Title: Workflow Redesign The Challenge in Implementing an Electronic Medical Record
1Workflow RedesignThe Challenge in Implementing
an Electronic Medical Record
- Patient Safety and Health Information Technology
2CCHS East Region Hospitals
South Pointe Hospital
Euclid Hospital
Huron Hospital
Hillcrest Hospital
3About Our Project
Order Entry
Remote Access
Results
EMR
Clinician Adoption
Rules Alerts
Strong Authentication
4Why Workflow Redesign?
If you do what youve always done, youll get
what youve always gotten.
5Our Project Org Structure
6Purpose, Goals Objectives
Process Redesign
To diagram existing processes, identify new
processes and revise workflow to maximize the
benefit of new technology
Physician Workflow
Business Processes
Nursing Workflow
Pharmacy Workflow
7Physician Workflow
- Mechanisms
- Physician Advisors
- Physician Advisory Committees
- Clinical Informatics Council
- Connectors
- Outcomes
- Regional formulary consolidation
- Regional best practice order sets
- Physician-friendly system design
- Revisions to Medical Staff by-laws
8Nursing Ancillary Workflow
- Mechanisms
- Patient Care Advisory Committee
- Clinical Informatics Council
- Unit-Specific Workflow Design Teams
- Outcomes
- Detailed flowcharts of every workflow
- Identification of new processes related to EMR /
CPOE - Revisions of all affected existing processes
- EMR version policies and procedures
9Pharmacy Workflow
- Mechanisms
- Patient Care Advisory Council
- External Consulting Services
- Outcomes
- Pharmacy Workflow Assessment Report
- Problem Definition
- Detailed Workflow Analysis
- Recommendations
10Pharmacy Workflow Problem Definition
- Reduced physician confidence in the safety of the
EMR and the delay in entry of medication orders
in the EMR - Pharmacists work environment is hectic and
disruptive and impedes accurate order entry - Replacement dose requests are documented and
processed in an inefficient manner - Orders written at night are queued for EMR entry
in the morning, putting the pharmacy behind at
the start of each day - Illegible physician names on order sheets
11Existing Replace Dose Process
12Proposed Replace Dose Process
13Pharmacy Workflow Recommendations
- Remodel space to create less disruptive
environment - Modify replace dose processing
- Implement EMR generated paper Medication
Administration Record (MAR) - Implement electronic MAR following software
upgrade - Perform time studies to measure workload,
identify additional resources and project when to
reactivate CPOE - Implement integrated pharmacy module to eliminate
duplicate order entry in pharmacy
14 QUESTIONS?Sue Kraus skraus_at_cchseast.org
- Patient Safety and Health Information Technology