Go With the Flow

Nursing workflow is essentially the series of tasks related to patient care (Whittenburg, 2010), and documentation is a key step in the patient care sequence. According to a survey reported by Hill (2014), nurses spend 28% on documentation, while only spending 16% on patient care, thereby making it critical to modify electronic charting systems in order to increase efficiency. One of the major concerns related to workflow within the electronic health record (EHR) platform that we use in the emergency department (ED) that I work in, is related to the trauma, stroke, and myocardial infarction (MI) documentation pieces. The integration of EHR's into hospital environments is largely beneficial to all stakeholders, though there are alterations that are necessary in order to enhance the usability of the software for nurses. The fast paced environment of the ED allows little room for extraneous charting elements, and the trauma, stroke, and MI narrators contain a great deal of this. Additionally, the charting sequence needs to align to a greater degree with the real time flow of the patient's actual care.

 



 

My recommendations to alleviate these issues and to improve the accuracy and timeliness of the ED documentation, is to gather a group of health information technology specialists, doctors, and nurses in real scenarios related to trauma, stroke, and MI's. Combining all of the individual professionals involved will allow for the computer specialists to gain a greater understanding of how charting fits into real world scenarios, and why it is imperative to tailor the charting experience to the unique needs of the ED. Based on the results of these sessions, unnecessary charting elements can be removed, and the flow of documentation can be re-ordered if necessary. Furthermore, it is essential that nurses actively participate in the redesign process (Schwartz 2012; The Urban Institute, 2013), in order to ensure success. I feel that the aforementioned suggestion to improve workflow in the emergency department will yield fruitful results by not only increasing efficiency, but also by encouraging staff engagement and buy-in of  yet another aspect of hi-tech healthcare.

 

 

 

 

References

 

Hill, L. (2014). Redesign of nursing workflow seeing success. Retrieved from http://news.vanderbilt.edu/2014/04/redesign-of-nursing-workflow-seeing-success/

 

Schwartz, A. (2012). Nurses adopt electronic health records. Science of Caring. Retrieved from http://scienceofcaring.ucsf.edu/future-nursing/nurses-adopt-electronic-health-records

 

The Urban Institute. (2013). Final report: Lessons from the literature on electronic health record implementation. Retrieved from

http://www.healthit.gov/sites/default/files/hit_lessons_learned_lit_review_final_08-01-2013.pdf

 

Whittenburg, L. (2010). Workflow viewpoints: Analysis of nursing workflow documentation in the electronic health record. Retrieved from http://www.himss.org/files/HIMSSorg/content/files/Code%2053%20Workflow%20Analysis%20of%20Nursing%20Documentation%20in%20EHR.pdf