Appl Clin Inform 2022; 13(02): 355-362
DOI: 10.1055/s-0042-1743561
Research Article

Improving Provisioning of an Inpatient Portal: Perspectives from Nursing Staff

Alice A. Gaughan
1   The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States
,
Daniel M. Walker
1   The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States
2   Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States
,
Lindsey N. Sova
1   The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States
,
Shonda Vink
3   The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
,
Susan D. Moffatt-Bruce
4   Royal College of Physicians and Surgeons of Canada, Ottawa, Canada
,
Ann Scheck McAlearney
1   The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States
2   Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States
› Institutsangaben
Funding This work was supported by the Agency for Healthcare Research and Quality (AHRQ) grants R01HS024091, R21HS024767, and P30HS024379. While this research was funded by the AHRQ, the study sponsor had no involvement in the collection, analysis, or interpretation of data; in the writing of this manuscript; or in the decision to submit the manuscript for publication.

Abstract

Background Inpatient portals are recognized to provide benefits for both patients and providers, yet the process of provisioning tablets to patients by staff has been difficult for many hospitals.

Objective Our study aimed to identify and describe practices important for provisioning an inpatient portal from the perspectives of nursing staff and provide insight to enable hospitals to address challenges related to provisioning workflow for the inpatient portal accessible on a tablet.

Methods Qualitative interviews were conducted with 210 nursing staff members across 26 inpatient units in six hospitals within The Ohio State University Wexner Medical Center (OSUWMC) following the introduction of tablets providing access to an inpatient portal, MyChart Bedside (MCB). Interviews asked questions focused on nursing staffs' experiences relative to MCB tablet provisioning. Verbatim interview transcripts were coded using thematic analysis to identify factors associated with tablet provisioning. Unit provisioning performance was established using data stored in the OSUWMC electronic health record about provisioning status. Provisioning rates were divided into tertiles to create three levels of provisioning performance: (1) higher; (2) average; and (3) lower.

Results Three themes emerged as critical strategies contributing to MCB tablet provisioning success on higher-performing units: (1) establishing a feasible process for MCB provisioning; (2) having persistent unit-level MCB tablet champions; and (3) having unit managers actively promote MCB tablets. These strategies were described differently by staff from the higher-performing units when compared with characterizations of the provisioning process by staff from lower-performing units.

Conclusion As inpatient portals are recognized as a powerful tool that can increase patients' access to information and enhance their care experience, implementing the strategies we identified may help hospitals' efforts to improve provisioning and increase their patients' engagement in their health care.

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 Ohio State University Institutional Review Board.




Publikationsverlauf

Eingereicht: 26. Oktober 2021

Angenommen: 24. Januar 2022

Artikel online veröffentlicht:
13. April 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Woollen J, Prey J, Wilcox L. et al. Patient experiences using an inpatient personal health record. Appl Clin Inform 2016; 7 (02) 446-460
  • 2 McAlearney AS, Hefner JL, MacEwan SR. et al. Care team perspectives about an inpatient portal: benefits and challenges of patients' portal use during hospitalization. Med Care Res Rev 2021; 78 (05) 537-547
  • 3 MacEwan SR, Gaughan A, Hefner JL, McAlearney AS. Identifying the role of inpatient portals to support health literacy: perspectives from patients and care team members. Patient Educ Couns 2021; 104 (04) 836-843
  • 4 McAlearney AS, Fareed N, Gaughan A, MacEwan SR, Volney J, Sieck CJ. Empowering patients during hospitalization: perspectives on inpatient portal use. Appl Clin Inform 2019; 10 (01) 103-112
  • 5 McAlearney AS, Walker DM, Gaughan A, Moffatt-Bruce S, Huerta TR. Helping patients be better patients: a qualitative study of perceptions about inpatient portal use. Telemed J E Health 2020; 26 (09) 1184-1187
  • 6 Kelly MM, Dean SM, Carayon P, Wetterneck TB, Hoonakker PL. Healthcare team perceptions of a portal for parents of hospitalized children before and after implementation. Appl Clin Inform 2017; 8 (01) 265-278
  • 7 Sieck CJ, Walker DM, Hefner JL, Volney J, Huerta TR, McAlearney AS. Understanding secure messaging in the inpatient environment: a new avenue for communication and patient engagement. Appl Clin Inform 2018; 9 (04) 860-868
  • 8 Hoonakker PLT, Rankin RJ, Passini JC. et al. Nurses' expectations of an inpatient portal for hospitalized patients and caregivers. Appl Clin Inform 2019; 10 (04) 625-633
  • 9 Hefner JL, Sieck CJ, McAlearney AS. Training to optimize collaborative use of an inpatient portal. Appl Clin Inform 2018; 9 (03) 558-564
  • 10 Greysen SR, Magan Y, Rosenthal J, Jacolbia R, Auerbach AD, Harrison JD. Patient recommendations to improve the implementation of and engagement with portals in acute care: hospital-based qualitative study. J Med Internet Res 2020; 22 (01) e13337
  • 11 Walker DM, Gaughan A, Fareed N, Moffatt-Bruce S, McAlearney AS. Facilitating organizational change to accommodate an inpatient portal. Appl Clin Inform 2019; 10 (05) 898-908
  • 12 Walker DM, Hefner JL, Sieck CJ, Huerta TR, McAlearney AS. Framework for evaluating and implementing inpatient portals: a multi-stakeholder perspective. J Med Syst 2018; 42 (09) 158
  • 13 Masterson Creber RM, Grossman LV, Ryan B. et al. Engaging hospitalized patients with personalized health information: a randomized trial of an inpatient portal. J Am Med Inform Assoc 2019; 26 (02) 115-123
  • 14 Grossman LV, Choi SW, Collins S. et al. Implementation of acute care patient portals: recommendations on utility and use from six early adopters. J Am Med Inform Assoc 2018; 25 (04) 370-379
  • 15 Huerta TR, McAlearney AS, Rizer MK. Introducing a patient portal and electronic tablets to inpatient care. Ann Intern Med 2017; 167 (11) 816-817
  • 16 Palinkas LA, Horwitz SM, Green CA, Wisdom JP, Duan N, Hoagwood K. Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Adm Policy Ment Health 2015; 42 (05) 533-544
  • 17 Miles MB, Huberman AM. Qualitative Data Analysis: An Expanded Sourcebook. Thousand Oaks, CA: Sage Publications; 1994
  • 18 Crabtree BF, Miller WL. Using Codes and Code Manuals: A Template Organizing Style Of Interpretation. Doing Qualitative Research.. Thousand Oaks, CA: Sage Publications; 1999: 163-177
  • 19 Glaser BG, Strauss AL. The Discovery of Grounded Theory: Strategies for Qualitative Research. New Brunswick, NJ: Aldine Transaction; 1967
  • 20 ATLAS.ti Scientific Software Development vol 7; 2013
  • 21 D'Costa SN, Kuhn IL, Fritz Z. A systematic review of patient access to medical records in the acute setting: practicalities, perspectives and ethical consequences. BMC Med Ethics 2020; 21 (01) 18
  • 22 Shah MK, Gandrakota N, Cimiotti JP, Ghose N, Moore M, Ali MK. Prevalence of and factors associated with nurse burnout in the US. JAMA Netw Open 2021; 4 (02) e2036469
  • 23 Prey JE, Woollen J, Wilcox L. et al. Patient engagement in the inpatient setting: a systematic review. J Am Med Inform Assoc 2014; 21 (04) 742-750
  • 24 Wieland D, Gibeau A, Dewey C, Roshto M, Frankel H. Patient portal readiness among postpartum patients in a safety net setting. Appl Clin Inform 2017; 8 (03) 698-709
  • 25 McAlearney AS, Sieck CJ, Gregory ME. et al. Examining patients' capacity to use patient portals: insights for telehealth. Med Care 2021; 59 (12) 1067-1074
  • 26 Walker DM, Menser T, Yen PY, McAlearney AS. Optimizing the user experience: identifying opportunities to improve use of an inpatient portal. Appl Clin Inform 2018; 9 (01) 105-113
  • 27 Ali SB, Romero J, Morrison K, Hafeez B, Ancker JS. Focus section health IT usability: applying a task-technology fit model to adapt an electronic patient portal for patient work. Appl Clin Inform 2018; 9 (01) 174-184
  • 28 Stein JN, Klein JW, Payne TH. et al. Communicating with vulnerable patient populations: a randomized intervention to teach inpatients to use the electronic patient portal. Appl Clin Inform 2018; 9 (04) 875-883
  • 29 Grossman LV, Masterson Creber RM, Ancker JS. et al. Technology access, technical assistance, and disparities in inpatient portal use. Appl Clin Inform 2019; 10 (01) 40-50
  • 30 Walker DM, Hefner JL, Fareed N, Huerta TR, McAlearney AS. Exploring the digital divide: age and race disparities in use of an inpatient portal. Telemed J E Health 2020; 26 (05) 603-613
  • 31 Hall WJ, Chapman MV, Lee KM. et al. Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: a systematic review. Am J Public Health 2015; 105 (12) e60-e76