Workflow
Workflow can be described simply as the movement of documents and tasks through a business process. Workflow can be a sequential progression of work activities or a complex set of processes each taking place concurrently, eventually impacting each other according to a set of rules, routes, and roles.
Workflow Management Systems
Workflow management systems allow organizations to define and control the various activities associated with a business process. In addition, many management systems also allow a business the opportunity to measure and analyze the execution of the process so that continuous improvements can be made. Such improvements may be short-term or long-term. Most workflow systems also integrate with other systems used by the organization: document management systems, databases, e-mail, office automation products, Geographic Information Systems, production applications, ect. This integration provides structure to a process which employs a number of otherwise independent systems. It can also provide a method for organizing documents from diverse sources.
The introduction of workflow management tools should be seen as an opportunity to improve both the underlying business process and the existing organizational structure. Many benefits can be accrued in the workflow management system is implemented as part of a broader business solution.
Here are some resources that address the information management concern:
Nurse to nurse report
Hand-off report
ED to floor report
Unity Hospital's Information Management
At Unity Hospital, most of the information management is done through the electronic health record. Any health care provider can go into a patients chart. Depending on what your role is, what you can see might be a little different. For example, a care assistant won't be able to see as much as the nurse or the doctors. The use of the EHR is a great tool for communication between different providers. The doctors, physician assistants, and residents can see what was recommended by their colleagues and can then put in orders accordingly. The nurses can, in turn, see what the doctors recommended and provide the proper care. Also, social work, physical and occupational therapy, psych, and other services can also access the patient's chart. I believe that Unity has a very productive information management system. However, not everything is perfect and there is always room for improvement on different aspects.
Informational Management Concern
One of the problems that I see at Unity with informational management is the nurse to nurse report from the emergency department to the units. There can sometimes be a lack of communication. The emergency department is a busy place and nurses see patients go in and out all shift. There is no telling how many patients a ED nurse will see during a shift. Because of this, there can be some confusion and lack of information being told when the ED nurse is calling up report to the floors. Important pieces of information are not being passed along and this can be detrimental to the patients. Also, sometimes patients are coming up to the floors but there are no orders written in the EHR. This can also be confusing for the accepting nurses on the floors.
Solution
I propose that there should be a form that the nurse can fill out that will be a part of the EHR. This form will address the pertinent information that the ED nurse wants the floor nurse to know. The nurse will still call report, however, this form will be filled out and in the EHR for the floor nurse to look back to. The information on the form will include reason for admission, orientation, if they are able to eat, how they transfer/ambulate, the code status, and if they are on telemetry, what their rhythm has been. Between this form and the nurse to nurse report, the accepting nurse will be able to anticipate what orders will written and provide the best quality of care they can.
Here are some resources that address the information management concern:
Nurse to nurse report
Hand-off report
ED to floor report
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