{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T09:14:04Z","timestamp":1762161244612,"version":"3.37.3"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2016,12,11]],"date-time":"2016-12-11T00:00:00Z","timestamp":1481414400000},"content-version":"vor","delay-in-days":101,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"National Institutes of Health's National Center for Advancing Translational Sciences","award":["UL1TR000150"],"award-info":[{"award-number":["UL1TR000150"]}]},{"DOI":"10.13039\/100000092","name":"National Library of Medicine","doi-asserted-by":"crossref","award":["5K01LM011973-02"],"award-info":[{"award-number":["5K01LM011973-02"]}],"id":[{"id":"10.13039\/100000092","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,3,1]]},"abstract":"<jats:p>Objective: Using Failure Mode and Effects Analysis (FMEA) as an example quality improvement approach, our objective was to evaluate whether secondary use of orders, forms, and notes recorded by the electronic health record (EHR) during daily practice can enhance the accuracy of process maps used to guide improvement. We examined discrepancies between expected and observed activities and individuals involved in a high-risk process and devised diagnostic measures for understanding discrepancies that may be used to inform quality improvement planning.<\/jats:p><jats:p>Methods: Inpatient cardiology unit staff developed a process map of discharge from the unit. We matched activities and providers identified on the process map to EHR data. Using four diagnostic measures, we analyzed discrepancies between expectation and observation.<\/jats:p><jats:p>Results: EHR data showed that 35% of activities were completed by unexpected providers, including providers from 12 categories not identified as part of the discharge workflow. The EHR also revealed sub-components of process activities not identified on the process map. Additional information from the EHR was used to revise the process map and show differences between expectation and observation.<\/jats:p><jats:p>Conclusion: Findings suggest EHR data may reveal gaps in process maps used for quality improvement and identify characteristics about workflow activities that can identify perspectives for inclusion in an FMEA. Organizations with access to EHR data may be able to leverage clinical documentation to enhance process maps used for quality improvement. While focused on FMEA protocols, findings from this study may be applicable to other quality activities that require process maps.<\/jats:p>","DOI":"10.1093\/jamia\/ocw083","type":"journal-article","created":{"date-parts":[[2016,9,3]],"date-time":"2016-09-03T00:19:18Z","timestamp":1472861958000},"page":"288-294","source":"Crossref","is-referenced-by-count":9,"title":["Leveraging electronic health record documentation for Failure Mode and Effects Analysis team identification"],"prefix":"10.1093","volume":"24","author":[{"given":"Gayle Shier","family":"Kricke","sequence":"first","affiliation":[{"name":"Division of Health and Biomedical Informatics, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew B","family":"Carson","sequence":"additional","affiliation":[{"name":"Division of Health and Biomedical Informatics, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Ji","family":"Lee","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Pittsburgh, Pittsburgh, PA, 15261, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corrine","family":"Benacka","sequence":"additional","affiliation":[{"name":"Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Chicago, IL, 60611, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. 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