数字相互依存:临床团队移交期间工作溢出的影响
Dori A Cross1, Josh Weiner1, Hannah T Neprash1
1Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, United States.
Journal of the American Medical Informatics Association : JAMIA
|January 13, 2026
概括
医生电子健康记录 (EHR) 的工作在班次之间发生溢出. 白天高和低的EHR活动都会增加患者夜间衰退的风险,强调需要优化护理协调.
科学领域:
- 医疗信息学 医疗信息学
- 临床操作 临床操作
- 患者安全 患者安全
背景情况:
- 医生使用电子健康记录 (EHR) 是现代医疗保健不可或缺的一部分.
- 白天和夜间临床团队之间的相互作用是复杂的,可能会影响患者的护理.
- 了解跨班次的EHR工作相互依赖性对于优化患者结果至关重要.
研究的目的:
- 描述相互依赖的医生EHR在住院病人的轮班工作的性质和后果.
- 检查白天EHR活动如何影响夜间工作量和患者的结果.
- 评估跨班次团队协调与患者病情恶化之间的关系.
主要方法:
- 进行了来自医院医药患者的EHR元数据的综合横截面分析.
- 一个混合效应回归模型分析了基于之前的白天团队活动的夜间EHR行为.
- 该研究评估了通过交换班间团队协调来预测夜间病人的病情是否会恶化.
主要成果:
- 医生始终使用交付工具,每班花费8-12分钟的时间来了解患者信息.
- 较高的白天EHR活动与增加的夜间EHR工作相关,并增加患者在一夜之间衰退的风险.
- 日间EHR时间的非常低和非常高水平都与患者在一夜之间临床衰退的风险增加有关.
结论:
- 有证据表明,从白天到夜间班次的EHR工作具有显著的溢出效应.
- 白天EHR活动的两种极端都与一夜之间患者衰退的风险更高有关.
- 调查结果表明,有机会改善协作实践和技术使用,以实现交替任务的相互依赖.
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