Physician Perceptions of the Electronic Problem List in Pediatric Trauma CareFunding Funding for this research was provided by the Agency for Healthcare Research and Quality (Grant No. R01 HS023837). The project described was also supported by the Clinical and Translational Science Award program through the National Institutes of Health (NIH) National Center for Advancing Translational Sciences (Grant UL1TR002373). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.
16 September 2018
10 December 2018
13 February 2019 (online)
Objective To describe physician perceptions of the potential goals, characteristics, and content of the electronic problem list (PL) in pediatric trauma.
Methods We conducted 12 semistructured interviews with physicians involved in the pediatric trauma care process, including residents, fellows, and attendings from four services: emergency medicine, surgery, anesthesia, and pediatric critical care. Using qualitative content analysis, we identified PL goals, characteristics, and patient-related information from these interviews and the hospital's PL etiquette document of guideline.
Results We identified five goals of the PL (to document the patient's problems, to make sense of the patient's problems, to make decisions about the care plan, to know who is involved in the patient's care, and to communicate with others), seven characteristics of the PL (completeness, efficiency, accessibility, multiple users, organized, created before arrival, and representing uncertainty), and 22 patient-related information elements (e.g., injuries, vitals). Physicians' suggested criteria for a PL varied across services with respect to goals, characteristics, and patient-related information.
Conclusion Physicians involved in pediatric trauma care described the electronic PL as ideally more than a list of a patient's medical diagnoses and injuries. The information elements mentioned are typically found in other parts of the patient's electronic record besides the PL, such as past medical history and labs. Future work is needed to evaluate the optimal design of the PL so that users with emergent cases, such as pediatric trauma, have access to key information related to the patient's immediate problems.
Keywordsproblem-oriented model - patient safety - human factors engineering - pediatric trauma - care coordination
Protection of Human and Animal Subjects
This study was reviewed by the University of Wisconsin-Madison Institutional Review Board and was provided exemption.
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