SHM Converge Scientific Abstract ePoster Gallery-Duplicate Medical Records in the Inpatient Setting, Perceptions and Experiences

Pdf Summary

This study examined inpatient duplicate medical records—situations where one patient has multiple MRNs and charts—which can create major patient safety risks. At University of Colorado Hospital, up to 10% of inpatients may have duplicate charts. The current consolidation process, called a contact move, is challenging because it can cause loss of active orders, require manual re-entry, and temporarily restrict chart access.<br /><br />The purpose was to understand how inpatient care team members perceive duplicate charts and the chart consolidation process. Researchers identified patients with duplicate charts over a 6-week period using the EHR’s analytics tool. They then invited nurses, advanced practice providers, pharmacists, residents, and attending physicians who cared for these patients to participate in semi-structured interviews. Fifteen people completed interviews.<br /><br />Key themes emerged. First, duplicate chart indicators in the EHR were easy to miss, leading to inadequate notification. Second, duplicate charts increased cognitive load: clinicians worried about missing important information, had to click and toggle between charts, and felt pressure to combine information from both. Third, there were barriers to initiating contact moves, including lack of awareness about the process and concern that losing orders during consolidation posed a greater safety risk than leaving duplicate charts in place.<br /><br />The study suggests several improvements: reduce duplicate charts overall, make Epic notifications more noticeable, improve communication about contact moves, include the right team members, schedule moves when fewer orders exist, notify providers when moves begin, retain or automate order re-entry, and tailor the process to team structure and patient complexity.<br /><br />Overall, the findings show that duplicate charts and contact moves create workflow burden and safety concerns, but better systems and communication could improve both efficiency and patient care.

Asset Subtitle

Hillary L. Western

Meta Tag

Author List Adam D. DeMey, Angela Keniston, Edie Seffrood, Hillary L. Western, Jessica Block, Jonathan Pell, Lauren McBeth, Sarah E. Mann

Category Research

Concept Duplicate Medical Record

Concept Chart Consolidation

Concept Patient Safety

Concept Contact Move

Concept Cognitive Load

Distinguished Non-Finalist

Presenter Organization University of Colorado

Presenting Author Hillary L. Western

Track Patient Safety

Keywords

duplicate medical records

duplicate charts

patient safety

inpatient records

electronic health record

chart consolidation

contact move

clinical workflow

order loss

care team communication

Duplicate Medical Record

Chart Consolidation

Patient Safety

Contact Move

Cognitive Load