Professional Development Exercise 1: Workflow Analysis of the Emergency Department
Workflow analysis is a vital tool that helps healthcare organizations optimize patient care by ensuring efficient and effective patient flow. One critical area where workflow analysis is necessary is in the emergency department (ED), where patient flow can be a matter of life and death. The workflow analysis of the patient flow in the ED will include the time the patient enters the ED to the time they interact with the following:
Receptionist: The receptionist is the first point of contact for patients when they arrive in the ED. The receptionist should be able to assess the patient’s level of urgency and direct them to the appropriate triage nurse. The time from the patient’s arrival to the time they see the receptionist should be less than five minutes.
Triage Nurse: The triage nurse is responsible for assessing the patient’s level of urgency and prioritizing care. The time from the patient’s arrival to the time they see the triage nurse should be less than ten minutes.
Assigned Nurse: The assigned nurse takes over care from the triage nurse and provides the patient with immediate care. The nurse will take the patient’s history, vital signs, and perform a physical exam. The time from the patient’s arrival to the time they see the assigned nurse should be less than twenty minutes.
Physician: The physician will review the patient’s medical history, vital signs, physical exam, and laboratory results. The time from the patient’s arrival to the time they see the physician should be less than forty minutes.
Lab and/or Imaging: The physician may order laboratory tests or imaging studies to help diagnose the patient’s condition. The time from the physician’s order to the time the patient receives the results should be less than forty-five minutes.
Admit to Floor or Discharge to Home: The physician will make the decision to admit the patient to the hospital or discharge them to their home. If the patient is admitted to the hospital, the time from the physician’s decision to the time the patient is admitted to the hospital should be less than one hour.
The SmartArt diagram below shows the different areas within the workflow:
Key:
- Receptionist: Patient Arrival
- Triage Nurse: Triage Assessment
- Assigned Nurse: Nursing Assessment
- Physician: Medical Assessment
- Lab and/or Imaging: Diagnostic Assessment
- Admit to Floor or Discharge to Home: Patient Disposition
Professional Development Exercise 2: Workflow Analysis and Clinical Information Systems
The use of paper-based workflows in clinical information systems is an inefficient practice that affects patient care. A workflow analysis helps practicing nurses to identify inefficiencies in the healthcare system and provides a platform for improving patient care. By analyzing workflow, nurses can improve communication, reduce delays, and optimize patient care.
It is not feasible to mold paper-based workflows into clinical information systems because it limits the potential of technology. The prevalence of paper-based workflows in many hospitals across the United States is due to the underlying fear of relying on electronic systems and a lack of appropriate integration. The best way to integrate clinical workflows into an electronic form is by leveraging the available technology to provide seamless care.
As the INS charged with implementing the use of electronic records, several strategies can be used to promote a seamless transition. The first strategy is to provide education and training to the staff on the importance of clinical information systems and the need to move away from paper-based workflows. The second strategy is to implement a phased transition, where different departments can migrate to the electronic system in stages. The third strategy is to involve the staff in the transition process by allowing them to provide feedback on the system’s functionality and how to improve the workflow.