Cook Katlyn E, Ludens Gail M, Ghosh Amit K, Mundell William C, Fleming Kevin C, Majka Andrew J
Division of General Internal Medicine at the Mayo Clinic in Rochester, MN, USA.
Perm J. 2013 Winter;17(1):26-30. doi: 10.7812/TPP/12-010.
The InBox messaging system is an internal, electronic program used at Mayo Clinic, Rochester, MN, to facilitate the sending, receiving, and answering of patient-specific messages and alerts. A standardized InBox was implemented in the Division of General Internal Medicine to decrease the time physicians, physician assistants, and nurse practitioners (clinicians) spend on administrative tasks and to increase efficiency.
Clinicians completed surveys and a preintervention InBox pilot test to determine inefficiencies related to administrative burdens and defects (message entry errors). Results were analyzed using Pareto diagrams, value stream mapping, and root cause analysis to prioritize administrative-burden inefficiencies to develop a new, standardized InBox. Clinicians and allied health staff were the target of this intervention and received standardized InBox training followed by a postintervention pilot test for clinicians.
Sixteen of 28 individuals (57%) completed the preintervention survey. Twenty-eight clinicians participated in 2 separate 8-day pilot tests (before and after intervention) for the standardized InBox. The number of InBox defects was substantially reduced from 37 (Pilot 1) to 7 (Pilot 2). Frequent InBox defects decreased from 25% to 10%. More than half of clinicians believed the standardized InBox positively affected their work, and 100% of clinicians reported no negative affect on their work.
This project demonstrated the successful implementation of the standardized InBox messaging system. Initial assessments show substantial reduction of InBox entry defects and administrative tasks completed by clinicians. The findings of this project suggest increased clinician and allied health staff efficiency, satisfaction, improved clinician work-life balance, and decreased clinician burden caused by administrative tasks.
InBox 消息系统是明尼苏达州罗切斯特市梅奥诊所使用的内部电子程序，用于促进特定患者消息和警报的发送、接收及回复。普通内科部门实施了标准化的 InBox，以减少医生、医师助理和执业护士（临床医生）在行政任务上花费的时间并提高效率。
临床医生完成了调查问卷和干预前的 InBox 试点测试，以确定与行政负担和缺陷（消息录入错误）相关的低效率情况。使用帕累托图、价值流映射和根本原因分析对结果进行分析，以确定行政负担低效率的优先级，从而开发新的标准化 InBox。临床医生及相关医护人员是此次干预的对象，他们接受了标准化 InBox 培训，随后临床医生进行了干预后的试点测试。
28 人中有 16 人（57%）完成了干预前调查。28 名临床医生参与了标准化 InBox 的 2 次为期 8 天的单独试点测试（干预前后各一次）。InBox 缺陷数量从 37 个（试点 1）大幅减少至 7 个（试点 2）。频繁出现的 InBox 缺陷从 25%降至 10%。超过一半的临床医生认为标准化 InBox 对他们的工作有积极影响，100%的临床医生报告其工作未受到负面影响。
该项目证明了标准化 InBox 消息系统的成功实施。初步评估显示 InBox 录入缺陷和临床医生完成的行政任务大幅减少。该项目的结果表明临床医生及相关医护人员的效率提高、满意度提升、工作与生活平衡得到改善，且行政任务给临床医生带来的负担减轻。
