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Impact of EHR-based rounding tools on interactive communication: A prospective observational study
Joanna Abraham1, Joanna Jaros2, Imade Ihianle2
1Department of Anesthesiology & Institute for Informatics, School of Medicine, Washington University in St Louis, St. Louis, MO, United States.
International Journal of Medical Informatics
|August 25, 2019
Summary
Electronic Health Record-integrated rounding tools streamline clinical communication and improve patient care workflows. These tools enhance discussion of patient identifiers and action items, while reducing communication breakdowns.
Area of Science:
- Health Informatics
- Clinical Communication
- Medical Education
Background:
- Structured rounding tools enhance efficiency and satisfaction.
- Impact of EHR-integrated tools on communication content and interactivity is understudied.
Purpose of the Study:
- Compare a Word-based tool with an EHR-integrated rounding report tool (RRT).
- Evaluate effects on clinical content, communication interactivity, and clinician perspectives.
Main Methods:
- Prospective pre-post evaluation with 27 clinicians across two teams.
- Audio-recorded and coded communication using conversational analysis.
- Follow-up interviews for clinician perspectives.
Main Results:
- RRT increased discussion of patient identifiers and action items.
- RRT decreased discussion of imaging and reduced questions/responses.
- RRT use was associated with fewer communication breakdowns related to incorrect responses.
Conclusions:
- EHR-integrated rounding tools streamline pre-rounding information gathering.
- RRT streamlines in-rounding conversations and supports post-rounding task discussion.
- RRT positively impacts patient care planning and management workflows.
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