Background: Physicians’ computer time in the U.S. is increasing. Over the years we have observed in our NICU a decrease in the amount of bedside time before rounds and an increase in the time performing computer tasks that have high administrative but low academic value for our residents. An EHR-generated rounding report is an informatics tool that can save time by gathering data from the patients’ electronic record and organizing it into one report. NICUs are a data dense service with lots of calculations and numbers to collect every day. We conducting a study to evaluate the impact of an EHR generated NICU rounding report on residents’ time. Aims: The aim of our study is to determine time savings in residents workflow after the introduction of a NICU specific rounding report. Our main outcome was time spent preparing the NICU rounding flowsheet. Secondary outcomes were: time spent inside the NICU and time performing physical exam on patients. Methods: We performed a time-study in which residents were shadowed individually by a research assistant during their NICU rotation before and after the NICU rounding report was made available. Residents were followed from 6:30am until the end of rounds. Each resident was followed twice at the end of their rotation and all relevant activities and their start and end times recorded. The post intervention observer was a different person and was blinded to the pre-intervention results. An anonymous web based survey assessing resident satisfaction and time perception was administered to all department residents before and after the NICU rounding report was launched. We are currently collecting post intervention data. Results: We report the preliminary results of our study. So far, we have observed 18 subjects before and 10 after the intervention. The duration of flowsheet preparation in minutes was 91 vs 31 (p=0.011). The percentage of residents unable to perform a physical exam before rounds in the pre-and post-populations was 33% vs 0% (p = 0.04). The percent of residents entering the NICU before rounds (88%) also improved in the post intervention phase (100%). In the preintervention survey 40% of the residents reported spending more than 1 hour for collecting patient data (pre-rounding) and most respondents (60%) spent less than 1 hour actually rounding in the NICU. Post intervention survey is currently underway. Conclusions: Our EHR-generated NICU rounding report successfully increased efficiency of residents daily NICU workflow by 66% (an average time savings of 60 minutes). It also allowed more residents to perform physical exam before rounds. We conclude that a NICU specific rounding report is a feasible and inexpensive tool to decrease cognitively distant tasks like data transcription and increase time at bedside, which could potentially improve the quality of clinical care.

Figure 1

NICU Rounding report

EHR generated NICU rounding report sample

Figure 1

NICU Rounding report

EHR generated NICU rounding report sample

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