Journal of Healthcare Management - March/April 2014 - (Page 133)

use of eHr d ocu Mentation By outcomes were beyond the scope of this project. In this study, we sought to answer the following questions related to the use of the EHR in the clinical setting: 1. Which parts of the EHR do clinical practitioners access to view documented information? 2. How do clinical practitioners use information from the EHR in their practice? 3. What information from the EHR are practitioners using when caring for patients? 4. What is the perception of the amount of time clinical practitioners spend reviewing documentation in the EHR? 5. What is the perception of the amount of time clinical practitioners spend documenting in the EHR? METHODS We administered a descriptive and exploratory online survey to a convenience sample of clinical practitioners at a large, six-facility community hospital system in the southeastern United States. The study population included clinical practitioners and caregivers who accessed, used, or contributed information to patients' EHRs, including physicians/providers, bedside nurses, managers/educators, medical/nurse assistants, advanced clinical nurses, ancillary professionals, discharge planners/social workers, and ancillary diagnostic personnel. Excluded from this study were team members who were not clinical practitioners, did not interface with the patient for a clinical purpose H ealtHcare w orkers in a H ospital s ysteM or service, did not use or document data in patients' EHRs for patient care, and worked in outpatient diagnostic areas. At the study organization, the EHR had been implemented incrementally over the course of the prior decade, starting with availability of diagnostic results (2004), nursing documentation (2005-2007), and physician order entry (2008). Gradual increases in adoption and use of various components were seen, which were integrated and expanded to a number of areas in the organization. At the time of the study, the inpatient (IP) and emergency department (ED) units were fully integrated into the current EHR and thus were the only areas of the organization that participated in the study. The survey instrument underwent a series of rigorous assessments and iterations by our multidisciplinary investigative team. To assess for face validity, the instrument was distributed to key clinical experts, leaders, and users of clinical documentation across disciplines. Evaluators were asked to assess for burden of completion, relevancy of documentation used in practice, clarity of the questions, and feasibility of survey items. We used the feedback and input from all reviews to make final revisions to the survey. We received approval from the study organization's nursing research council and institutional review board. The online survey was open for participation from November 1, 2011, to December 20, 2011. We used SPSS version 19 (IBM, 2010) to analyze all data. R E S U LT S In total, 837 healthcare practitioners accessed the online survey. Of those, 133

Table of Contents for the Digital Edition of Journal of Healthcare Management - March/April 2014

Journal of Healthcare Management - March/April 2014
Contents
Interview With Marna P. Borgstrom, FACHE, President and Chief Executive Officer, Yale New Haven Health System, and Chief Executive Officer, Yale-New Haven Hospital, Connecticut
Specialties: Missing in Our Healthcare Reform Strategies?
Costs and Benefits of Transforming Primary Care Practices: A Qualitative Study of North Carolina’s Improving Performance in Practice
Governing Board, C-suite, and Clinical Management Perceptions of Quality and Safety Structures, Processes, and Priorities in U.S. Hospitals
Use of Electronic Health Record Documentation by Healthcare Workers in an Acute Care Hospital System
Why Hospital Improvement Efforts Fail: A View From the Front Line

Journal of Healthcare Management - March/April 2014