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Provider Preference in Exam Room Layout Design and Computing.

ABSTRACT: BACKGROUND:The introduction of the electronic health record (EHR) has had a significant impact on provider-patient interactions, particularly revolving around patient-centeredness. More research is needed to understand the provider perspective of this interaction. OBJECTIVES:Our objective was to obtain provider feedback on a new exam room design compared with the one already in use with respect to the computing layout, which included a wall-mounted monitor for ease of (re)-positioning. An additional objective was to understand elements of exam room design and computing that were highly valued. METHODS:Semistructured interviews were conducted with 28 providers from several health care organizations. Interviews were audio recorded and transcribed for analysis. We used an inductive coding approach to abstract recurrent themes from the data. RESULTS:Our analysis revealed several themes organized around exam room layout, exam room computing, and provider workflow. We report frequency of occurrence of the coded data for computer accessories, computing usefulness, computer mobility, documentation habits, form factor, layout preference, patient interaction, screen sharing, and work habits. CONCLUSION:Providers in our study preferred exam room design to promote flexibility, mobility, and body orientation directed toward the patient. Providers also expressed the need for exam room design to support varying work habits and preferences, including whether to share the computer screen or not.

SUBMITTER: Read JM

PROVIDER: S-EPMC6930840 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Provider Preference in Exam Room Layout Design and Computing.

Read Jacob M JM Weiler Dustin T DT Satterly Tyler T Soares Catarina C Saleem Jason J JJ

Applied clinical informatics 20191001 5

<h4>Background</h4>The introduction of the electronic health record (EHR) has had a significant impact on provider-patient interactions, particularly revolving around patient-centeredness. More research is needed to understand the provider perspective of this interaction.<h4>Objectives</h4>Our objective was to obtain provider feedback on a new exam room design compared with the one already in use with respect to the computing layout, which included a wall-mounted monitor for ease of (re)-positio ...[more]

PMID: 31875647

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Project description:BACKGROUND:The rapid proliferation of electronic health records (EHRs) in clinics has had mixed impact on patient-centered communication, yet few evaluated interventions exist to train practicing providers in communication practices. AIMS:We extended the evidence-based Physician Asthma Care Education (PACE) program with EHR-specific communication strategies, and tested whether training providers with the extended program (EHR-PACE) would improve provider and patient perceptions of provider communication skills and asthma outcomes of patients. METHOD:A pilot randomized design was used to compare EHR-PACE with usual care. Participants were providers ( n = 18) and their adult patients with persistent asthma ( n = 126). Outcomes were assessed at baseline and 3- and 6-month postintervention, including patient perception of their provider's communication skills and provider confidence in using EHRs during clinical encounters. RESULTS:Compared with the control group, providers who completed the EHR-PACE program reported significant improvements at 3-month follow-up in their confidence with asthma counseling practices (estimate 0.90, standard error [ SE] 0.4); p < .05) and EHR-specific communication practices (estimate 2.3, SE 0.8; p < .01), and at 6-month follow-up, a significant decrease in perception that the computer interferes with the patient-provider relationship (estimate -1.0, SE 0.3; p < .01). No significant changes were observed in patient asthma outcomes or their perception of their provider's communication skills. DISCUSSION:Training providers with skills to accommodate EHR use in the exam room increases provider confidence and their perceived skills in maintaining patient-centered communications in the short term. CONCLUSION:Evidence-supported training initiatives that can increase capacity of busy providers to manage increased computing demands shows promise. More research is needed to fully evaluate EHR-PACE on patients' health status and their perceptions of their provider's care through a large-scale trial.

Project description:BackgroundResearch shows that interventions to protect the sensitive physiological process of birth by improving the birthing room design may positively affect perinatal outcomes. It is, however, crucial to understand the mechanisms and contextual elements that influence the outcomes of such complex interventions. Hence, we aimed to explore care providers' experiences of the implementation of a new hospital birthing room designed to be more supportive of women's birth physiology.MethodsThis qualitative study reports on the implementation of the new birthing room, which was evaluated in the Room4Birth randomised controlled trial in Sweden. Individual interviews were undertaken with care providers, including assistant nurses, midwives, obstetricians, and managers (n = 21). A content analysis of interview data was conducted and mapped into the three domains of the Normalisation Process Theory coding manual: implementation context, mechanism, and outcome.ResultsThe implementation of the new room challenged the prevailing biomedical paradigm within the labour ward context and raised the care providers' awareness about the complex interplay between birth physiology and the environment. This awareness had the potential to encourage care providers to be more emotionally present, rather than to focus on monitoring practices. The new room also evoked a sense of insecurity due to its unfamiliar design, which acted as a barrier to integrating the room as a well-functioning part of everyday care practice.ConclusionOur findings highlight the disparity that existed between what care providers considered valuable for women during childbirth and their own requirements from the built environment based on their professional responsibilities. This identified disparity emphasises the importance of hospital birthing rooms (i) supporting women's emotions and birth physiology and (ii) being standardised to meet care providers' requirements for a functional work environment.Trial registrationClinicalTrials.gov: NCT03948815, 14/05/2019.

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Provider Preference in Exam Room Layout Design and Computing.

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Provider Preference in Exam Room Layout Design and Computing.

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