299 - One-on-one training improves Pediatric Emergency Department provider satisfaction with the Electronic Health Record and facilitates timely documentation

Poster Number: 299

Owen Kahn, University of Connecticut School of Medicine, Niantic, CT, United States; Andrew Heggland, University of Connecticut School of Medicine, East Hartland, CT, United States

Background: Despite known benefits of EHRs, provider attitudes and proficiencies remain highly variable, leading to burnout and patient harm. Education has been demonstrated to improve knowledge of EHR features, however, the impact of education on efficiency and usability have scarcely been studied, despite adequate monitoring tools.

Objective: The purpose of this study was to evaluate the impact a novel EHR training method for Pediatric Emergency Medicine (PEM) providers on user-efficiency, reported usability and satisfaction with using the EHR. 

Design/Methods: One-on-one training sessions were conducted between participants and EHR super-users reviewing new EHR features and general efficiency recommendations. Surveys were completed pre and post training, including a validated EHR usability tool (NUHISS) and questions regarding satisfaction. Efficiency data was abstracted from EHR metadata, including minutes spent in the EHR per patient and timely completion of notes in three month periods.

Results: 34 of our 37 PEM providers participated. There was an increase in patients seen per shift from 17.8 to 20.5. Providers reported an overall increase in EHR usability of 17% and 18%, and satisfaction of 15% and 14% at 1 and 3 months, respectively. Reported usability of the EHR increased by 1 month in all four studied dimensions, and that increase was maintained in three of those dimensions. Reported relationship and proficiency with using the EHR significantly increased and was maintained at 1 and 3 months, respectively, while other parameters of satisfaction increased with variable statistical significance (Figure 1). A multivariate analysis of efficiency data was conducted including effects of provider role, patient acuity, and patients seen per shift. Despite the training, time spent in the EHR increased from 9.6 to 12.8 minutes per patient. Amongst attending physicians, there was an increase in percentage of notes signed within 12 hours of shift from 65 to 72% (p=0.04).Conclusion(s): After our user-focused, one-on-one training sessions with PEM providers, we observed a significant increase in all dimensions of the NUHISS usability tool, as well as reported satisfaction with using the EHR. We were unable to demonstrate a decrease in time spent within the EHR per patient, however there was a small but significant increase in PEM attending physician note completion within 12 hours of shift. Although training did not decrease providers’ time spent in the EHR, it did foster timely note completion, as well as a significant increase in reported usability and satisfaction with the EHR, all despite increased patient volumes.
Figure 1. Pediatric Emergency Medicine providers' reported usability of and satisfaction with the EHR before and after trainingComparing participant survey responses to NuHISS usability tool and questions pertaining to satisfaction before and at one and three months post-training. Post-training responses were compared to pre-training for statistical significance and all columns are statistically significant unless otherwise noted.