JAMIA -- Embi et al. 11 (4): 300 Table BL3

Table 3. Theme 2: Work Processes and Communication: RepresentativeQuotations

Category
Quotation
Less interaction with colleagues "... it's like being in a stenopool where you walk in (to the physician team office) and everybody'styping; there's no actual communication going on, no interaction with anybody else."
"I definitely notice we spend lesstime with the nurses (since the transition to CPD)... we're missing that 'by the way' interaction thatwe had before."
"There's none of the socialization happening at the nurses stationwhere people come and talk to one another."
Less time with patients "... and now (the information) is like all gathered and you don't sit with the patient as much."
More time in documenting "We're definitely spending moretime in the hospital, especially if you're a bad typist."
More time in office "The immediate thing I notice is that doctorsare now confined to their offices for a huge amount of their time...I don't know if that's good or bad; it's just different, and it's made the wards seem like a differentplace. There's a different milieu up there in general."
Documenting at different times "Because you can only do it when you're sitting right there, ...you can't write little bits of your noteon the fly like we used to. I suppose you could log into a computersomewhere else (to complete it), but it's justtoo much of a hassle; logging in, logging out, logging in."
Documenting at different locations "I remember having my piece ofpaper and my clipboard, filling in my H&P and talking to the patientat the same time, and getting my information and establishing a rapport,..."
Less dictation, more typing
"I think the dictated note hasmuch better flow and amount of content andactually pertinence of information is better that way, too, because you actually have to think about what you're saying.
The problem with typed notes, is that eitherthere's not as much information that goes into it, and you leave stuff out, or they automatically put in vast reams ofinformation that are irrelevant."

"I saw this specifically with this new group of interns, where sincenobody's ever taught them how to do a discharge summary, they feel uncomfortabledoing it; it's too much work. It's easier for them to cut-and-paste andtype, and have their note be done and gone, and not have to worry aboutit, than to take the time to figure out how to dictate a true dischargesummary."

Category	Quotation
Less interaction with colleagues	"... it's like being in a stenopool where you walk in (to the physician team office) and everybody'styping; there's no actual communication going on, no interaction with anybody else."
	"I definitely notice we spend lesstime with the nurses (since the transition to CPD)... we're missing that 'by the way' interaction thatwe had before."
	"There's none of the socialization happening at the nurses stationwhere people come and talk to one another."
Less time with patients	"... and now (the information) is like all gathered and you don't sit with the patient as much."
More time in documenting	"We're definitely spending moretime in the hospital, especially if you're a bad typist."
More time in office	"The immediate thing I notice is that doctorsare now confined to their offices for a huge amount of their time...I don't know if that's good or bad; it's just different, and it's made the wards seem like a differentplace. There's a different milieu up there in general."
Documenting at different times	"Because you can only do it when you're sitting right there, ...you can't write little bits of your noteon the fly like we used to. I suppose you could log into a computersomewhere else (to complete it), but it's justtoo much of a hassle; logging in, logging out, logging in."
Documenting at different locations	"*I remember having my piece ofpaper and my clipboard, filling in my H&P and talking to the patientat the same time, and getting my information and establishing a rapport,*..."
Less dictation, more typing	"I think the dictated note hasmuch better flow and amount of content andactually pertinence of information is better that way, too, because you actually have to think about what you're saying. The problem with typed notes, is that eitherthere's not as much information that goes into it, and you leave stuff out, or they automatically put in vast reams ofinformation that are irrelevant."
	"I saw this specifically with this new group of interns, where sincenobody's ever taught them how to do a discharge summary, they feel uncomfortabledoing it; it's too much work. It's easier for them to cut-and-paste andtype, and have their note be done and gone, and not have to worry aboutit, than to take the time to figure out how to dictate a true dischargesummary."