An Interprofessional Approach to Clinical Workflow Evaluation Focused on the Electronic Health Record Using Time...

Area of Science:

• Health Informatics
• Clinical Workflow Analysis
• Human-Computer Interaction

Background:

• Increasing prevalence of electronic health records (EHRs) has heightened concerns regarding documentation burden.
• EHR implementation presents an opportunity to evaluate and mitigate documentation workload and assess its impact on clinician workflow.

Purpose of the Study:

• To develop and validate a reliable interprofessional taxonomy for time-motion observation of nursing and physician workflow.
• To assess the reliability of this taxonomy for evaluating clinician activities before and after a new EHR implementation.

Main Methods:

• Development of an interprofessional taxonomy for time-motion observation.
• Conducting inter-observer reliability assessment sessions observing nurses and physicians.
• Testing the taxonomy's reliability in a large academic medical center setting.

Main Results:

• Four out of five observers achieved reliability in an average of 5.75 sessions.
• The developed taxonomy proved reliable for workflow evaluation of both nurses and physicians.
• The taxonomy effectively focuses on time and tasks associated with EHR use.

Conclusions:

• The interprofessional taxonomy is a reliable tool for evaluating clinician workflow and EHR-related tasks.
• This validated taxonomy can be used to measure and potentially reduce documentation burden.
• The findings support the use of time-motion observation with a standardized taxonomy for EHR impact assessment.