Tracking resident pre-rounding electronic health record usage.

IF 1 Q4 HEALTH POLICY & SERVICES
Conrad Krawiec, Cristin Marker, Christy Stetter, Lan Kong, Neal J Thomas
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引用次数: 4

Abstract

Purpose: Residents collect information from the electronic health record (EHR) to present during rounds, but this crucial process is understudied. The purpose of this paper is to examine the feasibility of utilizing an EHR embedded time-tracking software to quantify resident pre-round EHR activity and how patient acuity impacts this activity.

Design/methodology/approach: This was a retrospective observational study that quantified resident EHR activities (total time spent, tasks performed and patient encounters accessed) during pre-rounds on their pediatric intensive care unit rotation between May 2016 and December 2016. Patient encounters were reviewed to determine resident ownership and critical care resources provided.

Findings: Allo 21 eligible participants were included. In total, 907 patient encounters were included to evaluate patient acuity impact. EHR usage per patient encounter (median in minutes (25th, 75th percentile)) was significantly affected by the critical care resources utilized. Total EHR time: both ventilator and vasoactive support (10.54 (6.68, 17.19)); neither ventilator nor vasoactive support (8.23 (5.07, 12.72)); invasive/noninvasive ventilator support (8.74 (5.69, 13.2)); and vasoactive support (10.37 (7.72, 11.65)), p<0.001. Chart review, order entry and documentation EHR times demonstrated similar trends.

Practical implications: Residents spend more time utilizing the EHR to collect data on patients who require significant critical care resources. This information can be useful to determine optimal resident to patient workload. Future research is required to assess this EHR tool's ability to contribute to physician workflow study.

Originality/value: EHR embedded time-tracking software can offer insights into resident workflow.

跟踪居民舍入前电子健康记录的使用情况。
目的:住院医师从电子健康记录(EHR)中收集信息以在查房时呈现,但这一关键过程尚未得到充分研究。本文的目的是研究利用EHR嵌入式时间跟踪软件来量化住院医师前轮EHR活动的可行性,以及患者的锐度如何影响这种活动。设计/方法/方法:这是一项回顾性观察性研究,量化了2016年5月至2016年12月儿科重症监护病房轮转前的住院医师电子病历活动(花费的总时间、完成的任务和接触的患者)。对患者就诊情况进行审查,以确定住院医师的所有权和提供的重症监护资源。结果:纳入了21名符合条件的受试者。共纳入907例患者就诊以评估患者的视力影响。每次患者就诊的电子病历使用率(分钟中位数(25、75百分位数))受到重症监护资源利用的显著影响。EHR总时间:呼吸机和血管活性支持(10.54 (6.68,17.19));无呼吸机或血管活性支持(8.23 (5.07,12.72));有创/无创呼吸机支持(8.74 (5.69,13.2));和血管活性支持(10.37(7.72,11.65))),实际意义:住院医师花费更多时间利用电子病历收集需要重要重症护理资源的患者的数据。这些信息对于确定最佳住院医师对患者的工作量是有用的。未来的研究需要评估这种电子病历工具对医生工作流程研究的贡献能力。原创性/价值:EHR嵌入式时间跟踪软件可以深入了解住院医师的工作流程。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.00
自引率
6.70%
发文量
6
期刊介绍: ■Successful quality/continuous improvement projects ■The use of quality tools and models in leadership management development such as the EFQM Excellence Model, Balanced Scorecard, Quality Standards, Managed Care ■Issues relating to process control such as Six Sigma, Leadership, Managing Change and Process Mapping ■Improving patient care through quality related programmes and/or research Articles that use quantitative and qualitative methods are encouraged.
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