Attitude of Health Personnel
Conditions
Keywords
Physicians, Electronic Health Record, Education
Brief summary
This study was intended to test the effects of adding a one-on-one educational intervention taught by a physician to a physician during their clinical work to improve their acceptance and satisfaction with a new inpatient electronic health record and ordering system.
Detailed description
This study was a randomized, parallel , non- blinded controlled trial of real-time, focused educational interventions in an intervention arm compared with usual training and support in the control arm. Improvement in performance, defined as the time between opening and closing a progress note, and number of notes completed after shift , were the primary outcomes. Physician satisfaction was a secondary outcome. Participants from one 550-bed Academic Independent Medical Center were invited to participate if they were full-time hospitalists or residents in internal medicine with no prior experience with the EPIC electronic health record.
Interventions
OTHEROne-on-one physician training
Physicians in the experimental arm were visited by a instructing physician at a computer while performing clinical duties who had observed others to identify best practices. Instructors watched subjects' work, looking for a specific tip that could be applied to the current work, then demonstrated the tip, and answered any questions the subject had about using or applying this new technique .
OTHERUsual training
Usual training included online e-modules, 12 hours of classroom time, practice in the EPIC Playground, user acceptability training classes,non-physician technical support on all of the floors, and a physician-only help line.
Sponsors
The Reading Hospital and Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
25 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Internal Medicine physicians and resident physicians with inpatient clinical duties at the time of the EPIC electronic health record go-live (Feb 4, 2013)
Exclusion criteria
* Physicians whose duties did not include regular admissions and discharge of patients * Physicians whose work was limited to teaching * Physicians with prior experience in using EPIC systems for inpatient care . * Physician assistants and nurse practitioners
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to complete a progress note | within 1 week of note completion | the primary outcome measure will be time to complete a progress note. this is defined as the difference between the recorded time of opening the note and the recorded time the note was signed in the EPIC electronic health record system. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of notes completed after shift | within 1 week of posting note | Shifts are 7 a.m. - 7 p.m for doctors assigned to daytime work. We defined a note completed after shift as any note with a signed time that is after 7 p.m. on the day of a shift worked. |
| Physician Satisfaction with EPIC Electronic Health Record | at baseline, 15-20 shifts, and 35-40 shifts | We asked the participants this question: How comfortable are you specifically using the EPIC program for inpatient practice? at baseline, midpoint (after working 15-20 shifts), and end of the study (after working 35-40 shifts). |
Countries
United States
Outcome results
None listed