Electronic Health Record Solutions for Accurate Reporting of Data on Interprofessional Intensive Care Unit rounds (Oregon)

Project Details - Ongoing

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Summary:

Research has shown that the Intensive Care Unit (ICU) is susceptible to electronic health record (EHR)-related errors, in large part because of the severity of illness of patients, the large number of data points generated in the EHR, and the professional diversity in members of the care team involved in the daily management of ICU patients. Managing the high data density generated by continuous electronic monitoring of patients is essential for the delivery of safe and efficient care. Instituting interprofessional (IP) rounds in the ICU can improve communication and reduce errors. Unlike traditional rounds, IP rounds include participation by the bedside nurse, pharmacist, respiratory therapist, and nutritionist as well as physicians and physician extenders. This project will define which clinical data are likely to be miscommunicated on rounds and, through the use of a controlled ICU rounds simulation, develop a series of toolboxes to ensure accurate data reporting during, and effective integration of the EHR into, IP ICU rounds.

The specific aims of the project are as follows:

  • Determine frequency of and the factors responsible for data communication errors during IP ICU rounds 
  • Establish the infrastructure and protocol for an IP ICU rounds simulation 
  • Develop and test standardized methods for IP data collection and presentation for ICU Rounds 

The project team will conduct a comprehensive audit of ICU rounds to determine the data domains at greatest risk for communication errors and the role that the EHR and clinical users play in these errors. They will also conduct a national survey to determine which data domains should be examined and how data should be communicated between ICU IP rounding team members. These data will be used to create a series of use cases for an EHR-centered IP ICU rounds simulation. This simulation will recreate currently existing data communication errors and establish baseline usability metrics by incorporating eye and screen tracking to study and analyze team member interaction with the EHR before and during rounds. This work will inform the development of a series of toolboxes for the EHR, either for standard IP ICU rounds or a series of screens for an EHR-centric ICU rounding structure that allows for synchronous, real-time viewing of data by all members of the IP team. These toolboxes will be tested in a simulation environment to ensure their ability to improve the veracity of communicated data without having negative unintended consequences on team communication, workflow efficiency, or EHR usability.

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