Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Inform Health Soc Care. 2021 Sep 2;46(3):263-272. doi: 10.1080/17538157.2021.1885037. Epub 2021 Feb 18.
The intensive care unit (ICU) is a stressful and complex environment in due to its dynamic nature and severity of admitted patients. EHR interface design can be cumbersome and lead to prolonged times to complete tasks. This paper investigated the relationship between a prominent EHR interface design and interruptions with physician's efficiency during patient chart review at ICU Pre-Rounds. We conducted a live observation of ICU physicians in a 30-bed MICU at a tertiary, southeastern medical center. Directly after the observation sessions, the physicians completed a modified System Usability Scale (SUS) survey. A total of 52 EHR patient chart reviews were observed at the MICU Pre-rounds. There was statistically significant positive correlation between time spent to review patient EHR with both number of scrolling(p-value<0.0001) across EHR interface; and with number of visited EHR screens (p-value=0.0444). There was positive correlation between number of interruptions with time spent to review patient EHR during ICU prerounds. EHR design and the occurrence of interruptions lead to reduced physician-EHR efficiency levels. We report that the number of scrolling and visited screens executed by physicians to gather the required information was associated with increased screen time and consequently decreased physician efficiency.
重症监护病房（ICU）是一个充满压力和复杂性的环境，这是由于其动态性质和收治患者的严重程度。电子病历（EHR）界面设计可能很繁琐，导致完成任务的时间延长。本文研究了在 ICU 查房期间，一个突出的 EHR 界面设计与中断对医师效率的关系。我们对东南某三级医疗中心的 30 床 MICU 中的 ICU 医师进行了现场观察。观察结束后，医师们立即完成了一份经过修改的系统可用性量表（SUS）调查。在 MICU 查房期间，共观察了 52 次 EHR 患者病历回顾。在 EHR 界面上，浏览次数（p 值<0.0001）和访问的 EHR 屏幕数量（p 值=0.0444）与花费在查看患者 EHR 上的时间之间存在显著的正相关。在 ICU 查房期间，中断次数与花费在查看患者 EHR 上的时间之间存在正相关。EHR 设计和中断的发生导致医师-EHR 效率水平降低。我们报告称，医师为收集所需信息而执行的滚动次数和访问的屏幕数量与屏幕时间的增加有关，从而导致医师效率降低。
