SHM Converge Scientific Abstract ePoster Gallery-"Even if I'm Not Acting on It, I'm Constantly Thinking About It": How Providers Navigate Care Delays

Pdf Summary

This qualitative study explored how clinicians recognize and manage care delays in routine practice at a 600-bed academic medical center. Care delays can worsen patient experience, reduce quality, and slow throughput, yet little was known about the workflows providers use to address them.

Researchers conducted semi-structured virtual interviews with 15 clinicians across six specialties: 5 physicians, 8 nurse practitioners, and 2 physician assistants. Interviews were audio-recorded, transcribed, and analyzed using rapid qualitative methods.

Three main themes emerged:

1. <strong>Reliance on manual, individualized workflows</strong>  
   Providers often identified delays informally during rounds, transitions, or discharge planning. They depended heavily on memory, manual tracking, and inconsistent documentation to follow up on pending tasks.

2. <strong>Duplicative work</strong>  
   Because teams had limited visibility into one another’s workflows, providers often repeated follow-ups or were unsure what expectations existed for turnaround times. This created unnecessary touchpoints and inefficiency.

3. <strong>Proactive strategies to prevent delays</strong>  
   Clinicians sometimes developed their own preventive routines and collaborated across disciplines to avoid predictable delays. These strategies were often based on local experience rather than standardized systems.

Overall, the findings show that managing care delays places a high cognitive burden on individual providers and leads to operational inefficiency. The authors suggest that system-level solutions could reduce this burden by creating shared tracking processes, improving visibility across departments, and streamlining escalation pathways.

Asset Subtitle

Claire Howlett

Meta Tag

Author List Audrey Chow, Brandon S. Scott, Claire Howlett, David Arboleda, Madison Sui, Sarah Imershein

Category Research

Concept Care Delay

Concept Cross-team Visibility

Concept Systems-Level Intervention

Concept Care Coordination

Concept Manual Tracking

Distinguished Non-Finalist

Presenter Organization Columbia University

Presenting Author Claire Howlett

Track Quality Improvement

Keywords

care delays

clinical workflows

qualitative study

manual tracking

provider follow-up

duplicative work

care coordination

patient throughput

shared tracking processes

escalation pathways

Care Delay

Cross-team Visibility

Systems-Level Intervention

Care Coordination

Manual Tracking