Abstract
The purpose of this study was to describe a workflow analysis approach and apply it in emergency departments (EDs) using data extracted from the electronic health record (EHR) system. We used data that were obtained during 2013 from the ED of a children's hospital and its four satellite EDs. Workflow-related data were extracted for all patient visits with either a primary or secondary diagnosis on discharge of asthma (ICD-9 code=493). For each patient visit, eight different a priori time-stamped events were identified. Data were also collected on mode of arrival, patient demographics, triage score (i.e. acuity level), and primary/secondary diagnosis. Comparison groups were by acuity levels 2 and 3 with 2 being more acute than 3, arrival mode (ambulance versus walk-in), and site. Data were analyzed using a visualization method and Markov Chains. To demonstrate the viability and benefit of the approach, patient care workflows were visually and quantitatively compared. The analysis of the EHR data allowed for exploration of workflow patterns and variation across groups. Results suggest that workflow was different for different arrival modes, settings and acuity levels. EHRs can be used to explore workflow with statistical and visu...Continue Reading
References
Oct 7, 2004·Quality & Safety in Health Care·B-T Karsh
Mar 15, 2006·IEEE Transactions on Bio-medical Engineering·Jacob RosenBlake Hannaford
Dec 5, 2006·Quality & Safety in Health Care·P CarayonP Flatley Brennan
Apr 16, 2009·Pediatrics·Lara J AkinbamiEdward J Sondik
Mar 6, 2009·International Journal of Medical Informatics·Rebecca L Mador, Nicola T Shaw
Mar 6, 2009·Journal of the American Medical Informatics Association : JAMIA·Bonnie Kaplan, Kimberly D Harris-Salamone
Mar 12, 2009·Health Affairs·James M Walker, Pascale Carayon
Jan 12, 2010·Journal of Biomedical Informatics·L BouarfaJ Dankelman
May 6, 2010·Journal of the American Medical Informatics Association : JAMIA·Kim M UnertlNancy M Lorenzi
Jul 3, 2010·Journal of the American Medical Informatics Association : JAMIA·Kai ZhengDavid A Hanauer
Aug 6, 2010·Journal of Biomedical Informatics·Mithra VankipuramVimla L Patel
Oct 27, 2010·Quality & Safety in Health Care·Dean F Sittig, Hardeep Singh
Apr 30, 2011·Journal of the American Medical Informatics Association : JAMIA·Kai ZhengDavid A Hanauer
Mar 30, 2013·Journal of the American Medical Informatics Association : JAMIA·Mustafa OzkaynakSaira N Haque
Sep 7, 2013·Methods of Information in Medicine·M Ozkaynak, P Brennan
Sep 21, 2013·IEEE Transactions on Visualization and Computer Graphics·Megan MonroeBen Shneiderman
Dec 24, 2013·Journal of the American Medical Informatics Association : JAMIA·Jorge A GálvezMohamed A Rehman
Apr 16, 2014·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Elizabeth R AlpernUNKNOWN Pediatric Emergency Care Applied Research Network (PECARN)
Citations
Dec 4, 2020·Journal of Medical Internet Research·Jawad Ahmed ChishtieSusan Jaglal
May 23, 2017·Journal of Biomedical Informatics·Jane ChungGeorge Demiris
Mar 13, 2021·JAMIA Open·Jordan G NestorChunhua Weng
May 22, 2019·Applied Ergonomics·Scott R WalterJohanna I Westbrook