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Challenges in inpatient care coordinators’ clinical workflow and opportunities in designing a health IT solution: A mixed methods study

Challenges in inpatient care coordinators’ clinical workflow and opportunities in designing a... IntroductionInpatient care coordinators (ICCs) in the United States play a critical role in case management and care transition. ICCs spend a large amount of time in chart review and documentation through electronic health record (EHR) systems. However, significant knowledge gaps exist regarding their workflow barriers and their use of health information technology (Health IT). Using only quantitative or quantitative methods does not provide a comprehensive picture about ICC’s workflow due to its complex and dynamic nature. This work aimed to address this gap by conducting a mixed-methods study to understand the workflow of ICCs and identifying challenges in care deliver and documentation activities.MethodsThe study adopted a concurrent triangulation design including qualitative interviews with 12 ICC staff members in the United States followed by extraction of their EHR event logs for one month. The qualitative interview data were analyzed thematically, and the log data were analyzed statistically. The results were triangulated and interpreted.ResultsThree major workflow barriers faced by ICCs were identified: long travel time, heavy documentation load, and suboptimal communication. The event logs provided empirical evidence to support the workflow barriers identified in the interviews, especially in travel time and documentation load.DiscussionICC workflow has several inefficiencies. The study generated four design considerations to develop a Health IT solution: Mobility, EHR integration, Team-based Communication, and User Adoption to improve workflow efficiency and care coordination. Using a mixed-methods approach is effective and efficient in collecting and analyzing clinical workflow. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Journal of Care Coordination SAGE

Challenges in inpatient care coordinators’ clinical workflow and opportunities in designing a health IT solution: A mixed methods study

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Publisher
SAGE
Copyright
© The Author(s) 2022
ISSN
2053-4345
eISSN
2053-4353
DOI
10.1177/20534345221111004
Publisher site
See Article on Publisher Site

Abstract

IntroductionInpatient care coordinators (ICCs) in the United States play a critical role in case management and care transition. ICCs spend a large amount of time in chart review and documentation through electronic health record (EHR) systems. However, significant knowledge gaps exist regarding their workflow barriers and their use of health information technology (Health IT). Using only quantitative or quantitative methods does not provide a comprehensive picture about ICC’s workflow due to its complex and dynamic nature. This work aimed to address this gap by conducting a mixed-methods study to understand the workflow of ICCs and identifying challenges in care deliver and documentation activities.MethodsThe study adopted a concurrent triangulation design including qualitative interviews with 12 ICC staff members in the United States followed by extraction of their EHR event logs for one month. The qualitative interview data were analyzed thematically, and the log data were analyzed statistically. The results were triangulated and interpreted.ResultsThree major workflow barriers faced by ICCs were identified: long travel time, heavy documentation load, and suboptimal communication. The event logs provided empirical evidence to support the workflow barriers identified in the interviews, especially in travel time and documentation load.DiscussionICC workflow has several inefficiencies. The study generated four design considerations to develop a Health IT solution: Mobility, EHR integration, Team-based Communication, and User Adoption to improve workflow efficiency and care coordination. Using a mixed-methods approach is effective and efficient in collecting and analyzing clinical workflow.

Journal

International Journal of Care Coordination – SAGE

Published: Jun 1, 2022

Keywords: Social workers; workflow; efficiency; electronic health records

References

  • Social determinants of health: addressing barriers through screening, referrals, and care coordination
    Moore, K
  • Integrating social determinants of health into primary care clinical and informational workflow during care transitions
    Hewner, S; Casucci, S; Sullivan, S
  • Strong social support services, such as transportation and help for caregivers, can lead to lower health care use and costs
    Shier, G; Ginsburg, M; Howell, J
  • Characterizing communication patterns among members of the clinical care team to deliver breast cancer treatment
    Steitz, BD; Unertl, KM; Levy, MA
  • Surviving managed care: the effect on job satisfaction in hospital-based nursing
    Buiser, M
  • A concise tool for measuring care coordination from the provider’s perspective in the hospital setting
    Weston, CM; Yune, S; Bass, EB
  • Care coordination of multimorbidity: a scoping study
    Doessing, A; Burau, V
  • Patient-centered care coordination in hematopoietic cell transplantation
    Khera, N; Martin, P; Edsall, K
  • Implementation of a comprehensive program to improve coordination of care in an urban academic health care system
    Hsiao, YL; Bass, EB; Wu, AW
  • Evaluation of a multidisciplinary care coordination program for frequent users of the emergency department
    Flowers, A; Shade, K
  • Implementing chronic care for COPD: planned visits, care coordination, and patient empowerment for improved outcomes
    Fromer, L
  • The role of patient navigators in eliminating health disparities
    Natale-Pereira, A; Enard, KR; Nevarez, L
  • Coordination of diabetes care in four delivery models using an electronic health record
    MacPhail, LH; Neuwirth, EB; Bellows, J
  • Health information technology challenges to support patient-centered care coordination
    Séroussi, B; Jaulent, M-C; Lehmann, CU
  • The extent and importance of unintended consequences related to computerized provider order entry
    Ash, JS; Sittig, DF; Poon, EG
  • Effects of computer-based clinical decision support systems on physician performance and patient outcomes: a systematic review
    Hunt, DL; Haynes, RB; Hanna, SE
  • The future state of clinical data capture and documentation: a report from AMIA’s 2011 policy meeting
    Cusack, CM; Hripcsak, G; Bloomrosen, M
  • Improving clinical workflow in ambulatory care: implemented recommendations in an innovation prototype for the veteran’s health administration
    Patterson, ES; Lowry, SZ; Ramaiah, M
  • Developing electronic health record (EHR) strategies related to health center Patients’ social determinants of health
    Gold, R; Cottrell, E; Bunce, A
  • Describing and modeling workflow and information flow in chronic disease care
    Unertl, KM; Weinger, MB; Johnson, KB
  • Social determinants of health: an essential element in dental education
    Tiwari, T
  • A bold goal: more healthy days through improved community health
    Cordier, T; Song, Y; Cambon, J
  • Redesigning care delivery with patient support personnel: learning from accountable care organizations
    Gorbenko, KO; Fraze, T; Lewis, VA
  • How do health care workers manage a patient with multiple care needs from both health and social care services? - A vignette study
    Vehko, T; Jolanki, O; Aalto, A-M
  • Traversing the many paths of workflow research: developing a conceptual framework of workflow terminology through a systematic literature review
    Unertl, KM; Novak, LL; Johnson, KB
  • Quantifying the impact of health IT implementations on clinical workflow: a new methodological perspective
    Zheng, K; Haftel, HM; Hirschl, RB
  • Time motion studies in healthcare: what are we talking about?
    Lopetegui, M; Yen, P-Y; Lai, A
  • A method for the analysis and visualization of clinical workflow in dynamic environments
    Vankipuram, A; Traub, S; Patel, VL
  • Understanding transitional care provided to older adults with and without dementia: a mixed methods study
    Prusaczyk, B; Fabbre, V; Morrow-Howell, N
  • A design methodology for medical processes
    Ferrante, S; Bonacina, S; Pozzi, G
  • Applying direct observation to model workflow and assess adoption
    Unertl, KM; Weinger, MB; Johnson, KB
  • A mixed methods approach for measuring the impact of delivery-centric interventions on clinician workflow
    Cady, RG; Finkelstein, SM
  • Using the time and motion method to study clinical work processes and workflow: methodological inconsistencies and a call for standardized research
    Zheng, K; Guo, MH; Hanauer, DA
  • Secondary use of EHR timestamp data: validation and application for workflow optimization
    Hribar, MR; Read-Brown, S; Reznick, L
  • Secondary use of electronic health record data for clinical workflow analysis
    Hribar, MR; Read-Brown, S; Goldstein, IH
  • Building a robust, scalable and standards-driven infrastructure for secondary use of EHR data: the SHARPn project
    Rea, S; Pathak, J; Savova, G
  • Clinic workflow simulations using secondary EHR data
    Hribar, MR; Biermann, D; Read-Brown, S
  • Cost-benefit assessment of using electronic health records data for clinical research versus current practices: Contribution of the Electronic Health Records for Clinical Research (EHR4CR) European project
    Beresniak, A; Schmidt, A; Proeve, J
  • Chapter 3: choosing a mixed methods design
    Creswell, JW; Clark, VLP
  • Doing a thematic analysis: a practical, step-by-step guide for learning and teaching scholars
    Maguire, M; Delahunt, B
  • Advanced proficiency EHR training: effect on Physicians’ EHR efficiency, EHR satisfaction and job satisfaction
    Dastagir, MT; Chin, HL; McNamara, M
  • Impact of an electronic health record operating room management system in ophthalmology on documentation time, surgical volume, and staffing
    Sanders, DS; Read-Brown, S; Tu, DC
  • Oncologists’ views regarding the role of electronic health records in care coordination
    Asan, O; Nattinger, AB; Gurses, AP
  • A multiple case study of coordinated care for children with IBD through caregiver interviews
    deJong, NA; Vu, MB; Cui, J
  • Anticipating and addressing the unintended consequences of health IT and policy: a report from the AMIA 2009 health policy meeting
    Bloomrosen, M; Starren, J; Lorenzi, NM
  • Electronic health record innovations: helping physicians - one less click at a time
    Guo, U; Chen, L; Mehta, PH