Electronic Health Record User Dashboard for Optimization of Surgical Resident Procedural Reporting

Abstract

Background While necessary and educationally beneficial, administrative tasks such as case and patient tracking may carry additional burden for surgical trainees. Automated systems targeting these tasks are scarce, leading to manual and inefficient workflows.

Methods We created an electronic health record (EHR)-based, user-specific dashboard for surgical residents to compile resident-specific data: bedside procedures performed, operative cases performed or participated in, and notes written by the resident as a surrogate for patients cared for. Usability testing was performed with resident volunteers, and residents were also surveyed postimplementation to assess for efficacy and satisfaction. Access log data from the EHR was used to assess dashboard usage over time. Descriptive statistics were calculated.

Results The dashboard was implemented on a population of approximately 175 surgical residents in 5 different departments (General Surgery, Obstetrics and Gynecology, Neurosurgery, Orthopaedics, and Otolaryngology) at a single academic medical center. Six resident volunteers participating in usability testing completed an average of 96% of preset tasks independently. Average responses to five questions extracted from the System Usability Scale (SUS) questions ranged from 4.0 to 4.67 out of 5. Postimplementation surveys indicated high resident satisfaction (4.39 out of 5) and moderate rates of use, with 46.4% of residents using the dashboard at least monthly. Daily use of the dashboard has increased over time, especially after making the dashboard a default for surgical residents.

Conclusion An EHR-based dashboard compiling resident-specific data can improve the efficiency of administrative tasks and supplement longitudinal education.

Keywords

surgery - residents - surgical education - electronic health record - Epic - dashboard - case logging

Protection of Human and Animal Subjects

The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects and was reviewed by the Vanderbilt Institutional Review Board.

Publikationsverlauf

Eingereicht: 01. Juli 2024

Angenommen: 16. Oktober 2024

Accepted Manuscript online:
17. Oktober 2024

Artikel online veröffentlicht:
26. Februar 2025

• References

• 1 Lin JA, Pierce L, Murray SG. et al. Estimation of surgical resident duty hours and workload in real time using electronic health record data. J Surg Educ 2021; 78 (06) e232-e238
• 2 Bennett CL, McDonald DA, Chang Y. et al. A national cross-sectional study of surgery residents who underreport duty hours. J Surg Educ 2017; 74 (06) 928-933
• 3 Rodrigues H, Cobucci R, Oliveira A. et al. Burnout syndrome among medical residents: a systematic review and meta-analysis. PLoS One 2018; 13 (11) e0206840
• 4 Pulcrano M, Evans SR, Sosin M. Quality of life and burnout rates across surgical specialties: a systematic review. JAMA Surg 2016; 151 (10) 970-978
• 5 George BC, Bohnen JD, Schuller MC, Fryer JP. Using smartphones for trainee performance assessment: a SIMPL case study. Surgery 2020; 167 (06) 903-906
• 6 Eaton M, Scully R, Schuller M. et al. Value and barriers to use of the SIMPL tool for resident feedback. J Surg Educ 2019; 76 (03) 620-627
• 7 Bhattacharya P, Van Stavern R, Madhavan R. Automated data mining: an innovative and efficient web-based approach to maintaining resident case logs. J Grad Med Educ 2010; 2 (04) 566-570
• 8 Chen P-H, Chen YJ, Cook TS. Capricorn-a web-based automatic case log and volume analytics for diagnostic radiology residents. Acad Radiol 2015; 22 (10) 1242-1251
• 9 Bachur RG, Nagler J. Use of an automated electronic case log to assess fellowship training: tracking the pediatric emergency medicine experience. Pediatr Emerg Care 2008; 24 (02) 75-82
• 10 Smith M, Layng T. A comparison of resident procedure logs to data generated from an electronic health record. Appl Clin Inform Open 2023; 7: e87-e90
• 11 Kwan B, Engel J, Steele B. et al. An automated system for physician trainee procedure logging via electronic health records. JAMA Netw Open 2024; 7 (01) e2352370
• 12 Xiao G, Sikder S, Woreta F, Boland MV. Implementation and evaluation of integrating an electronic health record with the ACGME case log system. J Grad Med Educ 2022; 14 (04) 482-487
• 13 Rudolf F, Oyama LC, El-Kareh R. Impact of an automated patient outcome feedback system on emergency medicine resident patient follow-up: an interrupted time series analysis. AEM Educ Train 2024; 8 (04) e11011
• 14 Johnson KB, Neuss MJ, Detmer DE. Electronic health records and clinician burnout: a story of three eras. J Am Med Inform Assoc 2021; 28 (05) 967-973
• 15 Yan Q, Jiang Z, Harbin Z, Tolbert PH, Davies MG. Exploring the relationship between electronic health records and provider burnout: a systematic review. J Am Med Inform Assoc 2021; 28 (05) 1009-1021
• 16 Baxter SL, Saseendrakumar BR, Cheung M. et al. Association of electronic health record inbasket message characteristics with physician burnout. JAMA Netw Open 2022; 5 (11) e2244363
• 17 Tai-Seale M, Baxter S, Millen M. et al. Association of physician burnout with perceived EHR work stress and potentially actionable factors. J Am Med Inform Assoc 2023; 30 (10) 1665-1672
• 18 Nelson O, Sturgis B, Gilbert K. et al. A visual analytics dashboard to summarize serial anesthesia records in pediatric radiation treatment. Appl Clin Inform 2019; 10 (04) 563-569
• 19 Safranek CW, Feitzinger L, Joyner AKC. et al. Visualizing opioid-use variation in a pediatric perioperative dashboard. Appl Clin Inform 2022; 13 (02) 370-379
• 20 Hysong SJ, Yang C, Wong J, Knox MK, O'Mahen P, Petersen LA. Beyond information design: designing health care dashboards for evidence-driven decision-making. Appl Clin Inform 2023; 14 (03) 465-469
• 21 Jonnalagadda P, Swoboda C, Singh P. et al. Developing dashboards to address children's health disparities in Ohio. Appl Clin Inform 2022; 13 (01) 100-112
• 22 Harris PA, Taylor R, Minor BL. et al; REDCap Consortium. The REDCap consortium: building an international community of software platform partners. J Biomed Inform 2019; 95: 103208
• 23 Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42 (02) 377-381
• 24 Brooke J. SUS: a 'quick and dirty' usability scale. In: Jordan P, McClelland I, Weerdmeester B. eds. Usability Evaluation in Industry. London: Taylor & Francis; 1996: 189-194
• 25 Yarger JB, James TA, Ashikaga T. et al. Characteristics in response rates for surveys administered to surgery residents. Surgery 2013; 154 (01) 38-45