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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 3 of 3 Research Studies DisplayedGephart SM, Tolentino DA, Quinn MC
Neonatal intensive care workflow analysis informing NEC-Zero clinical decision support design.
The aim of this qualitative descriptive study was to explore the current clinical workflow and sociotechnical processes of clinicians for necrotizing enterocolitis risk awareness, timely discovery of symptoms, and treatment to guide decision support design. The researchers conducted 11 focus groups in two neonatal ICUs. The study found that workflow processes were different for nurses (who observe the signs of necrotizing enterocolitis and inform providers to order diagnostic tests and treatments) and providers (who receive notification of necrotizing enterocolitis concern and then decide what actions to take). The researchers reported that clinicians wanted a necrotizing enterocolitis-relevant dashboard with: 1) nutrition tracking and recognition of necrotizing enterocolitis; 2) features to support decision-making; 3) breast milk tracking and feeding clinical decision support; 4) tools for necrotizing enterocolitis surveillance and quality reporting; and 5) general electronic health records improvements to enhance user experience.
AHRQ-funded; HS022908.
Citation: Gephart SM, Tolentino DA, Quinn MC .
Neonatal intensive care workflow analysis informing NEC-Zero clinical decision support design.
Comput Inform Nurs 2023 Feb; 41(2):94-101. doi: 10.1097/cin.0000000000000929..
Keywords: Newborns/Infants, Clinical Decision Support (CDS), Intensive Care Unit (ICU), Workflow, Health Information Technology (HIT)
Salwei ME, Carayon P, Hoonakker PLT
Workflow integration analysis of a human factors-based clinical decision support in the emergency department.
Numerous challenges with the implementation, acceptance, and use of health IT are related to poor usability and a lack of integration of the technologies into clinical workflow, and have, therefore, limited the potential of these technologies to improve patient safety. In this paper, the investigators propose a definition and conceptual model of health IT workflow integration. Using interviews of 12 emergency department (ED) physicians, they identified 134 excerpts of barriers and facilitators to workflow integration of a human factors (HF)-based clinical decision support (CDS) implemented in the ED.
AHRQ-funded; HS022086.
Citation: Salwei ME, Carayon P, Hoonakker PLT .
Workflow integration analysis of a human factors-based clinical decision support in the emergency department.
Appl Ergon 2021 Nov;97:103498. doi: 10.1016/j.apergo.2021.103498..
Keywords: Emergency Department, Workflow, Clinical Decision Support (CDS), Health Information Technology (HIT), Implementation
Gephart S, Carrington JM, Finley B
A systematic review of nurses' experiences with unintended consequences when using the electronic health record.
The purpose of this article is to present the state of the science on nurses' experiences with unintended consequences of electronic health records (EHRs). Findings demonstrate that nurses experience changes to workflow, must continually adapt to meet patient's needs in the context of imperfect EHR systems, and have difficulty accessing the information they need to make patient care decisions. Implications for nurse administrators include the need for continual engagement with nurses along the continuum of EHR design, as well as the need to encourage nurses to speak up and acknowledge workflow changes that threaten patient safety or do not support work efficiency.
AHRQ-funded; HS021074.
Citation: Gephart S, Carrington JM, Finley B .
A systematic review of nurses' experiences with unintended consequences when using the electronic health record.
Nurs Adm Q 2015 Oct-Dec;39(4):345-56. doi: 10.1097/naq.0000000000000119.
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Keywords: Adverse Events, Clinical Decision Support (CDS), Electronic Health Records (EHRs), Nursing, Workflow