Effect of Patient Acuity of Illness and Nurse Experience on EMR Works in Intensive Care Unit

  • Sivamanoj Sreeramakavacham
  • Jung Hyup Kim
  • Laurel Despins
  • Megan Sommerfeldt
  • Natalie Bessette
Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 10917)


The objective of this study is to analyze the impact on the nurse’s process time during the electronic medical record (EMR) charting task in an intensive care unit (ICU). The dynamic uncertainty of clinical tasks in the ICU can make it difficult for nurses to take care of critically ill patients. According to the literature, EMR documentation is one of the tasks on which nurses spend most of their time during the shift. To understand and improve the EMR documenting process, a time & motion study was conducted in a medical ICU at the University of Missouri Hospital. Data was collected on processes and standard times of every EMR activity performed by ICU nurses. Based on the results of this study, hierarchical task analysis (HTA) charts were developed and analyzed nurse’s workflow during EMR documentation. After that, a simulation model was developed for documenting in the EMR in an ICU.


Electronic medical record systems Simulation Patient acuity level Nurse experience 



The Interdisciplinary Innovations Fund and Mizzou Advantage supported this research. We also thank nurses at the University Hospital, University of Missouri Health Care in Columbia, Missouri.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Sivamanoj Sreeramakavacham
    • 1
  • Jung Hyup Kim
    • 1
  • Laurel Despins
    • 2
  • Megan Sommerfeldt
    • 1
  • Natalie Bessette
    • 1
  1. 1.Industrial and Manufacturing Systems Engineering DepartmentUniversity of MissouriColumbiaUSA
  2. 2.Sinclair School of Nursing University of MissouriColumbiaUSA

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