Approaches to changing the use of time in a public hospital

This article describes a qualitative study that used documentary sources and interviews with a cross-section of clinical managers and staff to identify the ways in which use of time changed in two clinical units following the introduction of casemix-based funding in Victoria. For ␣ staff at all levels within the hospital system, changes in the use of time were experienced that affected both the organisation of work and the care provided. The two units approached the management of time in different ways. From the introduction of casemix-based funding to the conclusion of this study there were improvements in efficiency in both clinical units. The case studies are compared and the consequences of different approaches to managing time in clinical units are described. The context The two case studies described here are about the use of time in clinical units of a major public hospital. The study was undertaken in 1995–96, shortly after casemix-based funding was introduced, and when hospitals were struggling to adjust to the changes it required