7-2 final project IHP 340
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Southern New Hampshire University *
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IHP-340-X2
Subject
Industrial Engineering
Date
Feb 20, 2024
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docx
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4
Uploaded by DrIronFrog33
Angela Hannans
IHP 340- T2852 Stats-Healthcare Professionals
7-2 final project - Article Analysis
December 2023
SNHU
The purpose behind this study is to see how providers in the Emergency Department utilize their time during a shift and examine the scribes. The research question would be does the scribes in the Emergency Department impact provider time management? What impact would they have on time management? The hypothesis would be a study to test to see if the scribes had any effects on time management and how they spent their time.
The study would be observational because the scribes and the providers would have to be researched by research assistants in order to assess scribe impact on provider time utilization. For example they would use “
four research assistants (RAs) observed attending providers on 24 8-h control shifts (without a scribe), and 24 scribed shifts. RAs observed and categorized provider activity. Providers self-reported after-hours documentation times. Two-
sample t
-tests were used for normally distributed data, and Wilcoxon rank-sum tests were used for skewed data. All tests were two-sided, and p
-values < 0.05 were considered statistically significant”.
The methods that were used to collect the data were used by a tablet-based time recorder for real-time capture of all activities during the teams' 8-h shift. If the provider was still
at work when the RA's 8-h shift was complete, additional after-shift documentation time was self-reported by providers and electronically mailed to the RA at the end of the work day.
The data that was used to collect data were quantitative because the study is described numerically and can involve some hypothesis testing.
The data collection weaknesses for the method used didn’t account for the time that the Providers used to review medical records, time spent discussing the care, or to place any orders for the patient. The presence of scribes decreased overall provider shift documentation time, but did not change the amount of time physicians spent at the patient bedside or communicating with other care team members. The data analysis method that is used in this study is a t-test as a statistical test. All of the tests had statistical significance and were defined as the p-value of less than 0.05, were
two-sided and the conclusion was determined using the statistical test. The study was observational in order for the research assistants to make sure that the findings were recorded with or without a scribe.
The potential weaknesses of the data is that it was not measured correctly. The observation was limited to the research of a 24-8 hrs scribed shift and a 24-8 non-scribed shift, and based on the tasks that the provider undertook after those hours were not observed correctly by the research assistants but were self reported directly by the provider.The problem that this could cause is that the provider could modify the behaviors being studied and could rise the Hawthorne effect. The provider might not be spending the accurate amount of time with the patient by their bedside as they report.
The key demographics of the population sampled were the providers that were observed on a 24-8 hr scribed shift and a 24-8 not scribed shift. The inclusion criteria for the participants would be the providers that self reported their shifts. The exclusions were anyone that was outside of the scribes and the provider that were being observed.
The key findings showed that the scribes had decreased the time that was provided to the patient in total but did not decrease the time they spent reviewing the medical records, the orders they placed,the patient's chart with the other team members, and the time they
spent with the patient at their bedside. The result of the test was significant.
The results of the research were taken by the mean of the on-shift and the post-
shift. The on-shift =( the mean 55.3 vs 36.4 min, p<0.001) and post shift (mean 42.5vs 23.3 min, p= 0.038). They did not decrease the amount of time they spent looking at medical records or spending time with the patient. The limitations that are presented by the studies both arrived at the same test results that showed that the scribes decreased documentation time post- shift and on shift but did not decrease the time that they spent reviewing the medical records or placing orders. The mean which is (101.3 min vs. 87.1 min. Both tests were significant because the documentation time was decreased and more time was spent with the EHR with a p-value of<.001. There were some small limitations of the study population and sample size. One of the limitations was due to the small sample size, as there was not enough population to have effective samples. There was not great power and allocation. The results of this were not based on age, sex, and race and it would be difficult or challenging to see if the hospital could reduce the allocation of the data. The advantages of the choice of the analysis, is the use that they were able to determine how the two
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were related, between the organization level and the physician communications. One major disadvantage of the analysis was the leverage because the main variable was never verified. The leverage was obvious in the sample, and they identified opportunities to decrease the clerical burden so that way the providers didn’t get burned out
. https://www-sciencedirect-com.ezproxy.snhu.edu/science/article/pii/
S0736467918303561#cebib0010
https://www.jem-journal.com/article/S0736-4679(18)30356-1/fulltex https://www-
sciencedirect-com.ezproxy.snhu.edu/science/article/pii/S0736467918303561#cebib
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