Herasevich Svetlana, Pinevich Yuliya, Lipatov Kirill, Barwise Amelia K, Lindroth Heidi L, LeMahieu Allison M, Dong Yue, Herasevich Vitaly, Pickering Brian W
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
Department of Anesthesiology, Republican Clinical Medical Center, Minsk, Belarus.
Crit Care Explor. 2023 May 3;5(5):e0909. doi: 10.1097/CCE.0000000000000909. eCollection 2023 May.
To investigate whether a novel acute care multipatient viewer (AMP), created with an understanding of clinician information and process requirements, could reduce time to clinical decision-making among clinicians caring for populations of acutely ill patients compared with a widely used commercial electronic medical record (EMR).
Single center randomized crossover study.
Quaternary care academic hospital.
Attending and in-training critical care physicians, and advanced practice providers.
AMP.
We compared ICU clinician performance in structured clinical task completion using two electronic environments-the standard commercial EMR (Epic) versus the novel AMP in addition to Epic. Twenty subjects (10 pairs of clinicians) participated in the study. During the study session, each participant completed the tasks on two ICUs (7-10 beds each) and eight individual patients. The adjusted time for assessment of the entire ICU and the adjusted total time to task completion were significantly lower using AMP versus standard commercial EMR (-6.11; 95% CI, -7.91 to -4.30 min and -5.38; 95% CI, -7.56 to -3.20 min, respectively; < 0.001). The adjusted time for assessment of individual patients was similar using both the EMR and AMP (0.73; 95% CI, -0.09 to 1.54 min; = 0.078). AMP was associated with a significantly lower adjusted task load (National Aeronautics and Space Administration-Task Load Index) among clinicians performing the task versus the standard EMR (22.6; 95% CI, -32.7 to -12.4 points; < 0.001). There was no statistically significant difference in adjusted total errors when comparing the two environments (0.68; 95% CI, 0.36-1.30; = 0.078).
When compared with the standard EMR, AMP significantly reduced time to assessment of an entire ICU, total time to clinical task completion, and clinician task load. Additional research is needed to assess the clinicians' performance while using AMP in the live ICU setting.
为了研究一种基于对临床医生信息和流程需求的理解而创建的新型急性护理多患者查看器（AMP），与广泛使用的商业电子病历（EMR）相比，是否能减少照顾急性病患者群体的临床医生做出临床决策的时间。
单中心随机交叉研究。
四级医疗学术医院。
主治医生、住院医生以及高级实践提供者。
AMP。
我们比较了重症监护病房（ICU）临床医生在使用两种电子环境（标准商业EMR（Epic）与除Epic外的新型AMP）完成结构化临床任务时的表现。20名受试者（10对临床医生）参与了该研究。在研究过程中，每位参与者在两个ICU（每个7 - 10张床位）和8名个体患者身上完成任务。与标准商业EMR相比，使用AMP时评估整个ICU的调整时间和完成任务的调整总时间显著更低（分别为-6.11；95%置信区间，-7.91至-4.30分钟和-5.38；95%置信区间，-7.56至-3.20分钟；P < 0.001）。使用EMR和AMP评估个体患者的调整时间相似（0.73；95%置信区间，-0.09至1.54分钟；P = 0.078）。与标准EMR相比，在执行任务的临床医生中，AMP与显著更低的调整任务负荷（美国国家航空航天局任务负荷指数）相关（22.6；95%置信区间，-32.7至-12.4分；P < 0.001）。比较两种环境时，调整后的总错误数无统计学显著差异（0.68；95%置信区间，0.36 - 1.30；P = 0.078）。
与标准EMR相比，AMP显著减少了评估整个ICU的时间、临床任务完成的总时间以及临床医生的任务负荷。需要进一步研究以评估临床医生在实际ICU环境中使用AMP时的表现。
