Research Toolkit series

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A beginner's guide to time and motion studies

Jessica Coddo^1,2,3 BPharm, MClinPharm, FANZCAP (GeriMed), Hana Amer^2,3,4,5 BPharm (Hons), Penelope Alvaro^2,3 BPharm (Hons), and Mirela Prgomet⁶ BAppSc (HIM) (Hons), PhD

Corresponding email: jess.coddo@adelaide.edu.au

[Pharmacy GRIT article no: 20261427; published online 5 October 2026]

1. Geriatric Medicine SPG, Leadership Committee, Advanced Pharmacy Australia
2. Adelaide University, South Australia
3. SA Pharmacy, South Australia
4. SA/NT Branch Committee, Advanced Pharmacy Australia
5. School of Pharmacy, University of Sydney
6. Australian Institute of Health Innovation, Macquarie University

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Contents

• What is a time and motion study?
• Why choose a time and motion study?
• Method: how to conduct a time and motion study
• Defining and developing tasks
• Planning your time and motion study
• Strategies to strengthen your time and motion study

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What is a time and motion study?

A time and motion study is a research methodology that involves continuous observation with the aim of capturing how staff spend their working day, including the types of tasks they perform, how they perform them, and the time spent performing the task.^1,2

A systematic review, conducted in 2014,¹ reported that no standard definition or reporting framework exists for time and motion studies. Instead, the term encompasses a broad spectrum of studies with the overarching aim to capture and analyse the duration of one or more events.¹ According to Lopetegui et al. some time and motion studies referred to continuous observations by an external observer (i.e. a person other than one performing the task), whilst others used the term time and motion to refer to any study that measured the duration of one or more events.¹ Key methodological outcomes (e.g. how long the observations were, how many tasks were observed, whether multi-tasking or interruptions are recorded, and how observer training and reliability were addressed) differed greatly between the different studies reviewed.¹ Due to such variance in these outcomes, the authors of the review concluded it was difficult to compare study findings and clearly define time and motion studies as a singular method.¹

Time and motion studies with continuous observation by an external observer are considered the gold standard of clinical workflow measurement studies.³ Studies relying on self-reporting of tasks are prone to bias and unreliability, as participants may either underestimate or overestimate⁴ task durations  to present what they perceive as more favourable data.¹ Staff may also overestimate the time required for the tasks they perceive as burdensome.⁴

Time and motion studies are used in healthcare to help understand how staff spend their time and can allow us to identify workflow improvements to increase efficiency.  Time and motion studies are particularly useful in healthcare settings such as hospitals, pharmacies, and clinics, where even small improvements in workflow can save time, reduce errors, and improve patient outcomes. 

Why choose a time and motion study?

The main objective of a time and motion study is to understand how  work is completed and to evaluate the proportion of overall time spent on smaller discrete tasks which make up the work activies.²

Time and motion is useful to measure the impact of implementing a new initiative such as the introduction of an electronic medical record system, a change in policy or procedure, or the commencement of a new role.² Time and motion is also effective in evaluating safety processes and efficiencies in workflow.

Depending on the institution, some time and motion studies may require review from a Human Research Ethics Committee (HREC). Whilst other institutions may consider these types of studies to be quality assurance in nature and not require full ethics approval. Regardless, it is critical to obtain informed consent to observe participants.

If you are considering pursuing publication of your research in a peer reviewed journal, please read the journal’s author guidelines before undertaking your work as publication may require ethics approval or formal ethics exemption status.

Method: how to conduct a time and motion study

There are many factors to consider when planning and time and motion study. Including the study setting, participants, study design, and data collection methods.

Defining and developing tasks

When planning a time and motion study, tasks need to be broken down into different variables. For example, the task being performed, who will be performing the task, how the task will be performed, and the location where the task will be performed. Broadly, these variables address what, who, how, and where.

The guide below, based on the Work Observation Method by Activity Timing (WOMBAT)^5,6 time and motion tool, defines these key variables. This guide explains each variable and can be used when developing any time and motion study.

When defining and developing your tasks, you may wish to have subcategories that break down larger tasks further into discrete tasks. For example, ‘Supervision and Training’ can be further broken down into electronic medical record (EMR) training, clinical training, and ClinCAT etc.

There is the ability to select multiple options within each variable (WHAT, WHO, HOW, WHERE) if deemed appropriate and necessary for your study.

WHAT

First, consider what types of ‘tasks’ you will be observing.

The term task is used to refer to a work activity and often, you can use a standard definition for each task as defined in the literature. For example, the Advanced Pharmacy Australia (AdPha) Clinical Pharmacy Standards⁷ define the work activities of clinical pharmacists, including tasks such as taking medication histories, conducting medication reviews, providing advice for medicines management, and documenting clinical activities. 

Establish a clear definition, with inclusion and exclusion criteria, for each task that can be used by observers during the study period.² This will help ensure that tasks are captured consistently over time and across different observers.²

For each task (WHAT), additional domains which affect time spent on activities are captured such as who the task is being performed with, how and where the task is being performed.

WHO

Consider if the task is performed collaboratively (e.g. with a patient, carer, or another healthcare professional) or independently; the ‘who’ the task is performed by. This is important because performing a task with another person can influence the time spent on the task, or the way it is carried out, when compared to performing a task independently. It can also demonstrate the level of collaboration that occurs between different health professionals. For example, conducting a best possible medication history (BPMH) independently compared to doing the same task with a student, may take longer due to the discussion required

Despite being the same task (WHAT), the outcome is different depending on who the task is being performed with.

HOW

Consider how the task will be performed (e.g. face-to-face, over the phone, on a computer). This step can be particularly useful for studies measuring differences between electronic and paper-based medical records.

WHERE

Finally, determine the location where the task will be performed. For example, will the task be conducted on the ward, at the bedside, in the pharmacy office, or in the dispensary?

Applying the guide

To demonstrate how the guide can be used, example scenarios covering data collection, task interruptions and multitasking are outlined below. Each example identifies key variables in a table format as this format is used in the WOMBAT 3.0 data collection tool (Macquarie University, Sydney, Aus).  Guidance about how licensing and accessing WOMBAT and other collection tools is discussed later in this article.

Data collection

In the WOMBAT data collection tool, all variables are visible in a table format for the observer to easily record. The selected variables are highlighted to reflect the scenario being observed and automatically time-stamped to capture task timing data.

In the example scenarios below, relevant variables are indicated with bold text. 

Example scenario 1: medication history

A pharmacist is taking a medication history (WHAT) with a patient (WHO), face-to-face (HOW), at their bedside (WHERE).

WHAT
Medication history	Medication review	Education	Documentation	Handover
Rounding	Discharge planning	Meeting	Other
WHO
Patient	Carer	Doctor	Nurse	Independent
Another pharmacist	Pharmacy assistant or technician	Allied Health Professional	Other
HOW
Face-to-face	Phone	Pager	Desk computer	Laptop
Paper	Electronic medical record	Email	Fax	Tube
Other
WHERE
On ward	At beside	Pharmacy office	Dispensary	Other

Example scenario 2: medication advice

A pharmacist is providing clinical handover (WHAT) to a doctor (WHO) over the phone, (HOW) while in the pharmacy office (WHERE).

WHAT
Medication history	Medication review	Education	Documentation	Handover
Rounding	Discharge planning	Meeting	Other
WHO
Patient	Carer	Doctor	Nurse	Independent
Another pharmacist	Pharmacy assistant or technician	Allied Health Professional	Other
HOW
Face-to-face	Phone	Pager	Desk computer	Laptop
Paper	Electronic medical record	Email	Fax	Tube
Other
WHERE
On ward	At beside	Pharmacy office	Dispensary	Other

Interruptions and multitasking

Given the complexities of workflows in healthcare settings, some time and motion data collection tools provide the ability to capture interruptions and multitasking. For example, the WOMABT tool will pause the timing of TASK 1 whilst TASK 2 is being performed if an interruption is recorded. Alternatively, the tool will continue timing TASK 1 simultaneously with TASK 2 if a multitask is recorded.

Example scenario 3: recording an interruption

TASK 1: A pharmacist is documenting a medication history (WHAT) independently (WHO) on their desktop computer (HOW) in the pharmacy office (WHERE).

TASK 2 (the interrupting task): whilst the pharmacist is documenting the medication history, they stop to take a phone call (HOW) from a doctor (WHO) who provides handover about a patient (WHAT). The pharmacist remains seated at their desk in the pharmacy office (WHERE) whilst speaking to the doctor.

Example scenario 4: multitasking

In the above example, if the pharmacist continues documenting the medication history (TASK 1) whilst speaking to the doctor (TASK 2), this is considered a multitask.

Planning your time and motion study

There are a number of tools that can be used to conduct a time and motion study. The table below summarises some of the most common tools and their advantages and disadvantages.

Table 1: common data collection tools

Available tools	Features	Advantages	Disadvantages
Work Observation Method by Activity Timing (WOMBAT)6	Designed for use in healthcare and other settings Continuous recording of observations Validated data collection tool Data securely stored on server	Technical support available Ability to record multitasking and interruptions Allows offline data collection Templates are customisable and can be translated for any language	Subscription-based service, cost associated with use WOMBAT is free to download and a Lite Version is accessible to allow exploration of the software. However, a subscription must be obtained to collect and store data Only usable on iOS devices with collected data accessed via internet browser
Time Capture Tool (TimeCAT)3	Designed for use in healthcare settings Continuous recording of observations	User support available Usable on most browsers, desktops and mobile devices Ability to record multitasking Includes module for inter-observer reliability assessments (IORA)	Subscription-based service, cost associated with use Offline data collection unavailable
Clockify8	Designed for time keeping activities, including managing billable hours and timing tasks	Free and subscription-based services available Usable on most browsers, desktops and mobile devices Allows offline data collection	Able to track multiple tasks at once but requires manual input

Data analysis

The statistical analysis of time and motion data depends on the study design and research questions being addressed. Descriptive analyses are commonly used to characterise observed work patterns and authors will often report the proportion of time spent on different task categories relative to the total observation time. This approach provides a meaningful summary of how clinicians (or other participants) allocate their time across activities and is generally preferred over simple task counts, which are sensitive to how tasks are defined and segmented.

When a comparator is included in the study — such as before and after an intervention or different groups of healthcare professional — analyses may extend to comparing differences in task duration, task distribution, or rates of interruptions.

Observer Training

Ensuring all study observers have been adequately trained is vital to the success of a time and motion study.

Prior to data collection, a template outlining the task categories and standard definitions of tasks should be developed as discussed above. The template needs to be understood and interpreted the same way by all observers. It is also recommended for observers to partake in multiple simultaneous observation sessions using the template to ensure all observers apply the template in the same way. It is also recommended to measure the inter-observer reliability to ensure that each observer is capturing data in the same way.⁵ For studies where only one observer is involved in data collection, intra-observer reliability may be considered.⁹ This ensures that the observer is recording tasks and timing tasks in the same way across different occasions.⁹

Additionally, the various time and motion data collection tools such as WOMBAT⁶ and TimeCAT³ provide varying degrees of training support, through instruction manuals, demonstration videos, and software support which are available for training purposes. 

Inter-observer reliability

Inter-observer reliability is used when there are multiple observers within a study and demonstrates the level of agreement between the observers. Understanding the inter-observer reliability is important to minimise observation bias.⁹

Inter-observer reliability is underreported in time and motion studies and currently, there is no consistent approach to measure the inter-observer reliability in time and motion studies.⁹ However, measuring inter-rater reliability usually involves having multiple observers recording the same tasks independently, and then comparing how the tasks were recorded. This includes comparing the types of categories selected and the timing of tasks, to ensure consistency in data collection across observers.^2,9

Cohen’s kappa coefficient is most often used to report the level of agreement between different observers. However, this does not take into account the differences in time, which can impact the reliability and robustness of the results.^2,9,10 Measuring inter-observer reliability should be performed prior to the study and throughout to measure and account for observer practice changes.^2,9

The iota score is an alternative measure of inter-observer reliability and has been compared to Cohen’s kappa coefficient.¹⁰ It shows an improvement due to the ability to assess the impact of time on the categorical data, which is critical for time and motion studies.

The lack of consistency highlights the need for the development of a reliable and standard approach to measuring inter-observer reliability in time and motion studies.¹⁰

Strategies to strengthen your time and motion study

To summarise the above article, key strategies to use when developing your own time and motion study have been identified:

• Use a validated tool to record your time and motion data
• Utilise a standardised checklist, such as Suggested Time And Motion Procedures (STAMP),¹¹ as a guide when designing and reporting your time and motion study
• Consider intra- or inter-observer reliability and measure prior to and throughout your study to minimise the impact of observer practice changes^2,9
• Undertake a pilot phase and training, particularly when using multiple observers.

Additional reading and useful resources

• WOMBAT | Macquarie University
• Work Observation Method By Activity Timing (WOMBAT) | WHAT YOU NEED TO KNOW Guide
• TimeCAT
• Clockify

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References

1. Lopetegui M, Yen P-Y, Lai A, Jeffries J, Embi P, Payne P. Time motion studies in healthcare: what are we talking about? J Biomed Inform 2014; 49: 292–299.
2. Tanzini M, Westbrook JI, Guidi S, Sunderland N, Prgomet M, Donaldson L, et al, eds. Measuring clinical workflow to improve quality and safety. In: Textbook of patient safety and clinical risk management. Cham: Springer; 2021. p. 393–402.
3. Lopetegui M, Yen P-Y, Lai AM, Embi PJ, Payne PRO. Time capture tool (TimeCaT): development of a comprehensive application to support data capture for time motion studies. AMIA Annu Symp Proc 2012; 2012: 596–605.
4. Westbrook JI, Ampt A, Kearney L, Rob MI. All in a day's work: an observational study to quantify how and with whom doctors on hospital wards spend their time. Med J Aust 2008; 188(9): 506–509.
5. Westbrook JI, Ampt A. Design, application and testing of the Work Observation Method by Activity Timing (WOMBAT) to measure clinicians’ patterns of work and communication. Int J Med Inform 2009; 78: S25–S33.
6. Australian Institute of Health Innovation (AIHI). Work Observation Method By Activity Timing (WOMBAT). Sydney: Macquarie University; 2024. Available from <https://www.mq.edu.au/research/research-centres-groups-and-facilities/healthy-people/centres/australian-institute-of-health-innovation/our-projects/wombat>.
7. Dooley M, Bennett G, Clayson-Fisher T, Hill C, Lam N, Marotti S, et al. Advanced Pharmacy Australia clinical pharmacy standards. J Pharm Pract Res 2024; 54: 446–511.
8. Cake.com. Clockify. Palo Alto, CA: Cake.com. Inc; 2025. Available from https://clockify.me/.
9. Lopetegui MA, Bai S, Yen P-Y, Lai A, Embi P, Payne PRO. Inter-observer reliability assessments in time motion studies: the foundation for meaningful clinical workflow analysis. AMIA Annu Symp Proc 2013; 2013: 889–896.
10. Walter SR, Dunsmuir WTM, Westbrook JI. Inter-observer agreement and reliability assessment for observational studies of clinical work. J Biomed Inform 2019; 100: 103317.
11. Zheng K, Guo MH, Hanauer DA. Using the time and motion method to study clinical work processes and workflow: methodological inconsistencies and a call for standardized research. J Am Med Inform Assoc 2011; 18: 704–710.

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