Introduction: Creating inpatient rounding lists requires time-consuming chart review, is prone to inaccuracy, and often contributes to provider dissatisfaction.
Methods: We developed custom a list-generating system within our Neurosurgery department. Due to its subjective success, we integrated it into the Epic EHR and deployed it institution-wide. Our preliminary beta users completed baseline and follow-up surveys to assess impacts on workflow, satisfaction and list accuracy. We monitored server data to track the total number of users, active users per day, lists generated per day, and number of unique patients accessed across the health system.
Results: Chart review time decreased from 60 [60,90] to 30 mins [20,60], p<0.01. Provider satisfaction rated on a scale of 1 (unsatisfied) to 100 (satisfied) increased from 30 [17, 60] to 80 [65, 57], p<0.01. The burden of preparing for rounds rated on a scale of 1 (easy) to 100 (difficult) decreased from 70 [65, 78] to 50 [20, 65], p<0.01. Percentage of time providers perceived inaccuracies on the list decreased from 25% [10, 75] to 15% [5, 30], p=0.05.
System usage increased from 50 to over 800 users within 1 month of implementation. Usage data over the first three months reveals a daily median [IQR] of 109 [105,118] active users, 240 [213,264] lists generated, and 685 [641,726] patients accessed across the health system; notably, these numbers continue to increase
Conclusions: Our EHR-integrated application has succeeded in automating the creation of daily rounding lists for a majority of inpatient providers in our medical center. In doing so, it has demonstrated efficacy in saving clinicians time, decreasing rounding list errors, and improving provider satisfaction. If the reduction in chart review time experienced by our beta users is consistent across our current active users, the system will be responsible for saving over 1500 hours of chart review time per month at our institution.
Patient Care: Our research has shown a direct impact on decreasing provider EHR usage time, reducing the frequency of errors on rounding lists, and increasing physician satisfaction, all of which help to improve patient care
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe issues leading to inaccuracies and inefficiencies in current rounding list implementations 2) describe the importance of an accurate rounding list in preventing medication errors 3) Discuss the factors which led to preliminary success of our rounding list system