Background/Case Studies: Blood transfusions, while frequently performed, do not come without risk. It is critical to quickly assess and respond to transfusion reactions. Evaluation of a patient’s transfusion history and clinical status in our institution’s electronic health record (EHR) was convoluted and difficult, requiring multiple steps to obtain patient data and potentially delaying guidance to clinical teams. We created a novel user interface to improve workflow efficiency and EHR usability for pathology residents.
Study
Design/Methods: We evaluated the current workflow for chart review of transfused patients in our EHR (Epic Systems, Verona, WI) and designed a novel interface to address perceived user needs. A survey of available EHR summary reports identified multiple, user-friendly, and functional report formats. Report sections (or “print groups”) that were considered useful were compiled into one report, the “TM Dashboard.” Pathology residents were surveyed online for their feedback on the new TM Dashboard workflow as compared to the previous workflow.
Results/Findings: The previous workflow required review of 4 separate screens to obtain patient data to assess and advise on transfusion reactions: vital signs and transfusion start/stop times in one nursing flowsheet; patient intake and output in a separate nursing flowsheet; lab results and transfusion history (antibodies, transfusions, transfusion reactions) in a results section; and clinical history in a notes section. The TM Dashboard collated all but the clinical notes into a single screen (Figure 1). How often a particular pathology resident needed to interact with the TM Dashboard varied from daily to monthly, depending on clinical service demands. Survey results indicated that 100% of respondents who used the dashboard at least one time per month (n=15) were satisfied or extremely satisfied with the changes. They also felt that the new dashboard helped to complete tasks very or extremely well, and found it moderately to extremely easy to use. All users stated they would be moderately to extremely unhappy if they could no longer use the dashboard regularly. Free-text survey comments noted that less time and fewer mouse clicks were needed to locate critical clinical information. Users also found increased joy in completing transfusion reaction evaluations with the new TM Dashboard. Conclusions: Our novel EHR interface, the “TM Dashboard," increased perceived workflow efficiency and user satisfaction among pathology residents. Accurate and timely assessment of patients is imperative for optimal management of transfusion reactions, and the TM Dashboard could improve the turnaround time and accuracy of pathology resident guidance to clinicians. Future studies will be needed to confirm this hypothesis.
Importance of research: Created a novel user interface to improve user workflow efficiency and usability for path residents and guidance to clinicians. To our knowledge this interface doesn’t exist anywhere else in other institutions using our EHR. We hope that by sharing our novel interface that we can provide an example to others who may be looking to create something similar.
