To identify the impact of a full suite of health information technology () on the relationships that support safety and quality among intensive care unit () clinicians.
A year‐long comparative ethnographic study of three academic s was carried out. A total of 446 hours of observational data was collected in the form of field notes. A subset of these observations—134 hours—was devoted to job‐shadowing individual clinicians and conducting a time study of their usage.
Significant variation in implementation rates and usage was noted. Average use on the two “high‐use” s was 49 percent. On the “low‐use” , it was 10 percent. Clinicians on the high‐use s experienced “silo” effects with potential safety and quality implications. work was associated with spatial, data, and social silos that separated clinicians from one another and their patients. Situational awareness, communication, and patient satisfaction were negatively affected by this siloing.
has the potential to accentuate social and professional divisions as clinical communications shift from being in‐person to electronically mediated. Socio‐technically informed usability testing is recommended for those hospitals that have yet to implement . For those hospitals already implementing , we suggest rapid, locally driven qualitative assessments focused on developing solutions to identified gaps between usage patterns and organizational quality goals.
