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Emergency Physician Task Switching Increases With the Introduction of a Commercial Electronic Health Record.

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Citation: Annals of Emergency Medicine. 67(6):741-6, 2016 JunPMID: 26391355Institution: MedStar Institute for Innovation | MedStar Washington Hospital CenterDepartment: Emergency Medicine | National Center for Human Factors in HealthcareForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Electronic Health Records/ut [Utilization] | *Emergency Service, Hospital/og [Organization & Administration] | *Outcome and Process Assessment (Health Care) | *Practice Patterns, Physicians' | *Workload/sn [Statistics & Numerical Data] | Documentation/mt [Methods] | Humans | United StatesYear: 2016 Local holdings: Available online from MWHC library: 1994 - present, Available in print through MWHC library: 1997 - 2006ISSN:

0196-0644

Name of journal: Annals of emergency medicineAbstract: CONCLUSION: The increase in the number of tasks physicians engaged in per minute post-implementation indicates that physicians switched tasks more frequently. Frequent task switching behavior raises patient safety concerns.Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.METHODS: We completed a quasi-experimental study across 3 periods during the transition from a homegrown system to a commercially available electronic health record with computerized provider order entry. Observation periods consisted of pre-implementation, 1 month before the implementation of the commercial electronic health record; "go-live" 1 week after implementation; and post-implementation, 3 to 4 months after use began. Fourteen physicians were observed in each period (N=42) with a minute-by-minute observation template to record emergency physician time allocation across 5 task-based categories (computer, verbal communication, patient room, paper [chart/laboratory results], and other). The average number of tasks physicians engaged in per minute was also analyzed as an indicator of task switching.RESULTS: From pre- to post-implementation, there were no significant differences in the amount of time spent on the various task categories. There were changes in time allocation from pre-implementation to go-live and go-live to pre-implementation, characterized by a significant increase in time spent on computer tasks during go-live relative to the other periods. Critically, the number of tasks physicians engaged in per minute increased from 1.7 during pre-implementation to 1.9 during post-implementation (difference 0.19 tasks per minute; 95% confidence interval 0.039 to 0.35).STUDY OBJECTIVE: We evaluate how the transition from a homegrown electronic health record to a commercial one affects emergency physician work activities from initial introduction to long-term use.All authors: Benda NC, Hettinger AZ, Meadors ML, Ratwani RMFiscal year: FY2016Digital Object Identifier:

https://dx.doi.org/10.1016/j.annemergmed.2015.07.514

Date added to catalog: 2017-07-07

Holdings ( 1 )
Title notes ( 7 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	26391355	Available		26391355

Available online from MWHC library: 1994 - present, Available in print through MWHC library: 1997 - 2006

CONCLUSION: The increase in the number of tasks physicians engaged in per minute post-implementation indicates that physicians switched tasks more frequently. Frequent task switching behavior raises patient safety concerns.

METHODS: We completed a quasi-experimental study across 3 periods during the transition from a homegrown system to a commercially available electronic health record with computerized provider order entry. Observation periods consisted of pre-implementation, 1 month before the implementation of the commercial electronic health record; "go-live" 1 week after implementation; and post-implementation, 3 to 4 months after use began. Fourteen physicians were observed in each period (N=42) with a minute-by-minute observation template to record emergency physician time allocation across 5 task-based categories (computer, verbal communication, patient room, paper [chart/laboratory results], and other). The average number of tasks physicians engaged in per minute was also analyzed as an indicator of task switching.

RESULTS: From pre- to post-implementation, there were no significant differences in the amount of time spent on the various task categories. There were changes in time allocation from pre-implementation to go-live and go-live to pre-implementation, characterized by a significant increase in time spent on computer tasks during go-live relative to the other periods. Critically, the number of tasks physicians engaged in per minute increased from 1.7 during pre-implementation to 1.9 during post-implementation (difference 0.19 tasks per minute; 95% confidence interval 0.039 to 0.35).

STUDY OBJECTIVE: We evaluate how the transition from a homegrown electronic health record to a commercial one affects emergency physician work activities from initial introduction to long-term use.

English