Switching Electronic Health Record Systems: Effects on Rounds and Perceived Impact on Communication andWorkflow in a Paediatric Critical Care Unit

Abstract

The overall objective of this study was to explore the impact that switching electronic health record (EHR) systems has on daily bedside rounds in a paediatric critical care unit. Naturalistic observations were used to contextualize rounds and to characterize how EHRs are used during rounds. Semi-structured interviews occurred in two phases. In phase one, interviews were conducted with clinicians to elicit detailed perceptions of rounds, and to understand how EHRs were used during rounds. Six months after the implementation of a new EHR system, phase two interviews were conducted to understand perceptions on how the new EHR system had impacted communication and workflow during rounds. Thematic analysis was performed on the qualitative notes from observations and interviews to identify patterns based on the data collected. Results of thematic analysis indicate that switching EHRs has an impact on how clinicians prepare for rounds, access information during rounds and document patient care goals during rounds. The results from this study will inform the design of interventions to improve daily bedside rounds in future work.