The process by which organizations can take a close look at the establishment and determine where its strengths and weaknesses lie refers to workflow analysis. It is essential to conduct this type of analysis on a regular basis because it can ensure were inconsistencies, and inefficiencies are present throughout the organization and make the appropriate changes as soon as possible. Disregarding to perform a workflow analysis can result in problems that become lingering and are tough to resolve, potentially causing the organization to fall behind the competition and become obsolete or lose too much money to turn itself around (Ayers, n.d.)
Emergency Department Workflow Analysis
Why do we care about measuring patient flow? Long wait times are the number one complaint of patients in emergency rooms and urgent care.. Improved patient flow means wait times are shorter and more patients are satisfied; it also means increased productivity and added volume which allows for more revenue-generating visits without adding to staffing costs (Ayers, n.d.). The following is an emergency room (ER) workflow analysis; it will include the time the patient enters the ER, interaction with the receptionist, triage nurse, assigned nurse, physician, lab, and discharge to home.
Practicing Nurses and Workflow
Effective delivery of care or workflow suggests that the end product is in the most desirable state. What all organizations ultimately strive for efficient and effective delivery of patient care. An informatics nurse specialist (INS) uses a blend of nursing knowledge and expertise in computers to control the information systems used in hospitals, medical offices, and clinics by nurses. They collect and analyze data; this includes patient data, health insurance, and nursing information, they also plan and test the design of information systems, supervise their implementation and educate nurses and administrators on the use. Wherever they work, INS support the practice of all nursing specialties, from essential to advanced levels. They use their familiarity of computer and information science to build, execute, and assess health information technology functions and applications, means, and procedures to assist nurses with the organization and management of data that is used for taking care of patients or supporting their practice of nursing. They also work to develop and implement data management policies and practices that ensure the privacy, confidentiality, and security of patient information (Houston, Dieckhaus, Kircher, & Lardner, 2018)
Why is Workflow Important to Nurses
Workflow is a term used to describe the action or execution of a sequence of tasks in a prescribed order. Another definition of workflow is a progression of steps (tasks, events, interactions) that establish a work course, involve two or more persons, and create or add value to the organization’s activities (McGonigle & Mastrian, 2017). A critical purpose that workflow is of interest for today’s nurses is the indication “of new health care information technology (health IT) into clinical practice” (Cain & Hague, n.d., p. 2). Health IT assures many benefits for upgrading quality and efficiency. A respectable workflow will help achieve those goals quickly, leading to care that is provided more consistently, dependably, safely, and in compliance with standards of practice (Cain & Hague, n.d.).
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Today, thinking about workflow design is more challenging due to many aspects. The introduction of advanced technologies and treatment methodologies in clinical care, the challenge of organizing care for the chronically ill and the involvement of an increasing range of professionals on the patient’s care team, and new definitions in their roles are to name a few. Expense and productivity to improve patient flow, proposals to guarantee patient safety, execution of changes to make the care team more patient-focused are some more challenging aspects (Cain & Hague, n.d.).
Molding Paper-Based Workflows
Clinical working practices must be made safer, as too many errors happen to cause suffering or even death of patients. Due to the intricacy, the high flexibility and uncountability of the daily clinical work, safer working practices will require better coordination, efficient collaboration, and up to date clinical practice guidelines. One way of supporting this is by the use of IT-based clinical decision support and better linkages in and among IT-systems (Thomsen, 2015).
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Change is frequently a slow process that requires constant positive reinforcement and involvement of supporting resources. The implementation of electronic medical records (EMR) and removal of the paper-based medical record is possible but signifies a drastic change in the information milieu of the hospital. Many hospital systems have adopted (EHR) systems, but the rate of adoption has been prolonged due to obstacles and challenges (Thomsen, 2015).
Strategies of the INS
The problems with most EHRs do not arise from lack of a plan but form the failure to
implement the plan and from lack of experience in assessing the scope and cost of the
Internal resource commitment to make the EHR implementation work. The transition to electronic medical records signifies a major change to the clinical processes in medical practice. These changes must be cautiously thought out to ensure patient safety and quality of care through the transition period. Also, changes that are inherent with the transformation to electronic records such as patient privacy and information security must be accomplished (McGonigle & Mastrian, 2017).
In order to promote a seamless transition to electronic records, the INS must start by presenting the concept at a regular staff meeting, using an interactive session using an online demonstration tool, so employees can see how easy the system is to learn and practice entering data and generating reports. Present the concept as one way the organization is advancing in technology and upgrading capabilities, so staff’s daily workflows are made more efficient. In other words, point out that this to benefit nurses, not to burden them with yet another new system. The INS should spend significant time describing the real-world, concrete benefits that electronic records will provide to staff and patients and that is just as simple, if not simpler, to use than the old paper-and-pen based record-keeping method (McGonigle & Mastrian, 2017).
Workflow is the collection of tasks, assembled chronologically into processes, and the individuals or resources needed for those tasks that are essential to achieving a given goal. Moving to a EHR represents a change for the physician, nurse, and organization both in the capability to manage patient information and in the design of clinical processes. It also creates new and changing accountabilities for the use, disclosure, and security of the medical record. As a result, the transition from paper to electronic medical records is a complex task and must be managed from many aspects – clinically, administratively, culturally and organizationally.
The INS assist in determining what clinical IT application will help increase efficiency and ensure that electronic documentation meets all applicable standards of internal and external accreditation, they identify and support computerization needs related to patient care, educate nurses on changing record-keeping protocols, optimize the use and function of HER and patient care software.
- Ayers, A. (n.d.). Measuring patient flow in urgent care. Retrieved from www.alanayersurgentcare.com/Linked_Files/Ayers_UCAOA_Spring_11.
- Cain, C., & Hague, S. (n.d.). Organizational workflow and its impact on work quality. In (pp. 1-28). Retrieved from https://archive.ahrq.gov/professionals/clinicians-providers/resources/nursing/resources/nurseshdbk/CainC_W.pdf
- Houston, S. M., Dieckhaus, T., Kircher, B., & Lardner, M. (2018). An introduction to nursing informatics: Evolution & innovation (2nd ed.). Baca Raton, FL: CRC Press, Taylor and Francis Group.
- McGonigle, D., & Mastrian, K. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
- Thomsen, S. (2015). How to transition from paper to electronic patient rounding. Retrieved from http://www.myrounding.com/blog/how-to-transition-from-paper-to-electronic-patient-rounding
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