title: Evaluating the impact of computer-generated rounding reports on physician workflow in the nursing home: a feasibility time-motion study.
abstract: OBJECTIVE
  To determine the feasibility and impact of a computer-generated rounding report on physician rounding time and perceived barriers to providing clinical care in the nursing home (NH) setting.
  
  
  METHODS
  Three NHs located in Pittsburgh, PA.
  
  
  METHODS
  Ten attending NH physicians.
  
  
  METHODS
  Time-motion method to record the time taken to gather data (pre-rounding), to evaluate patients (rounding), and document their findings/develop an assessment and plan (post-rounding). Additionally, surveys were used to determine the physicians' perception of barriers to providing optimal clinical care, as well as physician satisfaction before and after the use of a computer-generated rounding report.
  
  
  RESULTS
  Ten physicians were observed during half-day sessions both before and 4 weeks after they were introduced to a computer-generated rounding report. A total of 69 distinct patients were evaluated during the 20 physician observation sessions. Each physician evaluated, on average, four patients before implementation and three patients after implementation. The observations showed a significant increase (P = .03) in the pre-rounding time, and no significant difference in the rounding (P = .09) or post-rounding times (P = .29). Physicians reported that information was more accessible (P = .03) following the implementation of the computer-generated rounding report. Most (80%) physicians stated that they would prefer to use the computer-generated rounding report rather than the paper-based process.
  
  
  CONCLUSIONS
  The present study provides preliminary data suggesting that the use of a computer-generated rounding report can decrease some perceived barriers to providing optimal care in the NH. Although the rounding report did not improve rounding time efficiency, most NH physicians would prefer to use the computer-generated report rather than the current paper-based process. Improving the accuracy and harmonization of medication information with the electronic medication administration record and rounding reports, as well as improving facility network speeds might improve the effectiveness of this technology.
authors: Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15206, USA.
authors: Patrice T
authors: PT
authors: Thorpe-Jamison
authors: Colleen M
authors: CM
authors: Culley
authors: Subashan
authors: S
authors: Perera
authors: Steven M
authors: SM
authors: Handler
mesh_terms: D001291:Attitude of Health Personnel; D001331:Automation; D017598:Efficiency, Organizational; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008503:Medical Staff / Q000458:organization & administration*; D009735:Nursing Homes; D010414:Pennsylvania; D017748:Time Management / Q000379:methods*; D013996:Time and Motion Studies; D057188:Workflow