title: In Search of Social Translucence: An Audit Log Analysis of Handoff Documentation Views and Updates.
abstract: Communication and information sharing are critical parts of teamwork in the hospital; however, achieving open and fluid communication can be challenging. Finding specific patient information within documentation can be difficult. Recent studies on handoff documentation tools show that resident handoff notes are increasingly used as an alternative information source by non-physician clinicians. Previous findings also show that residents have become aware of this unintended use. This study investigated the alignment of resident note updating patterns and team note viewing patterns based on usage log data of handoff notes. Qualitative interviews with clinicians were used to triangulate findings based on the log analysis. The study found that notes that were frequently updated were viewed significantly more frequently than notes updated less often (p < 2.2 × 10(-16)). Almost 44% of all notes had aligned frequency of views and updates. The considerable percentage (56%) of mismatched note utilization suggests an opportunity for improvement.
authors.affiliation: Department of Biomedical Informatics, Columbia University, New York, NY.
authors.forename: Silis Y
authors.initials: SY
authors.lastname: Jiang
authors.affiliation: Department of Pediatrics, Columbia University, New York, NY.
authors.forename: R Stanley
authors.initials: RS
authors.lastname: Hum
authors.affiliation: Department of Biomedical Informatics, Columbia University, New York, NY; NewYork-Presbyterian Hospital Value Institute, New York, NY.
authors.forename: David
authors.initials: D
authors.lastname: Vawdrey
authors.affiliation: Department of Biomedical Informatics, Columbia University, New York, NY.
authors.forename: Lena
authors.initials: L
authors.lastname: Mamykina
mesh_terms: D000046:Academic Medical Centers; D003142:Communication; D004282:Documentation / Q000706:statistics & numerical data*; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D006801:Humans; D007396:Internship and Residency; D016347:Medical Records Systems, Computerized; D009519:New York City; D010348:Patient Care Team; D062209:Patient Handoff