SHM Converge Scientific Abstract ePoster Gallery-Less Is More: Redesigning Documentation to Reduce Note Bloat

Pdf Summary

This quality improvement project addressed “note bloat” in electronic medical record progress notes, which can result from copy-forward and auto-populated content. At a large urban academic hospital in New York City, the team used stakeholder surveys from internal medicine residents and multidisciplinary staff to design a new standardized progress note template. The updated template emphasized current clinical priorities and removed extraneous imported data, and it was introduced in 2025 alongside an intern documentation teaching session.<br /><br />The study compared notes from July to September 2024 before the intervention with notes from the same period in 2025 after implementation. A total of 894 pre-intervention notes and 1,449 post-intervention notes were analyzed. After the redesign, template uptake increased. The average percentage of copied-forward content fell from 49% to 45% (p = 0.004), and mean note length decreased from 6,718 to 6,515 characters (p = 0.031).<br /><br />Overall, the intervention improved documentation quality by making notes more concise and reducing copied material. However, the notes remained lengthy and still contained substantial copied content, suggesting that template redesign alone is not sufficient. The authors conclude that ongoing provider education and broader system-level strategies, including better ways to archive outdated information, are needed to further reduce note bloat and support leaner, higher-quality documentation.

Asset Subtitle

Ari M. Fish

Meta Tag

Author List Ari M. Fish, Vinh-Tung P. Nguyen

Category Research

Concept Electronic Health Record

Concept Note Bloat

Concept Copy-Paste Error

Concept Auto-population

Concept Clinical Documentation

Distinguished Non-Finalist

Presenter Organization Icahn School of Medicine at Mount Sinai

Presenting Author Ari M. Fish

Track Quality Improvement

Keywords

electronic medical record

progress notes

note bloat

copy-forward

auto-populated content

template redesign

documentation quality

resident education

copied content

healthcare quality improvement

Electronic Health Record

Note Bloat

Copy-Paste Error

Auto-population

Clinical Documentation