Sockolow Paulina S, Bowles Kathryn H, Rogers Michelle, Adelsberger Marguerite C, Chittams Jesse L, Liao Cindy
Drexel University College of Nursing and Health Professions.
University of Pennsylvania School of Nursing.
Stud Health Technol Inform. 2014;201:371-9.
We conducted three evaluation studies in community and hospital settings to examine point-of-care documentation system adoption among interdisciplinary care team clinicians. In the community settings, quantitative methods included documentation time-to-completion and a clinician satisfaction survey. Qualitative methods included observations and follow-up interviews. Qualitative data and quantitative data were merged comparing findings along themes. In the hospitals, qualitative scenario testing results indicated clinician system adoption was universal, though not always timely. At all sites, mismatch between system functionality and workflow was a barrier to clinician system access during patient care and reduced clinician efficiency. Clinicians at all settings were satisfied with their ability to access other clinicians' notes, without increased interdisciplinary team communication. Clinicians did not identify any systems impact on patient outcomes. To facilitate adoption, clinicians should see the value of using the system as intended by receiving system data feedback that shows improvement of patient care and patient safety.
我们在社区和医院环境中开展了三项评估研究，以检验跨学科护理团队临床医生对即时护理文档系统的采用情况。在社区环境中，定量方法包括文档完成时间以及临床医生满意度调查。定性方法包括观察和后续访谈。定性数据和定量数据合并后，按照主题比较研究结果。在医院中，定性情景测试结果表明临床医生对系统的采用是普遍的，尽管并不总是及时。在所有场所，系统功能与工作流程之间的不匹配是患者护理期间临床医生使用系统的障碍，并降低了临床医生的效率。所有场所的临床医生对能够访问其他临床医生的记录感到满意，且跨学科团队沟通并未增加。临床医生未发现任何系统对患者结局有影响。为促进系统采用，临床医生应通过接收显示患者护理和患者安全得到改善的系统数据反馈，认识到按预期使用该系统的价值。
