Preambient Artificial Intelligence Clinical Documentation Time for Pediatric Residents: A 3-Year Baseline...

The objective of this study is to characterize pediatric resident documentation time using electronic health record (EHR) audit-log-data and to assess interindividual variability in documentation patterns.

We conducted a retrospective, longitudinal study at an academic children's hospital, analyzing the EHR audit-log-data between July 1, 2021 and June 30, 2024. All clinical notes to which a pediatric resident contributed were included. Results are shown as descriptive statistics and pairwise comparisons of log-transformed continuous variables were performed using Welch's analysis of variance and Games-Howell post hoc testing.

Over 3 years, 79 residents contributed to the documentation of 156,898 clinical notes for an average of 2.1 hours per day. The mean (95% confidence interval) total resident time spent on one note was 12.1 (12.0-12.1) minutes. First-year residents contributed to 51.6% of all notes. More than half of resident note-editing time occurred outside scheduled shift hours (54.4%), including 56.3% of ambulatory note time and 53.0% of inpatient note time. Across the study period, monthly documentation time showed substantial month-to-month fluctuation but only small overall trends, with adjusted time-per-note declining significantly over time for most graduating classes.

This single-center study quantified pediatric resident EHR documentation time and found that time was highest among postgraduate year-1 residents, frequently extended into nights and weekends, and varied widely between individuals. The data provide a baseline to inform residency-level workflow optimization and to evaluate interventions that aim to reduce documentation time while preserving quality and educational value.