Browsing by Subject "Workload"

Now showing 1 - 4 of 4
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    Closer to or Farther away from an Ideal Model of Care? Lessons Learned from Geographic Cohorting
    (Springer, 2022-09) Kara, Areeba; Kashiwagi, Deanne; Burden, Marisha; Medicine, School of Medicine
    Geographic "cohorting," "co-location," "regionalization," or "localization" refers to the assignation of a hospitalist team to a specific inpatient unit. Its benefits may be related to the formation of a team and the additional interventions like interdisciplinary rounding that the enhanced proximity facilitates. However, cohorting is often adopted in isolation of the bundled approach within which it has proven beneficial. Cohorting may also be associated with unintended consequences such as increased interruptions and increased indirect care time. Institutions may increase patient loads in anticipation of the efficiency gained by cohorting-leading to further increases in interruptions and time away from the bedside. Fragmented attention and increases in indirect care may lead to a perception of increased workload, errors, and burnout. As hospital medicine evolves, there are lessons to be learned by studying cohorting. Institutions and inpatient units should work in synergy to shape the day-to-day work which directly affects patient and clinician outcomes-and ultimately culminates in the success or failure of the parent organization. Such synergy can manifest in workflow design and metric selection. Attention to workloads and adopting the principles of continuous quality improvement are also crucial to developing models of care that deliver excellent care.
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    Impact of an untrained CPR Coach in simulated pediatric cardiopulmonary arrest: A pilot study
    (Elsevier, 2020-12-01) Badke, Colleen M.; Friedman, Matthew L.; Harris, Z. Leah; McCarthy-Kowols, Maureen; Tran, Sifrance; Pediatrics, School of Medicine
    Aim To determine if an untrained cardiopulmonary resuscitation (CPR) Coach, with no access to real-time CPR feedback technology, improves CPR quality. Methods This was a prospective randomized pilot study at a tertiary care children's hospital that aimed to integrate an untrained CPR Coach into resuscitation teams during simulated pediatric cardiac arrest. Simulation events were randomized to two arms: control (no CPR Coach) or intervention (CPR Coach). Simulations were run by pediatric intensive care unit (PICU) providers and video recorded. Scenarios focused on full cardiopulmonary arrest; neither team had access to real-time CPR feedback technology. The primary outcome was CPR quality. Secondary outcomes included workload assessments of the team leader and CPR Coach using the NASA Task Load Index and perceptions of CPR quality. Results Thirteen simulations were performed; 5 were randomized to include a CPR Coach. There was a significantly shorter duration to backboard placement in the intervention group (median 20s [IQR 0–27s] vs. 52s [IQR 38–65s], p=0.02). There was no self-reported change in the team leader's workload between scenarios using a CPR Coach compared to those without a CPR Coach. There were no significant changes in subjective CPR quality measures. Conclusions In this pilot study, inclusion of an untrained CPR Coach during simulated CPR shortened time to backboard placement but did not improve most metrics of CPR quality or significantly affect team leader workload. More research is needed to better assess the value of a CPR Coach and its potential impact in real-world resuscitation.
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    Impact of document consolidation on healthcare providers’ perceived workload and information reconciliation tasks: a mixed methods study
    (Oxford University Press, 2019-02) Hosseini, Masoud; Faiola, Anthony; Jones, Josette; Vreeman, Daniel J.; Wu, Huanmei; Dixon, Brian E.; Medicine, School of Medicine
    Background Information reconciliation is a common yet complex and often time-consuming task performed by healthcare providers. While electronic health record systems can receive “outside information” about a patient in electronic documents, rarely does the computer automate reconciling information about a patient across all documents. Materials and Methods Using a mixed methods design, we evaluated an information system designed to reconcile information across multiple electronic documents containing health records for a patient received from a health information exchange (HIE) network. Nine healthcare providers participated in scenario-based sessions in which they manually consolidated information across multiple documents. Accuracy of consolidation was measured along with the time spent completing 3 different reconciliation scenarios with and without support from the information system. Participants also attended an interview about their experience. Perceived workload was evaluated quantitatively using the NASA-TLX tool. Qualitative analysis focused on providers’ impression of the system and the challenges faced when reconciling information in practice. Results While 5 providers made mistakes when trying to manually reconcile information across multiple documents, no participants made a mistake when the system supported their work. Overall perceived workload decreased significantly for scenarios supported by the system (37.2% in referrals, 18.4% in medications, and 31.5% in problems scenarios, P < 0.001). Information reconciliation time was reduced significantly when the system supported provider tasks (58.8% in referrals, 38.1% in medications, and 65.1% in problem scenarios). Conclusion Automating retrieval and reconciliation of information across multiple electronic documents shows promise for reducing healthcare providers’ task complexity and workload.
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    Meeting the Consultation Surge: A Nationwide Survey of Consult Volume and Mitigation Strategies in Infectious Diseases Fellowship Programs
    (Oxford University Press, 2024-03-05) Mena Lora, Alfredo J.; Knodle, Ryan; Borgetti, Scott; Matt, Brionna; Osorio, Georgina; Sundareshan, Vidya; Rojas-Moreno, Christian; Bartash, Rachel; Van Schooneveld, Trevor C.; Reece, Rebecca; Chow, Brian; Prakash, Katya; Butt, Saira; Lastinger, Allison; Medicine, School of Medicine
    High patient volume in fellowship programs can affect learning, wellness, and patient outcomes. Training programs must find ways to mitigate high consultation volume to protect the learning environment. This survey describes average new consults and average censuses for infectious diseases training programs and strategies implemented to mitigate high volume.