SHM Converge Scientific Abstract ePoster Gallery-Characterizing Off-Hours Hospitalist Work and Workflows

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This study characterized off-hours hospitalist work using electronic health record (EHR) metadata and physician scheduling data from a six-month cohort of adult hospital medicine patients at a large urban center.<br /><br />The goal was to create novel shift-level measures of workload and workflow during off-hours, especially night shifts, to better understand how hospitalists work outside daytime hours and identify opportunities to improve the safety, quality, and efficiency of care.<br /><br />Researchers analyzed several EHR-based measures, including total EHR time per shift, the number of unique patient charts accessed, and time spent on different EHR activities.<br /><br />Key findings showed that night-shift hospitalists spent substantial time in the EHR, averaging 266 minutes per shift, and saw about 38.5 patients per night. They also accessed nearly three times as many patient charts as daytime colleagues. Work was unevenly distributed: the top 10% of patients accounted for 45% of total shift EHR time, while the bottom half accounted for only 10%. This imbalance became more pronounced as the number of patients per night increased, suggesting work compression and potentially higher cognitive load.<br /><br />The authors conclude that off-hours workloads are significant and uneven, with possible implications for safety and teamwork. Future research should connect these workflow measures with hospitalist engagement and with patient- and hospital-level outcomes.

Asset Subtitle

Andrew P.J Olson

Meta Tag

Author List Andrew P.J Olson, Dori A. Cross, Emily Melcher, Josh Weiner

Category Research

Concept Off-Hours Hospitalist Work

Concept Electronic Health Record

Concept EHR Use

Concept Chart Access

Concept EHR Time

Distinguished Non-Finalist

Presenter Organization University of Minnesota Medical School

Presenting Author Andrew P.J Olson

Track Translating Research into Practice

Keywords

hospitalist

off-hours

night shift

electronic health record

workload

workflow

patient charts

cognitive load

hospital medicine

patient safety

Off-Hours Hospitalist Work

Electronic Health Record

EHR Use

Chart Access

EHR Time