A Task-Analytic Framework Comparing Preoperative Electronic Health Record-Mediated Nursing Workflow in Different...

Area of Science:

• Nursing Informatics
• Healthcare Operations Management
• Health Services Research

Background:

• Preoperative care is a critical, time-sensitive process.
• Optimizing nursing workflow is challenging due to a lack of standardized analysis methods.
• Electronic health record (EHR) systems significantly impact preoperative nursing tasks.

Purpose of the Study:

• To comprehensively characterize EHR-mediated preoperative nursing workflow.
• To investigate and explain variations in workflow patterns.
• To identify factors contributing to workflow differences across settings.

Main Methods:

• Employed a structured methodological framework for workflow investigation.
• Utilized video recording software to capture 10 preoperative cases across two regional referral centers (Arizona and Florida).
• Conducted quantitative analysis of EHR and off-screen task distribution, supplemented by qualitative analysis of variations.

Main Results:

• Significant differences in EHR and off-screen task time distribution and patterns were observed between the two sites, despite using the same EHR system.
• Nurses in Arizona spent more time on preoperative assessments, with EHR tasks comprising a larger proportion of their work.
• Florida nurses allocated a higher proportion of time to off-screen tasks, with variations linked to documentation workload, patient preparation, and regional factors.

Conclusions:

• Workflow patterns in preoperative nursing differ substantially even with identical EHR systems.
• Documentation workload, patient preparation needs, and regional differences are key factors influencing workflow variation.
• Findings support future research for standardizing and harmonizing preoperative nursing workflows across different healthcare settings.