low, moderate , and high), and assess workflow variability (low, moderate, high). Nursing staff conducting the preconferencing session were categorized by self-report into three dominant language groups (English-only, partial Spanish, and bilingual). It was expected that clinic encounter time would increase when miss-matches between client's and staff's dominant language required the use of a translator, with decreased levels of client acculturation and with increased levels of workflow variability (i.e., with more exceptions to standard procedures). The results of the research failed to support these hypotheses. Analysis of variance revealed no significant differences between the mean scores for any of the variables measured. However, some variables did order as predicted (e.g., encounters done by bilingual staff took less time than encounters using a translator). The high variability in the scores suggests the need for researchers to consider other factors in addition to those measured here when determining the predictors of encounter time.