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Workflow Redesign The Challenge in Implementing an Electronic Medical Record

Patient Safety and Health Information Technology. Workflow Redesign The Challenge in Implementing an Electronic Medical Record. CCHS East Region Hospitals. South Pointe Hospital. Euclid Hospital. Huron Hospital. Hillcrest Hospital. About Our Project. Order Entry. Remote Access. Results.

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Workflow Redesign The Challenge in Implementing an Electronic Medical Record

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  1. Patient Safety and Health Information Technology Workflow RedesignThe Challenge in Implementing an Electronic Medical Record

  2. CCHS East Region Hospitals South Pointe Hospital Euclid Hospital Huron Hospital Hillcrest Hospital

  3. About Our Project Order Entry Remote Access Results EMR Clinician Adoption Rules & Alerts Strong Authentication

  4. Why Workflow Redesign? “If you do what you’ve always done, you’ll get what you’ve always gotten.”

  5. Our Project Org Structure

  6. Purpose, Goals & Objectives Process Redesign To diagram existing processes, identify new processes and revise workflow to maximize the benefit of new technology Physician Workflow Nursing Workflow Business Processes Pharmacy Workflow

  7. Physician 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

  8. Nursing & 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

  9. Pharmacy Workflow • Mechanisms • Patient Care Advisory Council • External Consulting Services • Outcomes • Pharmacy Workflow Assessment Report • Problem Definition • Detailed Workflow Analysis • Recommendations

  10. Pharmacy Workflow ProblemDefinition • Reduced physician confidence in the safety of the EMR and the delay in entry of medication orders in the EMR • Pharmacist’s 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

  11. Existing “Replace Dose” Process

  12. Proposed “Replace Dose” Process

  13. Pharmacy Workflow Recommendations • Remodel space to create less disruptive environment • Modify “replace dose” processing • ImplementEMR 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. Patient Safety and Health Information Technology QUESTIONS?Sue Kraus skraus@cchseast.org

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