Adrian Zurca, MD,
Associate Professor of Pediatrics
Penn State Milton S. Hershey Medical Center
Hershey, Pennsylvania
Disclosure information not submitted.
Conrad Krawiec, MD
Penn State Milton S. Hershey Medical Center
Hershey, Pennsylvania
Disclosure information not submitted.
Title: Quantification and Perception of Resident EHR Usage during Pre-Rounds
Introduction: Rotating pediatric intensive care unit (PICU) residents are tasked to collect and organize large amounts of data from the electronic health record (EHR) and other sources to present during rounds, a crucial process in the ongoing care of critically ill patients. It is unknown how much time residents spend collecting this data and whether they feel adequately prepared for rounds. The objective of this present study is to quantify resident pre-rounding EHR usage activity and to evaluate resident perceptions of their current pre-rounding process.
Methods: This was a retrospective observational study that quantified resident EHR activities (total time spent, EHR tasks performed, and patient encounters accessed) during pre-rounds (6:00 am-8:30 am) on their rotations in an 18 bed PICU between July 2020 and July 2021. We also surveyed pediatric, medicine/pediatric residents and emergency medicine to assess pre-rounding perceptions regarding preparedness for rounds. This study was approved by our IRB.
Results: Thirty-five residents were included in the EHR usage evaluation. Residents utilized the EHR to pre-round on 2.4±0.5 patients per day and spent an average of 37.3±7.2 minutes performing this task. Average EHR usage per patient encounter was 18.3±4.3 minutes. Compared to chart review (10.4±3.0 minutes) residents spent less time on documentation (2.9±1.8 minutes) and order entry (2.5±1.1 minutes). Of the 24 residents who responded to the survey, 30% felt they did not know what information they were expected to present on rounds and 25% did not have sufficient time to gather the necessary information. Only 54% felt they had adequate time to speak to the bedside nurse before rounds, and 17% did not have time to examine their patients prior to rounds.
Conclusions: Residents are not always certain what information they are expected to have on rounds. Despite utilizing the EHR to primarily collect patient data, residents perceive they do not always have enough time to adequately pre-round and are underprepared for rounds. Educational interventions should be considered to enhance pre-rounding efficiency and preparation for rounds.