Workflow

Workflow is the way in which a series of activities are represented, or a pattern of processes for information management.  In simpler terms,  workflow shows the way in which the nurse takes care of a patient.  Workflow should be efficient and timely within a technological system, allowing for the most up to date information possible.  This allows for all members of the healthcare team to be able to access patient information quickly, ensuring that the plan of care is kept on track and the patient gets the most effective plan of care possible.  Also, a workflow that enhances the care given to patient, creates better safety and less chance of errors for patients.  Quality and patient outcomes will be to the highest standard possible. 

The company that I work for, Fresenius Medical Care of North America, which provides dialysis products and services to End Stage Renal Disease patients,  is doing a great job improving on the management of technology and information.  One of the big problems within the company is how the electronic medical record (EMR) is being utilized. Though it is a highly organized and functional system,  it has been found that there are many different ways to accomplish tasks and that there isn't a lot of consistency with documentation within the EMR or the use of applications within the system.  In this way, there can be issues when audits are done on the meeting of documentation standards and the overall interoperability of the system because it is not standardized by all users. For example, within the EMR at Fresenius there are three different methods for charting an assessment on a patient, and those three methods do not integrate to one centralized area.  Assessments could include physical assessments or education, to name a few. It would be extremely helpful if these three areas of documentation merged into one location so that users would not have to search the three different areas for information .

This nursing documentation is extremely beneficial to all healthcare providers and the patient care when looking at each multidisciplinary team member's input on a patient in order to provide a holistic view of the patient plan of care.  When team members get frustrated with finding this information easily, there can be missing information in the overall picture of the patient . Not having pertinent data on a patient can be detrimental to a patient.  In addition, the attempt to search long periods of time for data can impact patient care because of the time it takes to do so, and also leads to decreased productivity of all members of the healthcare team.

My proposed solution would be aimed first at establishing a consistent plan for documentation in the EMR.  Secondly, the plan and expectations would need to be delivered to the nursing staff so that everyone knows where the proper documentation should occur.  This information would also need to be rolled out to all members of the healthcare team so that everyone knows where to find this information quickly and without searching multiple locations.  Finally, there would be hard stops in the EMR that would only allow for information to be documented in one specific location.  For instance, if the nurse went to two of the non-usable documentation locations, they would be redirected to the correct area.  Improving interoperability would be a challenge that we are facing, but there are solutions available, as discussed above.

 

It is important that nurse leaders continue to support their staff in technological advancement.  Allowing forums for the exchange of ideas, providing education and resources, and showing staff how to balance caring and compassion with technology are key components to making sure that workflow can be managed effectively is a key to success.