Electronic patient record use during ward rounds: a qualitative study of interaction between medical staff.
BACKGROUND
Electronic patient records are becoming more common in critical care. As their design and implementation are optimized for single users rather than for groups, we aimed to understand the differences in interaction between members of a multidisciplinary team during ward rounds using an electronic, as opposed to paper, patient medical record.


METHODS
A qualitative study of morning ward rounds of an intensive care unit that triangulates data from video-based interaction analysis, observation, and interviews.


RESULTS
Our analysis demonstrates several difficulties the ward round team faced when interacting with each other using the electronic record compared with the paper one. The physical setup of the technology may impede the consultant's ability to lead the ward round and may prevent other clinical staff from contributing to discussions.


CONCLUSIONS
We discuss technical and social solutions for minimizing the impact of introducing an electronic patient record, emphasizing the need to balance both. We note that awareness of the effects of technology can enable ward-round teams to adapt their formations and information sources to facilitate multidisciplinary communication during the ward round.
Morrison
Cecily
C
Computer Laboratory, University of Cambridge, 15 JJ Thompson Avenue, Cambridge, CB3 0FD, UK. cpm38@cam.ac.uk
Jones
Matthew
M
Blackwell
Alan
A
Vuylsteke
Alain
A
D001292:Attitude to Computers; D004059:Diffusion of Innovation; D006801:Humans; D007362:Intensive Care Units; D007407:Interviews as Topic; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D008505:Medical Staff, Hospital; D010348:Patient Care Team; D010362:Patients' Rooms; D014743:Videotape Recording