Utilization and Satisfaction with a Digital Aggregated Data Tool in Palliative Care and Hospice Clinicians

Purpose: The purpose of this clinical informatics lead initiative was to adapt and evaluate the perceived effectiveness of a digital aggregated data tool (DADT) that provides comprehensive patient information as a one-page summary for inpatient palliative care (PC) and hospice clinicians.

Description: The DADT project was initiated to assist PC and hospice clinicians who reported data foraging for pre-encounter information, requiring multiple clicks in the electronic health record (EHR) and using paper and pen to take notes. According to Golz, et. al. (2021), an EHR with limited functionality increases the risk of technology overload, resulting in clinicians working faster and longer to forage patient information. This can lead to technology-related stress, known as technostress.

Many EHRs are missing a one-page summary of aggregated clinical information, similar to a traditional nursing Kardex. Presenting a DADT may revive the salient principles of the Kardex such as patient status at glance, prospective memory aid, efficiency and ease of use, real time updates, activity management, shift-to-shift handoff tool, and non-clinical communication. A group of informatics nurses met with key stakeholders from the clinical team to identify information to include on the DADT, recreating a traditional nursing Kardex. Clinicians could view the DADT or print to carry with them during patient encounters.

Evaluation: Staff utilization and satisfaction were measured as an outcome of the project using the DADT satisfaction survey (DADT-SS), a 20-item questionnaire that was developed based on the unified theory of acceptance and use of technology (UTAUT) framework. According to the UTAUT, technology use is determined by performance expectancy, effort expectancy, social influence, and facilitating conditions. In addition to demographic variables, the DADT-SS included open-ended questions, Likert-like responses, and scale ratings. Clinicians who received DADT training were asked to complete the DADT-SS. Analysis of the DADT-SS provided support that clinicians were extremely satisfied with the DADT, and many used it often. Some clinicians reported that using DADT decreased pre-visit preparation time.