An Interprofessional Approach to Clinical Workflow Evaluation Focused on the Electronic Health Record Using Time motion Study Methods

Abstract

Documentation burden has become an increasing concern as the prevalence of electronic health records (EHRs) has grown. The implementation of a new EHR is an opportunity to measure and improve documentation burden, as well as assess the role of the EHR in clinician workflow. Time-motion observation is the preferred method for evaluating workflow. In this study, we developed and tested the reliability of an interprofessional taxonomy for use in time-motion observation of nursing and physician workflow before and after a new EHR is implemented at a large academic medical center. Inter-observer reliability assessment sessions were conducted while observing both nurses and physicians. Four out of five observers achieved reliability in an average of 5.75 sessions. Our developed taxonomy demonstrated to be reliable for conducting workflow evaluation of both nurses and physicians, with a focus on time and tasks in the EHR.