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Information Needs Assessment for a Medicine Ward-Focused Rounding Dashboard

  • Systems-Level Quality Improvement
  • Published:
Journal of Medical Systems Aims and scope Submit manuscript

Abstract

To identify the routine information needs of inpatient clinicians on the general wards for the development of an electronic dashboard. Survey of internal medicine and subspecialty clinicians from March 2014–July 2014 at Saint Marys Hospital in Rochester, Minnesota. An information needs assessment was generated from all unique data elements extracted from all handoff and rounding tools used by clinicians in our ICUs and general wards. An electronic survey was distributed to 104 inpatient medical providers. 89 unique data elements were identified from currently utilized handoff and rounding instruments. All data elements were present in our multipurpose ICU-based dashboard. 42 of 104 (40 %) surveys were returned. Data elements important (50/89, 56 %) and unimportant (24/89, 27 %) for routine use were identified. No significant differences in data element ranking were observed between supervisory and nonsupervisory roles. The routine information needs of general ward clinicians are a subset of data elements used routinely by ICU clinicians. Our findings suggest an electronic dashboard could be adapted from the critical care setting to the general wards with minimal modification.

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References

  1. Kohn, L.T., Corrigan, J.M., and Donaldson, M.S., To err is human: building a safer health system. National Academy Press, Washington, (DC), 2000.

  2. Committee on Quality of Health Care in America, Institute of Medicine. Crossing the Quality Chasm: A New Health System for the twenty-first Century. National Academies Press: Washington (DC), 2001.

  3. Leape, L.L., Berwick, D.M., and Bates, D.W., What practices will most improve safety? Evidence-based medicine meets patient safety. JAMA. 288:501–507, 2002.

    PubMed  Google Scholar 

  4. Philibert, I., and Ingrid, P., New requirements for resident duty hours. JAMA. 288:1112, 2002.

    Article  PubMed  Google Scholar 

  5. CB, B., MC, S., MD, M.C., JM, D., and Fahey, T.J. 3rd, Effects of limited work hours on surgical training. Effects of limited work hours on surgical training. J Am Coll Surg. 195:531–538, 2002.

    Article  Google Scholar 

  6. Petersen, L.A., Brennan, T.A., O’Neil, A.C., Cook, E.F., and Lee, T.H., Does housestaff discontinuity of care increase the risk for preventable adverse events? Ann Intern Med. 121:866–872, 1994.

    Article  CAS  PubMed  Google Scholar 

  7. Lofgren, R.P., Daniel, G., Williams, R.A., and Rich, E.C., Post-call transfer of resident responsibility. J Gen Intern Med. 5:501–505, 1990.

    Article  CAS  PubMed  Google Scholar 

  8. Singh, H., Thomas, E.J., Petersen, L.A., and Studdert, D.M., Medical errors involving trainees: a study of closed malpractice claims from 5 insurers. Arch Intern Med. 167:2030–2036, 2007.

    Article  PubMed  Google Scholar 

  9. Petersen, L.A., Orav, E.J., Teich, J.M., O’Neil, A.C., and Brennan, T.A., Using a computerized sign-out program to improve continuity of inpatient care and prevent adverse events. Jt Comm J Qual Improv. 24:77–87, 1998.

    CAS  PubMed  Google Scholar 

  10. Van Eaton, E.G., Horvath, K.D., Lober, W.B., and Pellegrini, C.A., Organizing the transfer of patient care information: the development of a computerized resident sign-out system. Surgery. 136:5–13, 2004.

    Article  PubMed  Google Scholar 

  11. Ryan, S., O’Riordan, J.M., Tierney, S., Conlon, K.C., and Ridgway, P.F., Impact of a new electronic handover system in surgery. Int J Surg. 9:217–220, 2011.

    Article  CAS  PubMed  Google Scholar 

  12. Van Eaton, E.G., Horvath, K.D., Lober, W.B., Rossini, A.J., and Pellegrini, C.A., A randomized, controlled trial evaluating the impact of a computerized rounding and sign-out system on continuity of care and resident work hours. J Am Coll Surg. 200:538–545, 2005.

    Article  PubMed  Google Scholar 

  13. Davis, J., Riesenberg, L.A., Mardis, M., Donnelly, J., Benningfield, B., Youngstrom, M., et al., Evaluating outcomes of electronic tools supporting physician shift-to-shift handoffs: a systematic review. J Grad Med Educ. 7:174–180, 2015.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Flemming, D., and Hübner, U., How to improve change of shift handovers and collaborative grounding and what role does the electronic patient record system play? Results of a systematic literature review. Int J Med Inform. 82:580–592, 2013.

    Article  PubMed  Google Scholar 

  15. Stahl K, Palileo A, Schulman CI, Wilson K, Augenstein J, Kiffin C, et al. Enhancing patient safety in the trauma/surgical intensive care unit. J Trauma. 67:430–433; discussion 433–5, 2009.

  16. Rosenbluth, G., Bale, J.F., Starmer, A.J., Spector, N.D., Srivastava, R., West, D.C., et al., Variation in printed handoff documents: Results and recommendations from a multicenter needs assessment. J Hosp Med. 10:517–524, 2015.

    Article  PubMed  Google Scholar 

  17. Ellsworth, M.A., Lang, T.R., Pickering, B.W., and Herasevich, V., Clinical data needs in the neonatal intensive care unit electronic medical record. BMC Med Inform Decis. Mak. 14:92, 2014.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Ahmed, A., Chandra, S., Herasevich, V., Gajic, O., and Pickering, B.W., The effect of two different electronic health record user interfaces on intensive care provider task load, errors of cognition, and performance. Crit Care Med. 39:1626–1634, 2011.

    Article  PubMed  Google Scholar 

  19. Herasevich, V., Ellsworth, M.A., Hebl, J.R., Brown, M.J., and Pickering, B.W., Information needs for the OR and PACU electronic medical record. Appl Clin Inform. 5:630–641, 2014.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Gurses, A.P., and Xiao, Y., A systematic review of the literature on multidisciplinary rounds to design information technology. J Am Med Inform. Assoc. 13:267–276, 2006.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Birtwistle, L., Houghton, J.M., and Rostill, H., A review of a surgical ward round in a large paediatric hospital: does it achieve its aims? Med Educ. 34:398–403, 2000.

    Article  CAS  PubMed  Google Scholar 

  22. Reuss, E., Menozzi, M., Büchi, M., Koller, J., and Krueger, H., Information access at the point of care: what can we learn for designing a mobile CPR system? Int J Med Inform. 73:363–369, 2004.

    Article  CAS  PubMed  Google Scholar 

  23. Friesdorf, W., Konichezky, S., Gross-Alltag, F., Federolf, G., Schwilk, B., and Wiedeck, H., System ergonomic analysis of the morning ward round in an intensive care unit. J Clin Monit. 10:201–209, 1994.

    Article  CAS  PubMed  Google Scholar 

  24. Osheroff, J.A., Forsythe, D.E., Buchanan, B.G., Bankowitz, R.A., Blumenfeld, B.H., and Miller, R.A., Physicians’ information needs: analysis of questions posed during clinical teaching. Ann Intern Med. 114:576–581, 1991.

    Article  CAS  PubMed  Google Scholar 

  25. Wayne, J.D., Tyagi, R., Reinhardt, G., Rooney, D., Makoul, G., Chopra, S., et al., Simple standardized patient handoff system that increases accuracy and completeness. J Surg Educ. 65:476–485, 2008.

    Article  PubMed  Google Scholar 

  26. Gorman, P.N., Ash, J.S., Lavelle, M., Lyman, J., Delcambre, L., and Maier, D., Bundles in the wild: managing information to solve problems and maintain situation awareness. Libr Trends. 49:266–289, 2000.

    Google Scholar 

  27. Raval, M.V., Rust, L., Thakkar, R.K., Kurtovic, K.J., Nwomeh, B.C., Besner, G.E., et al., Development and implementation of an electronic health record generated surgical handoff and rounding tool. J Med Syst. 39:8, 2015.

    Article  PubMed  Google Scholar 

  28. Bernstein, J.A., Imler, D.L., Sharek, P., and Longhurst, C.A., Improved physician work flow after integrating sign-out notes into the electronic medical record. Jt Comm J Qual Patient Saf. 36:72–78, 2010.

    PubMed  Google Scholar 

  29. Pickering, B.W., Herasevich, V., Ahmed, A., and Gajic, O., Novel representation of clinical information in the ICU: developing user interfaces which reduce information overload. Appl Clin Inform. 1:116–131, 2010.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Pickering, B.W., Hurley, K., and Marsh, B., Identification of patient information corruption in the intensive care unit: using a scoring tool to direct quality improvements in handover. Crit Care Med. 37:2905–2912, 2009.

    Article  PubMed  Google Scholar 

  31. Harris, P.A., Robert, T., Robert, T., Jonathon, P., Nathaniel, G., and Conde, J.G., Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 42:377–381, 2009.

    Article  PubMed  Google Scholar 

  32. Inouye, S.K., Clarifying confusion: the confusion assessment method. Ann Intern Med. 113:941, 1990.

    Article  CAS  PubMed  Google Scholar 

  33. Manning, D.M., Keller, A.S., and Frank, D.L., Home alone: assessing mobility independence before discharge. J Hosp Med. 4:252–254, 2009.

    Article  PubMed  Google Scholar 

  34. Anderson, J., Shroff, D., Curtis, A., Eldridge, N., Cannon, K., Karnani, R., et al., The veterans affairs shift change physician-to-physician handoff project. Jt Comm J Qual Patient Saf. 36:62–71, 2010.

    PubMed  Google Scholar 

  35. Young, R.J., Horsley, S.D., and McKenna, M., The potential role of IT in supporting the work of junior doctors. J R Coll Physicians Lond. 34:366–370, 2000.

    CAS  PubMed  Google Scholar 

  36. Kochendorfer, K.M., Morris, L.E., Kruse, R.L., Ge, B.G., and Mehr, D.R., Attending and resident physician perceptions of an EMR-generated rounding report for adult inpatient services. Fam Med. 42:343–349, 2010.

    PubMed  Google Scholar 

  37. Manor-Shulman, O., Beyene, J., Frndova, H., and Parshuram, C.S., Quantifying the volume of documented clinical information in critical illness. J Crit Care. 23:245–250, 2008.

    Article  PubMed  Google Scholar 

  38. Collins, S.A., Stein, D.M., Vawdrey, D.K., Stetson, P.D., and Bakken, S., Content overlap in nurse and physician handoff artifacts and the potential role of electronic health records: a systematic review. J Biomed Inform. 44:704–712, 2011.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Collins, S., Hurley, A.C., Chang, F.Y., Illa, A.R., Benoit, A., Laperle, S., et al., Content and functional specifications for a standards-based multidisciplinary rounding tool to maintain continuity across acute and critical care. J Am Med Inform. Assoc. 21:438–447, 2014.

    Article  PubMed  Google Scholar 

  40. Gurses, A.P., Yan, X., and Peter, H., User-designed information tools to support communication and care coordination in a trauma hospital. J Biomed Inform. 42:667–677, 2009.

    Article  PubMed  Google Scholar 

  41. MedFools.com. Patient Trackers, Patient Info Sheets, Daily Work Sheets, Medical Progress Notes [Internet]. MedFools. 2015 [cited 2015 Oct 27]. Available from: http://www.medfools.com/downloads/

  42. Abraham, J., Kannampallil, T., and Patel, V.L., A systematic review of the literature on the evaluation of handoff tools: implications for research and practice. J Am Med Inform Assoc. 21:154–162, 2014.

    Article  PubMed  Google Scholar 

  43. Salerno, S.M., Arnett, M.V., and Domanski, J.P., Standardized sign-out reduces intern perception of medical errors on the general internal medicine ward. Teach Learn Med. 21:121–126, 2009.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of General Internal Medicine, Department of Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, USA

    Christopher A. Aakre

  2. Division of Primary Care Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA

    Rajeev Chaudhry

  3. Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA

    Brian W. Pickering & Vitaly Herasevich

  4. Multidisciplinary Epidemiology and Translation Research in Intensive Care (METRIC), Mayo Clinic, Rochester, MN, USA

    Vitaly Herasevich

Authors
  1. Christopher A. Aakre
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  2. Rajeev Chaudhry
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  3. Brian W. Pickering
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  4. Vitaly Herasevich
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Corresponding author

Correspondence to Christopher A. Aakre.

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Conflict of Interest

AWARE is patent pending (US 2010/0,198,622, 12/697,861, PCT/US2010/022,750). Drs. Herasevich, and Pickering and Mayo Clinic have a financial conflict of interest relating to licensed technology described in this paper. This research has been reviewed by the Mayo Clinic Conflict of Interest Review Board and is being conducted in compliance with Mayo Clinic Conflict of Interest Policies.

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No external funding was used for this research.

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This article is part of the Topical Collection on Systems-Level Quality Improvement

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Aakre, C.A., Chaudhry, R., Pickering, B.W. et al. Information Needs Assessment for a Medicine Ward-Focused Rounding Dashboard. J Med Syst 40, 183 (2016). https://doi.org/10.1007/s10916-016-0542-1

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  • DOI: https://doi.org/10.1007/s10916-016-0542-1

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