Table 1.
Study characteristics by intervention type
| Intervention Type(s) |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
|
Time
a
|
Teamwork
b
|
Transitions
c
|
Technology
d
|
|||||||
| NO. | Reference | Scheduling | Efficiency & productivity | Team-based care | HIT documentation | Process improvement | Workflow change | Adoption | Implementation | Optimization |
| 1 | Agha, 201014 | |||||||||
| 2 | Amis, 201817 | |||||||||
| 3 | Babbott, 201320 | |||||||||
| 4 | Baccei, 202021 | |||||||||
| 5 | Beam, 201722 | |||||||||
| 6 | Chapman, 201727 | |||||||||
| 7 | Contratto, 201529 | |||||||||
| 8 | Contratto, 201728 | |||||||||
| 9 | Danila, 201830 | |||||||||
| 10 | DeChant, 201910 | |||||||||
| 11 | Dunn, 200732 | |||||||||
| 12 | Ehrlich, 201635 | |||||||||
| 13 | Gidwani, 201739 | |||||||||
| 14 | Goyal, 201841 | |||||||||
| 15 | Heaton, 201643 | |||||||||
| 16 | Heyworth, 201244 | |||||||||
| 17 | Hung, 201845 | |||||||||
| 18 | Imdieke, 201746 | |||||||||
| 19 | Joseph, 201749 | |||||||||
| 20 | Keefer, 201851 | |||||||||
| 21 | Koshy, 201053 | |||||||||
| 22 | Lapointe, 201856 | |||||||||
| 23 | Lee, 201857 | |||||||||
| 24 | Linzer, 201559 | |||||||||
| 25 | Linzer, 201758 | |||||||||
| 26 | Mazur, 201962 | |||||||||
| 27 | McCormick, 201863 | |||||||||
| 28 | Mehta, 201864 | |||||||||
| 29 | Menachemi, 200965 | |||||||||
| 30 | Michelotti, 201366 | |||||||||
| 31 | Milenkiewicz, 201767 | |||||||||
| 32 | Mishra, 201870 | |||||||||
| 33 | Payne, 201875 | |||||||||
| 34 | Pierce, 201776 | |||||||||
| 35 | Pozdynakova, 201877 | |||||||||
| 36 | Shaw, 201783 | |||||||||
| 37 | Willard-Grace, 201792 | |||||||||
| 38 | Wylie, 201493 | |||||||||
| COUNTS | 6 | 17 | 23 | 16 | 10 | 25 | 5 | 11 | 6 | |
Note: Cell shading indicates if intervention contained 1 or more of the following 4Ts intervention categorizations:
Time: studies involved duty hour restrictions and changes to work schedules or use of time on duty (eg, a program for mindfulness during on-duty time). Scheduling included schedule modifications and flexibility; efficiency & productivity included productivity related interventions regarding efficiency, documentation time, task completion, work interruptions, or patient contact time.
Teamwork: studies examined care team processes and the addition of scribes to the team. Team-based care included any additional member of the care team including nurses, medical assistants/scribes, other physicians; HIT documentation was limited to studies that used a member of the care team to shift data entry away from the physician.
Transitions: studies of process improvements and quality initiatives. Process improvement included explicit use of lean methodologies or quality improvement initiatives; workflow change included any intervention that demonstrated a process change whereby a workflow was modified for improvement.
Technology: studies involved implementation or improvement of health information technology, namely electronic health records. Health information technology included adoption (ie, the sociological process of uptake in usage of a new technology), implementation (ie, installation of new technology and training to use it effectively), or optimization (ie, iterations or changes to technology for improvement).
Abbreviation: HIT, health information technology.