Hospitalist Connecticut Children's Hartford, Connecticut, United States
Background: The Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirements require residency programs to monitor work intensity and workload compression that may affect resident well-being. Studies have shown that increasing Electronic Health Record (EHR) use post-pandemic was associated with higher physician trainee burnout and mental health issues, and have demonstrated the objectively high burden of time spent in documenting residents face in ambulatory settings. Amidst the surge in patient volume and acuity associated with the pandemic, respiratory surge, and pediatric mental health crisis, there are national and local concerns for increasing hospital-based clinician stress and workload including time spent in the EHR documenting, ordering and reviewing patient data. Pediatric resident EHR workload for inpatient rotations and strategies to decrease burden have not yet been extensively explored. Objective: To describe and quantify the time spent by pediatric residents at a single, free-standing academic children’s hospital in the acute care EHR utilization related to patient care during inpatient pediatrics rotations before, during, and after workflow optimization. Design/Methods: This is a single center, observational study in which pediatric resident EHR use metrics for time spent documenting, ordering, and performing clinical review was tracked over time using vendor provided EHR usage data (known as “Signal”). A workgroup including members of the pediatric residency and clinical informatics was convened to identify key areas for optimization. Metrics were analyzed across 3 periods related to implementation of requested workflow optimizations: Baseline (9/23-10/23; before any optimization); Post A immediately after a series of optimizations implemented (11/23-12/23); and Post B (1/24-2/24) to test for seasonal effects and sustainability using Mann Whitney U tests and multivariable regression models adjusting for residency year. A satisfaction survey was also administered.
