title: Utility of Daily Mobile Tablet Use for Residents on an Otolaryngology Head & Neck Surgery Inpatient Service.
abstract: The objective of this study was to investigate the utility of electronic tablets and their capacity to increase hospital floor productivity, efficiency, improve patient care information safety, and to enhance resident education and resource utilization on a busy Otolaryngology - Head & Neck Surgery inpatient service. This was a prospective cohort study with a 2-week pre-implementation period with standard paper census lists without mobile tablet use, and a 2-week post-implementation period followed with electronic tablets used to place orders, look up pertinent clinical data, educate patients as appropriate, and to record daily to-dos that would previously be recorded on paper. The setting for the study was Duke University Medical Center in Durham, North Carolina, with 13 Otolaryngology residents comprising the study population. The time for inpatient rounding was shorter with the use tablets (p = 0.037). There was a non-significant trend in the number of times a resident had to leave rounds to look up a clinical query on a computer, with less instances occurring in the post-implementation study period. The residents felt that having a tablet facilitated more detailed and faster transfer of information, and improved ease of documentation in the medical record. Seventy percent felt tablets helped them spend more time with patients, 70 % could spend more time directly involved in rounds because they could use the tablet to query information at point-of-care, and 80 % felt tablets improved morale. The utility of a mobile tablet device coupled with the electronic health record appeared to have both quantitative and qualitative improvements in efficiency, increased time with patients and attendance at academic conferences. Tablets should be encouraged but not mandated for clinical and educational use.
authors.affiliation: Division of Otolaryngology-Head & Neck Surgery, Duke University Medical Center, 2301 Erwin Road, Durham, NC, 27710, USA. matthew.crowson@dm.duke.edu.
authors.forename: Matthew G
authors.identifier: http://orcid.org/0000-0001-9950-0985
authors.initials: MG
authors.lastname: Crowson
authors.affiliation: Division of Otolaryngology-Head & Neck Surgery, Duke University Medical Center, 2301 Erwin Road, Durham, NC, 27710, USA.
authors.forename: Russel
authors.initials: R
authors.lastname: Kahmke
authors.affiliation: Division of Otolaryngology-Head & Neck Surgery, Duke University Medical Center, 2301 Erwin Road, Durham, NC, 27710, USA.
authors.forename: Marisa
authors.initials: M
authors.lastname: Ryan
authors.affiliation: Division of Otolaryngology-Head & Neck Surgery, Duke University Medical Center, 2301 Erwin Road, Durham, NC, 27710, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Scher
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration; D017598:Efficiency, Organizational; D057286:Electronic Health Records; D006739:Hospital Administration; D006801:Humans; D007297:Inpatients; D008838:Microcomputers; D010036:Otolaryngology / Q000458:organization & administration*; D019095:Point-of-Care Systems; D011446:Prospective Studies; D016526:Workload
keywords: Electronic health record; Electronic medical record; Mobile computing; Mobile tablets; Resident education; Resident rounding