Pre-Ambient Artificial Intelligence Clinical Documentation Time for Pediatric Residents: A 3-Year Baseline Observational Study.

Objective Electronic health record (EHR) audit log data is used to examine the nature and extent of documentation time incurred by pediatric residents and to explore inter-individual variability in documentation time. Methods We conducted a retrospective, longitudinal study at an academic children's hospital, analyzing the EHR audit log data between 7/1/2021 and 6/30/2024. All clinical notes to which a pediatric resident contributed were included. Results are shown as descriptive statistics and pairwise comparisons of log-transformed continuous variables were performed using Welch's analysis of variance and Games-Howell post-hoc testing. Results Over three years, 79 residents contributed to the documentation of 156,898 clinical notes for an average of 2.1 hours per day. The mean (standard deviation) total resident time spent on one note was 12.1 (32.6) minutes. First year residents contributed to 51.6% of all notes. Approximately half (53.1%) of resident note editing time occurred after hours for all notes, with 47.1% for inpatient notes and 61.1% for ambulatory notes. Across the study period, monthly documentation time showed substantial month-to-month fluctuation but only small overall trends, with adjusted time-per-note declining significantly over time for most graduating classes. Conclusion This single-center study quantified pediatric resident EHR documentation time and found that time was highest among PGY-1 residents, frequently extended into nights and weekends, and varied widely between individuals. The data provide a baseline to inform residency-level workflow optimization and to evaluate interventions that aim to reduce documentation time while preserving educational value.