• Katherine R Schlosser Metitiri and Adler Perotte.
• Division of Critical Care and Hospital Medicine, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY.
• Pediatr Crit Care Me. 2024 Jan 1; 25 (1): 546154-61.

ObjectivesPatient vital sign data charted in the electronic health record (EHR) are used for time-sensitive decisions, yet little is known about when these data become nominally available compared with when the vital sign was actually measured. The objective of this study was to determine the magnitude of any delay between when a vital sign was actually measured in a patient and when it nominally appears in the EHR.DesignWe performed a single-center retrospective cohort study.SettingTertiary academic children's hospital.PatientsA total of 5,458 patients were admitted to a PICU from January 2014 to December 2018.InterventionsNone.Measurements And Main ResultsWe analyzed entry and display times of all vital signs entered in the EHR. The primary outcome measurement was time between vital sign occurrence and nominal timing of the vital sign in the EHR. An additional outcome measurement was the frequency of batch charting. A total of 9,818,901 vital sign recordings occurred during the study period. Across the entire cohort the median (interquartile range [IQR]) difference between time of occurrence and nominal time in the EHR was in hours:minutes:seconds, 00:41:58 (IQR 00:13:42-01:44:10). Lag in the first 24 hours of PICU admission was 00:47:34 (IQR 00:15:23-02:19:00), lag in the last 24 hours was 00:38:49 (IQR 00:13:09-01:29:22; p < 0.001). There were 1,892,143 occurrences of batch charting.ConclusionsThis retrospective study shows a lag between vital sign occurrence and its appearance in the EHR, as well as a frequent practice of batch charting. The magnitude of the delay-median ~40 minutes-suggests that vital signs available in the EHR for clinical review and incorporation into clinical alerts may be outdated by the time they are available.Copyright © 2023 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

11 keywords...

hide…