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.