Impact of a critical care clinical information system on interruption rates during intensive care nurse and physician documentation tasks.
Computerized documentation methods in Intensive Care Units (ICUs) may assist Health Care Providers (HCP) with their documentation workload, but evaluating impacts remains problematic. A Critical Care clinical Information System (CCIS) is an electronic charting tool designed for ICUs that may fit seamlessly into HCP work. Observers followed ICU nurses and physicians in two ICUs in Edmonton, Canada, in which a CCIS had recently been introduced. Observers recorded amounts of time HCPs spent on documentation related tasks, interruptions encountered by HCPs, and contextual information in field notes. Interruption rates varied depending on the charting medium used, with physicians being interrupted less frequently when performing documentation tasks using the CCIS, than when performing documentation tasks using other methods. In contrast, nurses were interrupted more frequently when charting using the CCIS than when using other methods. Interruption rates coupled with qualitative observations suggest that physicians utilize strategies to avoid interruptions if interfaces for entering textual notes are not well adapted to interruption-rich environments such as ICUs. Potential improvements are discussed such that systems like the CCIS may better integrate into ICU work.
Ballermann
Mark A
MA
Department of Family Medicine, University of Alberta, Edmonton, Alberta, T6G 2M8, Canada.
Shaw
Nicola T
NT
Arbeau
Kelly J
KJ
Mayes
Damon C
DC
Noel Gibney
R T
RT
D002170:Canada; D003422:Critical Care / Q000706:statistics & numerical data*; D006751:Hospital Information Systems / Q000706:statistics & numerical data*; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D009726:Nurses / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*; D013996:Time and Motion Studies; D057188:Workflow; D016526:Workload / Q000706:statistics & numerical data*