CHIME News

Publication: Cognitive workload changes for nurses transitioning from a legacy system with paper documentation to a commercial electronic health record

1 April 2015

Hospitals across the world are moving to electronic health records, but adapting to using any new system can be a challenge. In the high risk environment of medicine, increases in cognitive workload can be dangerous. In a study in the United States, Lacey Colligan (MSc Risk Management 2006) along with Henry Potts (senior lecturer in CHIME), Chelsea Finn and Robert Sinkin, followed paediatric nurses on a ward and a neonatal intensive care unit as they coped with a new EHR.

Colligan, Potts, et al Figure 1

The paper has now been published in the International Journal of Medical Informatics: Colligan, Potts, Finn & Sinkin (2015). “Cognitive workload changes for nurses transitioning from a legacy system with paper documentation to a commercial electronic health record,” Int J Med Inform. doi: 10.1016/j.ijmedinf.2015.03.003

Even though multiple measures were put in place to ease the transition, including double staffing for 2 weeks, the study saw a large increase in cognitive workload. Such an increase is a cause for concern as it could lead to an increase in errors. It took about 10 shifts for cognitive workload to return to baseline.

Nurses adapted to the new system at varying rates, so “one-size-fits-all” training may not be optimal. The study also found that a simple computer attitude score could help predict which nurses struggled most, both in the short and long term. Training could thus be targeted based on a simple questionnaire before adoption, or by using simple cognitive workload measures during a “go-live” period.

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