Quantifying work patterns of health professionals: a narrative review of studies using the Work Observation Method By Activity Timing (WOMBAT)

Background: The Work Observation Method By Activity Timing (WOMBAT) is a widely adopted technique for direct observational studies of health professionals’ work patterns. Over the past 14 years its use has grown substantially, enabling researchers to generate rich quantitative data reflecting the complexity of clinical workflows across diverse healthcare settings.
Objective: To review and narratively synthesise direct observational studies which used WOMBAT to describe or compare patterns of health professionals’ work, or assess the impact of interventions, interruptions, and multitasking on work patterns.
Methods: A search of Scopus, MEDLINE, Embase, PsycINFO, CINAHL, and Google Scholar (January 2008-July 2025) identified 54 English-language studies using WOMBAT. Studies were categorised as descriptive, comparison, or intervention-focused, and were analysed by aim, setting, and professional groups observed.
Results: WOMBAT has been used to assess a range of phenomena including task time allocation, compliance with practice standards, and the impact of care delivery changes, and electronic health records. Twenty-four studies compared work patterns across roles, settings, geographical areas, task types, and shifts, e.g. weekdays versus weekends. Fifteen studies evaluated interventions including electronic medication systems, charting tools, decision support systems, and policy reforms. Thirty studies examined interruptions and multitasking, revealing associations with clinical errors and adaptive strategies. Only one study collected data concurrently across two countries. The majority of studies (43/54) were published in the last decade, with 24 in the past five years.
Conclusion: The application of WOMBAT has enabled a shift from basic time and motion studies to comprehensive, context-rich workflow analyses. Its standardised, yet adaptable, design supports a broad range of study questions about health professionals’ work and the effects of health system interventions on workflows.