Subscribe to RSS
Just-in-Time Electronic Health Record Retraining to Support Clinician Redeployment during the COVID-19 SurgeFunding This study was funded by the U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, grant no.: R01HS02373.
Background In response to surges in demand for intensive care unit (ICU) care related to the COVID-19 pandemic, health care systems have had to increase hospital capacity. One institution redeployed certified registered nurse anesthetists (CRNAs) as ICU clinicians, which necessitated training in ICU-specific electronic health record (EHR) workflows prior to redeployment. Under time- and resource-constrained settings, clinical informatics (CI) fellows could effectively be lead instructors for such training.
Objective This study aimed to deploy CI fellows as lead EHR instructional trainers for clinician redeployment as part of an organization's response to disaster management.
Methods CI fellows led a multidisciplinary team alongside subject matter experts to develop and deploy a tailored EHR curriculum comprising in-person classes and online video modules, leveraging high-fidelity simulated patient cases. The participants completed surveys immediately after the in-person training session and after deployment.
Results Eighteen CRNAs participated, with 15 completing the postactivity survey (83%). All felt the training was useful and improved their EHR skills with a Net Promoter score of +87. Most (93%) respondents indicated the pace of the session was “just right,” and 100% felt the clarity of instruction was “just right” or “extremely easy” to understand. Twelve participants (67%) completed the postdeployment survey. The training increased comfort in the ICU for all respondents, and 91% felt the training prepared them to work in the ICU with minimal guidance. All stated that the concepts learned would be useful in their anesthesia role. Fifty-eight percent viewed the online video library.
Conclusion This case report demonstrates that CI fellows with dual domain expertise in their clinical specialty and informatics are uniquely poised to deliver clinician redeployment EHR training in response to operational crises. Such opportunities can achieve fellowship educational goals while conserving physician resources which can be a strategic option as organizations plan for disaster management.
Keywordselectronic health records - computer simulation - COVID-19 - professional role - graduate medical education
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 Oregon Health and Science University Institutional Review Board.
Received: 14 May 2022
Accepted: 26 August 2022
Accepted Manuscript online:
29 August 2022
Article published online:
05 October 2022
© 2022. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
- 1 Grange ES, Neil EJ, Stoffel M. et al. Responding to COVID-19: the UW medicine information technology services experience. Appl Clin Inform 2020; 11 (02) 265-275
- 2 Callan V, Eshkevari L, Finder S. et al. Impact of COVID-19 pandemic on certified registered nurse anesthetist practice. AANA J 2021; 89 (04) 334-340
- 3 Manor-Shulman O, Beyene J, Frndova H, Parshuram CS. Quantifying the volume of documented clinical information in critical illness. J Crit Care 2008; 23 (02) 245-250
- 4 Holzer KJ, Lou SS, Goss CW. et al. Impact of changes in EHR use during COVID-19 on physician trainee mental health. Appl Clin Inform 2021; 12 (03) 507-517
- 5 Miller ME, Scholl G, Corby S, Mohan V, Gold JA. The impact of electronic health record-based simulation during intern boot camp: interventional study. JMIR Med Educ 2021; 7 (01) e25828
- 6 Gold JA, Tutsch AS, Gorsuch A, Mohan V. Integrating the electronic health record into high-fidelity interprofessional intensive care unit simulations. J Interprof Care 2015; 29 (06) 562-563
- 7 Mohan V, Garrison C, Gold JA. Using a new model of electronic health record training to reduce physician burnout: a plan for action. JMIR Med Inform 2021; 9 (09) e29374
- 8 Subash M, Sakumoto M, Bass J. et al. The emerging role of clinical informatics fellows in service learning during the COVID-19 pandemic. J Am Med Inform Assoc 2021; 28 (03) 487-493
- 9 Moore Jr. DE, Green JS, Gallis HA. Achieving desired results and improved outcomes: integrating planning and assessment throughout learning activities. J Contin Educ Health Prof 2009; 29 (01) 1-15
- 10 March CA, Steiger D, Scholl G, Mohan V, Hersh WR, Gold JA. Use of simulation to assess electronic health record safety in the intensive care unit: a pilot study. BMJ Open 2013; 3 (04) e002549
- 11 English EF, Holmstrom H, Kwan BW. et al. Virtual sprint outpatient electronic health record training and optimization effect on provider burnout. Appl Clin Inform 2022; 13 (01) 10-18
- 12 Longhurst CA, Pageler NM, Palma JP. et al. Early experiences of accredited clinical informatics fellowships. J Am Med Inform Assoc 2016; 23 (04) 829-834
- 13 Silverman HD, Steen EB, Carpenito JN, Ondrula CJ, Williamson JJ, Fridsma DB. Domains, tasks, and knowledge for clinical informatics subspecialty practice: results of a practice analysis. J Am Med Inform Assoc 2019; 26 (07) 586-593