Person-centred care in a digital hospital: observations and perspectives from a specialist rehabilitation setting
Letitia Burridge A E , Michele Foster A , Rachel Jones B , Timothy Geraghty B C and Sridhar Atresh B DA The Hopkins Centre, School of Human Services and Social Work, Griffith University, Division of Rehabilitation, Level 1, Building 17, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Qld 4102, Australia. Email: michele.foster@griffith.edu.au
B Queensland Spinal Cord Injury Service, Princess Alexandra Hospital, Metro South Health Service, Division of Rehabilitation, Level 1, Building 17, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Qld 4102, Australia. Email: rachel.jones4@health.qld.gov.au; timothy.geraghty@health.qld.gov.au; sridhar.atresh@health.qld.gov.au
C The Hopkins Centre, A joint initiative of Division of Rehabilitation and Menzies Health Institute, Division of Rehabilitation Executive Office, Lower Ground Floor, Building 15, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Qld 4102, Australia.
D Southside Clinical School, School of Medicine, The University of Queensland, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Qld 4102, Australia.
E Corresponding author. Email: l.burridge@griffith.edu.au
Australian Health Review 42(5) 529-535 https://doi.org/10.1071/AH17156
Submitted: 6 July 2017 Accepted: 5 September 2017 Published: 30 October 2017
Abstract
Objective This study investigated use of electronic medical records (eMRs) in a spinal cord injury rehabilitation unit and the implications for person-centred care.
Methods This exploratory mixed-methods study conducted 17.5 hours of observations of practitioner–patient encounters, 50 patient-experience surveys and 10 focus groups with 53 practitioners. Descriptive statistics and qualitative analysis were integrated into key themes.
Results Practitioners in this specialised setting were reconciling the emergent challenges of eMR in practice with the advantages of improved accessibility and documentation legibility. eMR increased task complexity and information retrieval, particularly for nurses. Some documentation was an uneasy fit with the specialised setting, disrupting informal communications and aspects of person-centred care.
Conclusions Technological change closely aligned with frontline practice brought expected and unexpected challenges that may resolve over time. Practitioners’ persistence and adaptability demonstrated their commitment to person-centred care in the digital environment. The impact of this less visible work of professional discretion seemed to vary, primarily by discipline-specific roles, with nurses experiencing the greatest pressure.
What is known about this topic? Integrated electronic medical records (eMRs) bring benefits but challenge person-centred care.
What does this paper add? These first insights regarding frontline implementation of eMR in spinal injury rehabilitation suggest nursing challenges when seeking to fit specialised work into the generic eMR. However, most patients reported receiving person-centred care.
What are the implications for practitioners? Commitment to person-centred care appears to strengthen practitioners’ perseverance with the eMR implementation challenges.
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