Understanding the work of case managers in Australian community aged care: a longitudinal time and motion study

Objective. The aim of this study was to quantify the work activities of community aged care case managers and assess changes following consumer-directed policy reforms. Methods. A longitudinal, time and motion study was performed, with direct observation (n = 339 h) of case managers undertaking work in the office or in the community. We compared the distribution of proportions of time spent across seven broad work task categories during May-August 2014 (P1) and May-October 2016 (P2). Results. Office time was primarily consumed by communication (43.7%) and documentation (33.3%) tasks. Documentation increased substantially from P1 to P2 (29.4% vs 37.0% respectively; P < 0.001), with more time spent on the subtask of recording information (18.0% vs 24.5% respectively; P = 0.039). Travel (45.9%) and communication (41.0%) accounted for most community time. Time in communication increased from P1 to P2 (37.3% vs 48.4% respectively; P = 0.047), with more time allocated to client communication (14.6% vs 31.7%; P < 0.001). Case managers spent 33.6% of community time in clients' homes (median 25.2 min per client; 22.8 vs 30.1 min in P1 and P2 respectively) and visited a median of two clients per day (3 vs 1 visits per day in P1 and P2 respectively). Conclusions. This study provides the first quantification of task-time distribution among this workforce and how work patterns have changed during a time of significant policy reform and operational changes within the community aged care sector.