Departmental EHR Optimization Process
| Preimplementation Empowerment from the department chair Set expectations for outcomes Freed adequate time from participants’ schedule Mandated participation in the dissemination process Created a vision Mission statement: Due to issues beyond our control, the EHR is here to stay. We, as a department, will move past the inertia of helplessness and improve the EHR by either molding it into a tool for our purposes or becoming agile enough to accommodate its imperfections. This will be accomplished through the following: Identifying imperfections in the way the EHR allows patient care Creating practical solutions to optimize physician workflow Allowing transparency of our innovation to the department and beyond Designating an individual to facilitate the project Engaging organizational IT resources |
| Implementation Create multidisciplinary work groups for target areas in workflow |
| Work Groups | Composition of Work Groups by Rolesa | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Adiminstrators | Care Coordinators | Faculty | IT | Nurses | Residents | Pharmacy | Front Desk Staff | Social Worker | |
| Care coordination | 0 | 1 | 3 | 1 | 1 | 1 | 1 | 0 | 1 |
| Communication | 0 | 0 | 3 | 1 | 2 | 1 | 0 | 1 | 0 |
| Front desk | 1 | 1 | 3 | 1 | 1 | 1 | 0 | 1 | 0 |
| Medications | 0 | 0 | 4 | 1 | 1 | 1 | 1 | 0 | 0 |
| Notes | 0 | 0 | 4 | 1 | 1 | 1 | 0 | 0 | 0 |
| Nursing | 0 | 0 | 3 | 1 | 3 | 1 | 0 | 0 | 0 |
| Orders/referrals | 0 | 1 | 4 | 1 | 2 | 1 | 1 | 1 | 1 |
| Revenue | 2 | 1 | 3 | 1 | 0 | 1 | 0 | 1 | 0 |
| Meet Monthly Hourly standing monthly meetings for each work group for 4 months Project lead attended all meetings to provide inter-group insights Facilitated discussions sought to understand every facet of the workflow Optimizations created to optimize patient safety Changes were implemented immediately upon group consensus Assignments (testing and developing workflows) were carried out by work group members between meetings New issues were brought to the attention of work group chairs between meetings | |||||||||
| Dissemination Departmental dissemination meetings Mandatory Virtual format Participants utilized a dual screen computer format to allow for simultaneous experimentation Role-specific meetings (nurses, patient service representatives, and clinicians) IT staff also attended Individualized favorite order sets and templates Disseminated to new hires Institutional dissemination Real-time improvements shared with all departments Process presented at the institution’s annual Quality Improvement and Safety Conference | |||||||||
EHR = electronic health record; IT = information technology.
↵a This table shows the number of individuals in each work group by role. Some served on more than 1 work group.