title: Discuss now, document later: CIS/CPOE perceived to be a 'shift behind' in the ICU.
abstract: Effective communication is essential to safe and efficient patient care. We aimed to understand the current patterns and perceptions of communication of common goals in the ICU using the distributed cognition and clinical communication space theoretical frameworks. We conducted a focus group and 5 interviews with ICU clinicians and observed 59.5 hours of interdisciplinary ICU morning rounds. Clinicians used a CIS/CPOE system and paper artifacts for documentation; yet, preferred verbal communication as a method of information exchange because they perceived that the documentation was often not updated or efficient for information retrieval. These perceptions that the CIS/CPOE is a "shift behind" may lead to a further reliance on verbal information exchange, which is a valuable clinical communication activity, yet, is subject to information loss. Electronic documentation tools that, in real time, capture information that is currently verbally communicated may increase the effectiveness of communication.
authors.affiliation: Department of Biomedical Informatics, Columbia University, School of Nursing, and New York Presbyterian Hospital, New York, NY, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Collins
authors.forename: Suzanne
authors.initials: S
authors.lastname: Bakken
authors.forename: David
authors.initials: D
authors.lastname: Vawdrey
authors.forename: Enrico
authors.initials: E
authors.lastname: Coiera
authors.forename: Leanne M
authors.initials: LM
authors.lastname: Currie
mesh_terms: D001291:Attitude of Health Personnel; D002984:Clinical Laboratory Information Systems / Q000706:statistics & numerical data*; D004282:Documentation / Q000379:methods*; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D050316:Medical Order Entry Systems / Q000706:statistics & numerical data*; D009518:New York; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D014600:Utilization Review