Implementation of an Electronic Health Record–Based Messaging System in the Emergency Department: Effects on Physician Workflow and Resident Burnout

Luu, Tiffany; Spiegelman, Lindsey; Nykin, David; Abido, Kimberly; Roh, Jennifer; Rudkin, Scott; Toohey, Shannon

doi:10.1097/pts.0000000000000869

Cited by 10 publications

(8 citation statements)

References 10 publications

(32 reference statements)

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“…At present many electronic healthcare records systems used in the NHS have limited functionality in supporting productivity and email is used as a suboptimal work-around solution. Future record systems could include features such as task management and some benefits have already been found when using an electronic health records-based secure messaging system, replacing paging or phone calls (Luu 2022).…”

Section: Organisational Email Workflow Systematisationmentioning

confidence: 99%

Email in healthcare: pros, cons and efficient use

Ginn

2024

BJPsych advances

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SUMMARY Email is a major means of communication in healthcare and it facilitates the fast delivery of messages and information. But email's ubiquity has brought challenges. It has changed the way we get things done, and working days can be dictated by the receipt and reply of multiple email messages, which drown out other priorities. This article examines email's advantages and disadvantages and, with a focus on healthcare professionals, examines what individuals and organisations can do to ensure email works for us, rather than – as can seem the case – the other way around.

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Section: Organisational Email Workflow Systematisationmentioning

confidence: 99%

Email in healthcare: pros, cons and efficient use

Ginn

2024

BJPsych advances

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“…[9][10][11][12] Linking education to outcomes is complicated because most datasets (e.g., Medicare or Medicaid) lack the granularity needed to examine individual performance; this has led to exploration of other datasets, such as electronic health record (EHR) data, audit logs, and secure messaging. [13][14][15] Several teams have examined how EHR data could be used more intentionally to assess the performance of trainees delivering patient care. [16][17][18] Concepts such as Resident-Sensitive Quality Measures (RSQMs) 19,20 (which focus on meaningful measures of patient care predominantly attributable to individual trainees) and Trainee Attributable and Automatable Care Evaluations in Real-time (TRACERs; which build on RSQMs and focus on automation, scale, and real-time feedback) 21 have emerged.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous efforts and calls linking medical education with health outcomes cite a lack of data to inform decision making, a moral responsibility to the needs of patients and society, and a desire to understand what trainees are learning in the clinical environment 9–12 . Linking education to outcomes is complicated because most datasets (e.g., Medicare or Medicaid) lack the granularity needed to examine individual performance; this has led to exploration of other datasets, such as electronic health record (EHR) data, audit logs, and secure messaging 13–15 . Several teams have examined how EHR data could be used more intentionally to assess the performance of trainees delivering patient care 16–18 .…”

mentioning

confidence: 99%

Leveraging Electronic Health Record Data and Measuring Interdependence in the Era of Precision Education and Assessment

Sebok-Syer,

Small,

Lingard

et al. 2024

Acad Med

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Purpose The era of precision education is increasingly leveraging electronic health record (EHR) data to assess residents’ clinical performance. But precision in what the EHR-based resident performance metrics are truly assessing is not fully understood. For instance, there is limited understanding of how EHR-based measures account for the influence of the team on an individual’s performance—or conversely how an individual contributes to team performances. This study aims to elaborate on how the theoretical understandings of supportive and collaborative interdependence are captured in residents’ EHR-based metrics. Method Using a mixed methods study design, the authors conducted a secondary analysis of 5 existing quantitative and qualitative datasets used in previous EHR studies to investigate how aspects of interdependence shape the ways that team-based care is provided to patients. Results Quantitative analyses of 16 EHR-based metrics found variability in faculty and resident performance (both between and within resident). Qualitative analyses revealed that faculty lack awareness of their own EHR-based performance metrics, which limits their ability to act interdependently with residents in an evidence-informed fashion. The lens of interdependence elucidates how resident practice patterns develop across residency training, shifting from supportive to collaborative interdependence over time. Joint displays merging the quantitative and qualitative analyses showed that residents are aware of variability in faculty’s practice patterns and that viewing resident EHR-based measures without accounting for the interdependence of residents with faculty is problematic, particularly within the framework of precision education. Conclusions To prepare for this new paradigm of precision education, educators need to develop and evaluate theoretically robust models that measure interdependence in EHR-based metrics, affording more nuanced interpretation of such metrics when assessing residents throughout training.

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“…54 Luu et al assessed the impact of using an EHR-based messaging system for nonemergent communication between nurses and physicians in US emergency departments. 55 Nether et al assessed implementation of a robust process improvement training program by the hospital neonatal intensive care units in the US. 56 Swedlund et al examined a primary care redesign process aimed at reducing refill requests made outside of office visits in the US.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Pandemic-Driven Care Redesign on Hospital Efficiency

Jakovljevic,

Timofeyev,

Zhuravleva

2024

RMHP

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This study aims to identify medical care transformations during the COVID-19 pandemic and to assess the economic efficiency of these care transformations. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviewing and Meta-Analysis (PRISMA) guidelines. The databases used in the search protocol included PubMed, RSCI, and Google Scholar. Results: Ten eligible studies in English and one publication in Russian were identified. In general, the following changes in organization of health care processes since 2020 are observed: hospital at home, telemedicine (physician-to-patient), and the adoption of new information communication technologies within physician-to-physician and physician-to-nurse communication. Earlier trends, such as (a) wider use of electronic devices, (b) adoption of Lean techniques, (c) the incorporation of patient and other customer experience feedback, and (d) the implementation of clinical decision support systems and automation of workflow, tend to be preserved. Conclusion:The most common changes in hospital care organization and the respective impacts of workflow changes (ie, workflow interventions, redesign, and transformations) on the efficiency of hospital care were summarized and avenues for future research and policy implications were discussed. The pandemic demonstrated a need for building more resilient and adaptive healthcare systems, enhancing crisis preparedness along with rapid and effective responses.

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Implementation of an Electronic Health Record–Based Messaging System in the Emergency Department: Effects on Physician Workflow and Resident Burnout

Cited by 10 publications

References 10 publications

Email in healthcare: pros, cons and efficient use

Email in healthcare: pros, cons and efficient use

Leveraging Electronic Health Record Data and Measuring Interdependence in the Era of Precision Education and Assessment

The Impact of Pandemic-Driven Care Redesign on Hospital Efficiency

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