NR599 Final

process or workflow analysis

Observation and documentation of workflow to better understand what is happening in the current environment and how it can be altered

Workflow

- a term used to describe the action or execution of a series of tasks in a prescribed sequence. - a progression of steps (tasks, events, interactions) that constitute a work process, involve two or more persons, and create or add value to the organization's activities. - sometimes used interchangeably with process or process flows, particularly in the context of implementations

Alert fatigue and clinical burnout

- common byproducts of poorly implemented clinical decision support features that overwhelm users with unimportant information or frustrating workflow freezes that require extra clicks to circumvent.

PHR

- defined as an electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual.

Clinical decision support (CDS)

- a process designed to aid directly in clinical decision making, in which characteristics of individual patients are used to generate patient-specific interventions, assessments, recommendations, or other forms of guidance that are then presented to a decision-making recipient or recipients that can include clinicians, patients, and others involved in care delivery.

alert fatigue

- most vexing problem of CDSs - benefit of alert is rapidly extinguished if alert becomes a routine part of using the system. - 49% to 96% of alerts are overridden, raising questions about the effectiveness of decision support - common byproduct of poorly implemented clinical decision support features that overwhelm users with unimportant information or frustrating workflow freezes that require extra clicks to circumvent. - significant burden for clinicians. - a fact of human cognition and cannot be eliminated through training, education, or vigilance.

The primary goal of implementing a CDS tool

- to leverage data and the scientific evidence to help guide appropriate decision making.

EHR vs EMR

EMR is defined as an electronic record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within ONE healthcare organization. However, an EHR is defined as an electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff ACROSS MORE THAN ONE healthcare organization

Five-Rights Framework for Success of Clinical Decision Support (CDS)

Right information: Evidence-based and actionable information constitutes the "what" of the CDS program. Right person: Clinicians and the patient constitute the correct individuals impacted by the CDS program, identifying the "who." Right CDS intervention format: The tools that include documents/forms, data display, answers, order sets, algorithms, and alerts define the "how." Right channel: The vehicle for delivering the CDS program, such as within the EHR, or supporting technology, such as smartphones or dashboards, reflect the "where." Right point in the workflow: The process within which the clinical care is delivered that will be impacted by the CDS program comprising the workflow for redesign using CDS outlining and diagraming constitutes the "when."

workflow design

critical aspect of the informatics role