Measurement of clinical documentation burden among physicians and nurses using electronic health records: a scoping review.

Background: .Objective: Electronic health records (EHRs) are linked with documentation burden resulting in clinician burnout. While clear classifications and validated measures of burnout exist, documentation burden remains ill-defined and inconsistently measured. We aim to conduct a scoping review...

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Publicado en:Journal of the American Medical Informatics Association Vol. 28; no. 5; pp. 998 - 1009
Autores principales: Moy, Amanda J, Schwartz, Jessica M, Chen, RuiJun, Sadri, Shirin, Lucas, Eugene, Cato, Kenrick D, Rossetti, Sarah Collins
Formato: research Journal Article
Publicado: Oxford University Press / USA May2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2021
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      pub: Oxford University Press / USA
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        atl: Measurement of clinical documentation burden among physicians and nurses using electronic health records: a scoping review.
      aug:
        au:
          Moy, Amanda J
          Schwartz, Jessica M
          Chen, RuiJun
          Sadri, Shirin
          Lucas, Eugene
          Cato, Kenrick D
          Rossetti, Sarah Collins
        affil: Department of Biomedical Informatics, Columbia University , New York, New York, USA
      sug:
        subj:
          Workload
          Task Performance and Analysis
          Nurses
          Physicians
          Documentation
          Systems Analysis
          Human
          Meta Analysis
          Impact of Events Scale
          Scales
      ab: Background: .Objective: Electronic health records (EHRs) are linked with documentation burden resulting in clinician burnout. While clear classifications and validated measures of burnout exist, documentation burden remains ill-defined and inconsistently measured. We aim to conduct a scoping review focused on identifying approaches to documentation burden measurement and their characteristics.Materials and Methods: Based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Extension for Scoping Reviews (ScR) guidelines, we conducted a scoping review assessing MEDLINE, Embase, Web of Science, and CINAHL from inception to April 2020 for studies investigating documentation burden among physicians and nurses in ambulatory or inpatient settings. Two reviewers evaluated each potentially relevant study for inclusion/exclusion criteria.Results: Of the 3482 articles retrieved, 35 studies met inclusion criteria. We identified 15 measurement characteristics, including 7 effort constructs: EHR usage and workload, clinical documentation/review, EHR work after hours and remotely, administrative tasks, cognitively cumbersome work, fragmentation of workflow, and patient interaction. We uncovered 4 time constructs: average time, proportion of time, timeliness of completion, activity rate, and 11 units of analysis. Only 45.0% of studies assessed the impact of EHRs on clinicians and/or patients and 40.0% mentioned clinician burnout.Discussion: Standard and validated measures of documentation burden are lacking. While time and effort were the core concepts measured, there appears to be no consensus on the best approach nor degree of rigor to study documentation burden.Conclusion: Further research is needed to reliably operationalize the concept of documentation burden, explore best practices for measurement, and standardize its use.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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