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Time-motion examination of electronic health record utilization and clinician workflows indicate frequent task switching and documentation burden.电子健康记录利用和临床医生工作流程的时间-动作研究表明,经常需要任务切换和文档负担。
AMIA Annu Symp Proc. 2021 Jan 25;2020:886-895. eCollection 2020.
2
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A Computational Framework to Evaluate Emergency Department Clinician Task Switching in the Electronic Health Record Using Event Logs.使用事件日志评估电子健康记录中急诊科临床医生任务切换的计算框架。
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9
Understanding the perceived role of electronic health records and workflow fragmentation on clinician documentation burden in emergency departments.了解电子健康记录和工作流程碎片化对急诊科临床医生文档记录负担的感知作用。
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Measuring and Maximizing Undivided Attention in the Context of Electronic Health Records.在电子健康记录背景下测量和最大化全神贯注程度
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本文引用的文献

1
An Interprofessional Approach to Clinical Workflow Evaluation Focused on the Electronic Health Record Using Time motion Study Methods.一种采用时间动作研究方法、以电子健康记录为重点的跨专业临床工作流程评估方法。
AMIA Annu Symp Proc. 2020 Mar 4;2019:1187-1196. eCollection 2019.
2
BALANCING DOCUMENTATION AND DIRECT PATIENT CARE ACTIVITIES: A STUDY OF A MATURE ELECTRONIC HEALTH RECORD SYSTEM.平衡文档记录与直接患者护理活动:对一个成熟电子健康记录系统的研究
Int J Ind Ergon. 2019 Jul;72:338-346. doi: 10.1016/j.ergon.2019.06.012. Epub 2019 Jul 1.
3
Rethinking the electronic health record through the quadruple aim: time to align its value with the health system.从四重目标重新思考电子健康记录:是时候使其价值与医疗体系保持一致了。
BMC Med Inform Decis Mak. 2020 Feb 17;20(1):32. doi: 10.1186/s12911-020-1048-9.
4
A cross-sectional study exploring the relationship between burnout, absenteeism, and job performance among American nurses.一项横断面研究,探讨美国护士职业倦怠、旷工与工作绩效之间的关系。
BMC Nurs. 2019 Nov 21;18:57. doi: 10.1186/s12912-019-0382-7. eCollection 2019.
5
Evidence Relating Health Care Provider Burnout and Quality of Care: A Systematic Review and Meta-analysis.与医疗保健提供者倦怠和护理质量相关的证据:系统评价和荟萃分析。
Ann Intern Med. 2019 Oct 15;171(8):555-567. doi: 10.7326/M19-1152. Epub 2019 Oct 8.
6
Forced Inefficiencies of the Electronic Health Record.电子健康记录的强制低效性。
J Gen Intern Med. 2019 Nov;34(11):2299-2301. doi: 10.1007/s11606-019-05281-3.
7
Effect of Restriction of the Number of Concurrently Open Records in an Electronic Health Record on Wrong-Patient Order Errors: A Randomized Clinical Trial.电子病历中同时打开记录数量限制对错误患者医嘱错误的影响:一项随机临床试验。
JAMA. 2019 May 14;321(18):1780-1787. doi: 10.1001/jama.2019.3698.
8
Assessment of Inpatient Time Allocation Among First-Year Internal Medicine Residents Using Time-Motion Observations.运用时间动作观察评估第一年内科住院医师的住院时间分配。
JAMA Intern Med. 2019 Jun 1;179(6):760-767. doi: 10.1001/jamainternmed.2019.0095.
9
Task errors by emergency physicians are associated with interruptions, multitasking, fatigue and working memory capacity: a prospective, direct observation study.急诊医师的任务错误与中断、多任务处理、疲劳和工作记忆容量有关:一项前瞻性、直接观察研究。
BMJ Qual Saf. 2018 Aug;27(8):655-663. doi: 10.1136/bmjqs-2017-007333. Epub 2018 Jan 9.
10
A national survey assessing the number of records allowed open in electronic health records at hospitals and ambulatory sites.一项全国性调查,评估医院和门诊场所电子健康记录中允许公开的记录数量。
J Am Med Inform Assoc. 2017 Sep 1;24(5):992-995. doi: 10.1093/jamia/ocx034.

电子健康记录利用和临床医生工作流程的时间-动作研究表明,经常需要任务切换和文档负担。

Time-motion examination of electronic health record utilization and clinician workflows indicate frequent task switching and documentation burden.

机构信息

Columbia University Department of Biomedical Informatics, NY, NY.

Columbia University School of Nursing, NY, NY.

出版信息

AMIA Annu Symp Proc. 2021 Jan 25;2020:886-895. eCollection 2020.

PMID:33936464
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8075533/
Abstract

Clinical documentation burden has been broadly acknowledged, yet few interprofessional measures of burden exist. Using interprofessional time-motion study (TMS) data, we evaluated clinical workflows with a focus on electronic health record (EHR) utilization and fragmentation among 47 clinicians: 34 advanced practice providers (APPs) and 13 registered nurses (RNs) from: an acute care unit (n=15 observations [obs]), intensive care unit (n=14), ambulatory clinic (n=3), and emergency department (n=15). We examined workflow fragmentation, task-switch type, and task involvement. In our study, clinicians on average exhibited 1.4±0.6 switches per minute in their workflow. Eighty-four (19.6%) of the 429 task-switch types presented in the data accounted for 80.1% of all switches. Among those, data viewing- and data entry-related tasks were involved in 48.2% of all switches, indicating documentation burden may play a critical role in workflow disruptions. Therefore, interruption rate evaluated through task switches may serve as a proxy for measuring burden.

摘要

临床文档负担已得到广泛认可,但很少有针对负担的跨专业衡量标准。我们使用跨专业时间-动作研究 (TMS) 数据,通过关注电子健康记录 (EHR) 的使用情况和 47 名临床医生之间的工作流程碎片化,对工作流程进行了评估:34 名高级实践提供者 (APP) 和 13 名注册护士 (RN) 分别来自:急症病房 (n=15 次观察 [obs])、重症监护病房 (n=14)、门诊诊所 (n=3) 和急诊室 (n=15)。我们检查了工作流程的碎片化、任务切换类型和任务参与情况。在我们的研究中,临床医生在其工作流程中平均每分钟表现出 1.4±0.6 次切换。在数据中呈现的 429 种任务切换类型中,有 84 种 (19.6%) 占所有切换的 80.1%。其中,数据查看和数据录入相关任务涉及所有切换的 48.2%,表明文档负担可能在工作流程中断中起着关键作用。因此,通过任务切换评估的中断率可以作为衡量负担的替代指标。