Tracking resident pre-rounding electronic health record usage
International Journal of Health Care Quality Assurance
ISSN: 0952-6862
Article publication date: 15 April 2019
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.
Keywords
Acknowledgements
Financial support for this study was provided by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant Nos UL1 TR000127 and TR002014. The content is solely the authors’ responsibility and does not necessarily represent the NIH’s official views. Ms Cristin S. Marker receives salary support from the Cerner Corporation. The authors declare the following relevant financial activities outside the work: Dr Neal Thomas has directly received research funding from Gene Fluidics, a National Institute of Health subaward. He also receives funding for consultation services for Therabron and Care Fusion. The remaining authors declare no conflict of interest with respect to the research, authorship and/or article publication.
Citation
Krawiec, C., Marker, C., Stetter, C., Kong, L. and Thomas, N.J. (2019), "Tracking resident pre-rounding electronic health record usage", International Journal of Health Care Quality Assurance, Vol. 32 No. 3, pp. 611-620. https://doi.org/10.1108/IJHCQA-06-2018-0137
Publisher
:Emerald Publishing Limited
Copyright © 2019, Emerald Publishing Limited