A Multi-Phased Approach to Using Clinical Data to Drive Evidence-Based EMR Redesign

We optimized our technology and use a multi-tier approach to efficiently redesigned the Nursing Electronic Medical Record to match the nurses work flow to support patient centered care. You will learn how to transform nursing practice by empowering Registered Nurses decision making and influence in the design and educational rollout leading to excellence in documentation compliance.  Maximizing the use of technology to improve processes and enhance the delivery of safe quality care is fundamental to the transformation of the future of nursing. Integrated data analytics measuring nursing workflow capture real-time information from the electronic medical record to provide a patient-centered, outcomes-driven approach to allow for measurable improvements to the delivery of care. The EHR provides timely acuity data to enable nurses to adjust staffing and patient assignments to best match the needs of the patient to the competencies of the nurse to promote evidenced based patient outcomes. 

Abstract:Maximizing the use of technology to improve processes and enhance the delivery of safe quality care is fundamental to the transformation of the future of nursing

Utilization of an electronic medical record (EMR) can provide an important foundation for preventing harm; predict staffing, and improving outcomes. Incentivized by the economic stimulus initiative, healthcare systems are implementing vendor-based EMR systems. Evidence suggests that nurse driven design decisions, rather than the specific EMR product or technology are the primary drivers of the quality improvement performance of these systems.

A multi-phased redesign approach demonstrates a cost effective redesign for accurate documentation, time reduction, and effective approaches to leveraging data to drive evidenced based outcomes. This evidence-based approach uses real-time data driving a patient acuity system to make care decisions. Maximizing the use of technology to improve processes and enhance the delivery of safe quality care is fundamental to the transformation of the future of nursing.

This quality improvement project examined and optimizes the utility of the current electronic medical record (EMR) to increase the efficiency, quality of documentation and nurse satisfaction with workflow redesign using LEAN methodology and Implementation science. The use of LEAN and Evidence Based Practices fostered cooperation and provided principals to empower nurses to own their practice and use realtime data for clinical decision making. 

Methods: Data were collected by multiple means; observation, nursing survey, chart abstraction and application of Lean methodology.

Results:Use of real-time patient data to improve documentation, and drive an outcomes driven patient acuity to continuously monitor patient needs and staffing requirements to improve clinical efficiency and outcomes. Expected Outcomes to actual patient status provide a clinical decision making tool from admission to discharge.

Conclusions: Redesigning and aligning technology to match nurse work flow and real-time patient data demonstrated improved financial outcomes: staffing to drive patient outcomes results in improved skill matching assignments, fewer instances of overstaffing while continuous updating of patient needs facilitates the precise allocation of resources.