Comparing the information seeking strategies of residents, nurse practitioners, and physician assistants in critical care settings

Kannampallil, Thomas; Jones, Laura K.; Patel, Vimla L.; Buchman, Timothy G.; Franklin, Amy

doi:10.1136/amiajnl-2013-002615

Cited by 28 publications

(24 citation statements)

References 46 publications

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“…For example, respondents from our survey demonstrated that ready access to a single source was preferred just slightly over a tool that provides multiple links to various sources. These findings suggest that an infobutton with options for varying degrees of resource density may be a way to personalize these tools to the different information-seeking strategies of the user [35]. For example, users who prefer only a single source may select an option where point-of-care links would take a user directly to the UpToDate article (or similar source based on user preference) on the topic rather than have to select from a myriad of sources provided them.…”

Section: Discussionmentioning

confidence: 99%

A Survey from a Large Academic Medical Center

Homan¹,

Cimino²,

Peters³

et al. 2015

Appl Clin Inform

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Electronic health records, evidence-based medicine, information storage and retrieval, point of care technology, user-computer interface SummaryObjective: To better understand the literature searching preferences of clinical providers we conducted an institution-wide survey assessing the most preferred knowledge searching techniques. Materials and Methods: A survey regarding literature searching preferences was sent to 1862 unique clinical providers throughout Mayo Clinic. The survey consisted of 25 items asking respondents to select which clinical scenarios most often prompt literature searches as well as identify their most preferred knowledge resources. Results: A total of 450 completed surveys were returned and analyzed (24% response rate). 48% of respondents perform literature searches for more than half of their patient interactions with 91% of all searches occurring either before or within 3 hours of the patient interaction. When a search is performed 57% of respondents prefer synthesized information sources as compared to only 13% who prefer original research. 82% of knowledge searches are performed on a workstation or office computer while just 10% occur on a mobile device or at home. Conclusion:Providers in our survey demonstrate a need to answer clinical questions on a regular basis, especially in the diagnosis and therapy domains. Responses suggest that most of these searches occur using synthesized knowledge sources in the patient care setting within a very short time from the patient interaction.

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Section: Discussionmentioning

confidence: 99%

A Survey from a Large Academic Medical Center

Homan¹,

Cimino²,

Peters³

et al. 2015

Appl Clin Inform

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“…As we develop new methods of inquiry, we will also be faced with ancillary challenges, such as (1) whether it is ethical to blind patients or clinicians to the high probability of an adverse event that can be prevented with available resources, (2) how information resources could affect patient behaviors (eg, treatment adherence in outpatient settings), and (3) determining optimal information visualization strategies for different clinicians and patients (given that a one-size-fits-all approach is likely inadequate 34 ). Although nurses were the clinicians highlighted in this review, all healthcare providers will soon be faced with these challenges pertinent to HPA, and healthcare is ready to have these issues explored.…”

Section: Discussionmentioning

confidence: 99%

Methodological Challenges in Examining the Impact of Healthcare Predictive Analytics on Nursing-Sensitive Patient Outcomes

Jeffery¹

2015

CIN: Computers, Informatics, Nursing

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The expansion of real-time analytic abilities within current electronic health records has led to innovations in predictive modeling and clinical decision support systems. However, the ability of these systems to influence patient outcomes is currently unknown. Even though nurses are the largest profession within the healthcare workforce, little research has been performed to explore the impact of clinical decision support on their decisions and the patient outcomes associated with them. A scoping literature review explored the impact clinical decision support systems containing healthcare predictive analytics have on four nursing-sensitive patient outcomes (pressure ulcers, failure to rescue, falls, and infections). While many articles discussed variable selection and predictive model development/validation, only four articles examined the impact on patient outcomes. The novelty of predictive analytics and the inherent methodological challenges in studying clinical decision support impact are likely responsible for this paucity of literature. Major methodological challenges include (1) multilevel nature of intervention, (2) treatment fidelity, and (3) adequacy of clinicians' subsequent behavior. There is currently insufficient evidence to demonstrate efficacy of healthcare predictive analytics-enhanced clinical decision support systems on nursing-sensitive patient outcomes. Innovative research methods and a greater emphasis on studying this phenomenon are needed.

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“…However, there are other external constraints that play into the decisions regarding the priority order of patient presentation that can accelerate the disposition of patients in a unit. Tools supporting such global strategies and assisting in patient prioritization have been described to improve efficiency in critical care settings [38]. In an another study, Iapichino et al [39], suggested stratification of patients in intensive care settings should be based on their illness severity at patient admission to achieve cost effectiveness in the care delivery process.…”

Section: Discussionmentioning

confidence: 99%

Impact of Structured Rounding Tools on Time Allocation During Multidisciplinary Rounds: An Observational Study

Abraham¹,

Kannampallil²,

Patel³

et al. 2016

JMIR Hum Factors

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BackgroundRecent research has shown evidence of disproportionate time allocation for patient communication during multidisciplinary rounds (MDRs). Studies have shown that patients discussed later during rounds receive lesser time.ObjectiveThe aim of our study was to investigate whether disproportionate time allocation effects persist with the use of structured rounding tools.MethodsUsing audio recordings of rounds (N=82 patients), we compared time allocation and communication breakdowns between a problem-based Subjective, Objective, Assessment, and Plan (SOAP) and a system-based Handoff Intervention Tool (HAND-IT) rounding tools.ResultsWe found no significant linear dependence of the order of patient presentation on the time spent or on communication breakdowns for both structured tools. However, for the problem-based tool, there was a significant linear relationship between the time spent on discussing a patient and the number of communication breakdowns (P<.05)––with an average of 1.04 additional breakdowns with every 120 seconds in discussion.ConclusionsThe use of structured rounding tools potentially mitigates disproportionate time allocation and communication breakdowns during rounds, with the more structured HAND-IT, almost completely eliminating such effects. These results have potential implications for planning, prioritization, and training for time management during MDRs.

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Comparing the information seeking strategies of residents, nurse practitioners, and physician assistants in critical care settings

Cited by 28 publications

References 46 publications

A Survey from a Large Academic Medical Center

A Survey from a Large Academic Medical Center

Methodological Challenges in Examining the Impact of Healthcare Predictive Analytics on Nursing-Sensitive Patient Outcomes

Impact of Structured Rounding Tools on Time Allocation During Multidisciplinary Rounds: An Observational Study

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