What "to-do" with physician task lists: clinical task model development and electronic health record design...

Area of Science:

• Medical Informatics
• Clinical Workflow Analysis
• Health Systems Research

Background:

• Physician signout (or handoff) includes clinical task lists vital for patient care continuity and safety.
• Despite their importance, the specific content and structure of these tasks have not been systematically analyzed.
• Understanding task elements is key to improving collaborative patient management and electronic health record (EHR) system design.

Purpose of the Study:

• To systematically examine the subject matter, structure, and components of clinical tasks within physician signout documents.
• To develop a conceptual model for classifying clinical tasks based on their action types and components.
• To identify design considerations for EHR systems supporting clinical task management.

Main Methods:

• A manual sublanguage analysis was performed on a dataset of 500 physician signout tasks.
• A hierarchical conceptual model for clinical tasks was inductively constructed.
• Tasks were classified by action type (Assess, Order, Communicate, Perform) and their constituent components.

Main Results:

• The most frequent task action types identified were 'Assess' and 'Order'.
• The most common task components were 'What' type, specifically 'Tests', including subtypes like 'Laboratory' and 'Imaging'.
• The analysis provided a structured understanding of clinical task elements in signout.

Conclusions:

• Clinical tasks in physician signout are predominantly action-oriented (Assess, Order) and focused on diagnostic or therapeutic interventions (Tests).
• The findings offer critical insights for designing more effective EHR functionalities for collaborative clinical task management.
• Future EHR systems should be optimized to support the identified common task types and components to enhance workflow and patient safety.