scholarly journals Real-World Management of Hyperkalemia in the Emergency Department: An Electronic Medical Record Analysis

2021 ◽  
Author(s):  
Jill Davis ◽  
Rubeen Israni ◽  
Keith A. Betts ◽  
Fan Mu ◽  
Erin E. Cook ◽  
...  
Keyword(s):  
Emergency Department ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Real World

scholarly journals Doctors documenting: an ethnographic and informatics approach to understanding attending physician documentation in the pediatric emergency department

2020 ◽  
Author(s):  
Sarah D Fouquet ◽  
Laura Fitzmaurice ◽  
Y Raymond Chan ◽  
Evan M Palmer
Keyword(s):  
Emergency Department ◽  
Mixed Methods ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Pediatric Emergency ◽  
Second Phase ◽  
Pediatric Emergency Department ◽  
Mixed Methods Approach ◽  
Time And Motion ◽  
Attending Physician

Abstract Objective The pediatric emergency department is a highly complex and evolving environment. Despite the fact that physicians spend a majority of their time on documentation, little research has examined the role of documentation in provider workflow. The aim of this study is to examine the task of attending physician documentation workflow using a mixed-methods approach including focused ethnography, informatics, and the Systems Engineering Initiative for Patient Safety (SEIPS) model as a theoretical framework. Materials and Methods In a 2-part study, we conducted a hierarchical task analysis of patient flow, followed by a survey of documenting ED providers. The second phase of the study included focused ethnographic observations of ED attendings which included measuring interruptions, time and motion, documentation locations, and qualitative field notes. This was followed by analysis of documentation data from the electronic medical record system. Results Overall attending physicians reported low ratings of documentation satisfaction; satisfaction after each shift was associated with busyness and resident completion. Documentation occurred primarily in the provider workrooms, however strategies such as bedside documentation, dictation, and multitasking with residents were observed. Residents interrupted attendings more often but also completed more documentation actions in the electronic medical record. Discussion Our findings demonstrate that complex work processes such as documentation, cannot be measured with 1 single data point or statistical analysis but rather a combination of data gathered from observations, surveys, comments, and thematic analyses. Conclusion Utilizing a sociotechnical systems framework and a mixed-methods approach, this study provides a holistic picture of documentation workflow. This approach provides a valuable foundation not only for researchers approaching complex healthcare systems but also for hospitals who are considering implementing large health information technology projects.

scholarly journals Evaluation of Electronic Medical Record Downtime in a Busy Emergency Department

2020 ◽  
Vol 2020 (1) ◽  
Author(s):  
Dominic Jenkins ◽  
Raheel Sharfeen Qureshi ◽  
Jibin Moinudheen ◽  
Sameer A. Pathan ◽  
Stephen H. Thomas
Keyword(s):  
Emergency Department ◽  
Medical Record ◽  
Electronic Medical Record

scholarly journals An intervention based on the Electronic Medical Record to improve smoking cessation guidance in an urban tertiary care center emergency department

2019 ◽  
Vol 5 (May) ◽  
Author(s):  
Michael Phelan ◽  
Balaji Nithianandam ◽  
Nathan Eikoff ◽  
Daniel Good ◽  
Fredric Hustey ◽  
...  
Keyword(s):  
Emergency Department ◽  
Smoking Cessation ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center

scholarly journals United Kingdom Diabetic Retinopathy Electronic Medical Record (UK DR EMR) Users Group: report 4, real-world data on the impact of deprivation on the presentation of diabetic eye disease at hospital services

2018 ◽  
Vol 103 (6) ◽  
pp. 837-843 ◽  
Author(s):  
Alastair K Denniston ◽  
Aaron Y Lee ◽  
Cecilia S Lee ◽  
David P Crabb ◽  
Clare Bailey ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Real World ◽  
Eye Disease ◽  
Inclusion Criteria ◽  
Data Set ◽  
Diabetic Eye Disease ◽  
The Impact

AimTo assess the impact of deprivation on diabetic retinopathy presentation and related treatment interventions, as observed within the UK hospital eye service.MethodsThis is a multicentre, national diabetic retinopathy database study with anonymised data extraction across 22 centres from an electronic medical record system. The following were the inclusion criteria: all patients with diabetes and a recorded, structured diabetic retinopathy grade. The minimum data set included, for baseline, age and Index of Multiple Deprivation, based on residential postcode; and for all time points, visual acuity, ETDRS grading of retinopathy and maculopathy, and interventions (laser, intravitreal therapies and surgery). The main  outcome measures were (1) visual acuity and binocular visual state, and (2) presence of sight-threatening complications and need for early treatment.Results79 775 patients met the inclusion criteria. Deprivation was associated with later presentation in patients with diabetic eye disease: the OR of being sight-impaired at entry into the hospital eye service (defined as 6/18 to better than 3/60 in the better seeing eye) was 1.29 (95% CI 1.20 to 1.39) for the most deprived decile vs 0.77 (95% CI 0.70 to 0.86) for the least deprived decile; the OR for being severely sight-impaired (3/60 or worse in the better seeing eye) was 1.17 (95% CI 0.90 to 1.55) for the most deprived decile vs 0.88 (95% CI 0.61 to 1.27) for the least deprived decile (reference=fifth decile in all cases). There is also variation in sight-threatening complications at presentation and treatment undertaken: the least deprived deciles had lower chance of having a tractional retinal detachment (OR=0.48 and 0.58 for deciles 9 and 10, 95% CI 0.24 to 0.90 and 0.29 to 1.09, respectively); in terms of accessing treatment, the rate of having a vitrectomy was lowest in the most deprived cohort (OR=0.34, 95% CI 0.19 to 0.58).ConclusionsThis large real-world study suggests that first presentation at a hospital eye clinic with visual loss or sight-threatening diabetic eye disease is associated with deprivation. These initial hospital visits represent the first opportunities to receive treatment and to formally engage with support services. Such patients are more likely to be sight-impaired or severely sight-impaired at presentation, and may need additional resources to engage with the hospital eye services over complex treatment schedules.

scholarly journals 278 Effect of Electronic Medical Record Transition on Emergency Department Length of Stay

2015 ◽  
Vol 66 (4) ◽  
pp. S100 ◽  
Author(s):  
R. Didehban ◽  
C.M. Lohse ◽  
D. Nguyen ◽  
S.J. Traub
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Medical Record ◽  
Electronic Medical Record
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