At a major teaching hospital in New England, researchers observed care teams during morning rounds and conducted semi-structured interviews as well as an electronic survey of hospital clinicians. They gathered structured field notes during observations to identify workflow patterns. They extracted emerging themes from interview transcripts and analyzed survey responses.
Researchers performed data triangulation across the three analyses, which resulted in four significant findings:
• The ways care teams used EHRs during morning rounds varies widely.
• Care teams pervasively used workarounds at critical points of care.
• Care teams did not use EHRs for information sharing and the systems frequently impede intra-care team communication.
• System design and hospital room settings do not provide enough support for care team workflow.
“Gaps between EHR design and the functionality needed in the complex inpatient environment result in lack of standardized workflows, extensive use of workarounds and team communication issues,” study authors concluded. “These issues pose a threat to patient safety and quality of care.”
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