Comparison of extent of use, information accuracy, and functions for manual and electronic patient status boards

Purpose: Electronic software packages to support patient tracking and disposition decision making in emergency departments (EDs) are being considered for implementation in many hospitals. We compared extent of use, information accuracy, and functions of manual and electronic patient status boards at 2 EDs where both were continuously in use.

Methods: Ethnographic observations were conducted at 2 Veterans Affairs Medical Center Emergency Departments using both manual and electronic patient status boards (100 h, 9 physicians at Site 1; 64 h, 14 physicians at Site 2). Data included board information collected at 20-min intervals, observable behavior while using boards, and interviews.

Results: Few physicians (3/9 [33%] Site 1; 0/14 [0%] Site 2) used the e-board, whereas all physicians used the whiteboards. Whiteboards had fewer inaccuracies (6/462 [1%] Site 1; 21/864 [3%] Site 2) than e-boards (62/462 [13%] Site 1; 107/864 [12%] Site 2). The primary functions of the whiteboard were to track real-time changes to patient identifiers, locations, nursing assignments, and pending activities; facilitate patient handoffs; inform physicians and nurses about newly arrived patients assigned to them; inform nurses of physicians' orders; and inform physicians of the status of ordered items. The primary functions of the e-board were to support electronic data entry (by clerks) of patient admitting and departure times; and highlight patients who had been in the ED for longer than 6 h.

Conclusions: Whiteboards were more extensively used and had greater information accuracy than e-boards. Nevertheless, e-boards provided functionality not easily achievable with whiteboards.