A Theory-Based Approach for Identifying Nurse and Team Member Contributions in the Electronic Health Record

Introduction: Team-based care delivered by an interprofessional team has been shown to be an effective strategy for caring for diverse, complex patient populations. Interprofessional teams can improve outcomes, reduce costs, and enhance the patient experience through patient-centered care. Nurses are essential members of healthcare teams within and across settings. Background: It is imperative for practicing nurses, educators, and researchers to be able to identify and report the contributions of nurses to team performance and care outcomes to prepare students for high-performance teamwork to improve practice and influence healthcare policy. Currently, the work of many nurses and other team members is not discoverable in electronic health records. Methods used to identify all members of the healthcare team may not be aligned with theories and definitions of teamwork embedded in emerging nursing and interprofessional accreditation guidelines. Purpose: This paper describes a promising new, theoretically grounded approach to identify team members, including nurses, in electronic health records. Methods: Using operational constructs from a common team definition, grounded in theory, primary care teams were data mined from EHR data to find the hidden members of the team. Discussion/Conclusion: Further testing and use of this approach have the potential to provide a robust strategy to identify and distinguish each team member's contributions to clinical outcomes while laying the foundation for a meaningful study of teams in large data sets like the electronic health record. Clinical Relevance: New strategies to study nursing and team member contributions utilizing EHR data may lead to improved clinical outcomes. A better understanding of how teams are structured may enhance the understanding of each team member's contribution to outcomes and lead to more equitable recognition and reimbursement for all team members.