Journal of Healthcare Management - March/April 2014 - (Page 134)

J o u r n al of H ealt H care M anage Ment 59:2 M arcH /a pril 2014 9 did not consent to participate in the study, leaving 828 surveys. Eighty surveys were blank, leaving 748 possible surveys for analysis. Nineteen surveys were less than 80% completed and were eliminated. We then eliminated those surveys completed by individuals whose role types were ineligible for inclusion, leaving 700 total usable surveys. To determine the number of potential subjects who would be eligible to join the study, we applied several filters to the approximately 14,000 team members from the study organization's human resources database. We used specific job codes for roles, hospitals, and unit locations that would meet inclusion. Applying those criteria, the number of eligible IP and ED team members was 6,664. Our sample represented approximately a 10.5% response rate based on this assessment. Of those, 591 subjects were from the IP setting and 109 were from the ED. Data on EHR usage by subjects from the ED were analyzed separately from IP findings because of the differences in pace, priorities, and patient flow. Because fewer types of providers are actively involved in ED patient care, providers were grouped as prescribers (MDs, nurse practitioners, or physician assistants), nurses, and ancillary staff in this subanalysis. Table 1 summarizes the total sample in the study. Sample Characteristics The sample of 591 subjects from the IP setting consisted primarily of women (78.3%) and individuals who had achieved a baccalaureate degree or higher education (75.8%). The average age of the participants was 41.49 years; the youngest respondent was 19, and the oldest was 71. The sample also reflected an average tenure of 14.6 years in participants' role and 8.59 years' longevity with the organization. The primary role represented in the sample was bedside nurses (40%), followed by ancillary clinical roles (19%). Study Question Results Which parts of the EHR do clinical practitioners access to view documented information? An analysis of IP results was performed in 50 specific areas of the EHR to determine which areas are most often reviewed during patient care. We found that Diagnostic Results was the most frequently accessed (89%) by all providers, with 96% of advanced clinical nurse professionals accessing this screen often or frequently. Physicians Orders was also heavily used to review information, with 86% of respondents often or frequently accessing this portion of the record. Two forms of provider core documents heavily accessed were History and Physical by a Physician (84%) and Physician Progress Notes (83%), while the Nursing Care documents and Patient Work List were less frequently viewed by all subjects; only 63% of respondents indicated that they view this area regularly, of whom 90% of bedside nurses and 7% of prescribers access this area of the EHR for review. Table 2 summarizes the parts of the EHR that subjects reportedly review often in their role. In contrast, many other areas of the EHR were less frequently accessed for review. Numerous nursing and ancillary core documents were rarely reviewed, 134

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