Professional Development 1: Workflow analysis of the Emergency Department
Workflow analysis helps optimize the care of patients by optimizing patient flow. Workflow analysis is essential in emergency departments (ED) where the patient’s flow can make or break their life. Workflow analysis will be performed on the flow of patients in the ED from the moment they enter the ED until the point when the interact with:
Receptionist: When patients arrive at the ED, the receptionist will be their first contact. 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 nursing takes care of patients immediately after the triage nurses. 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.
If the physician decides to discharge the patient home, the doctor will either admit them to a floor or to a hospital. 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.
SmartArt Diagram below shows different workflow areas:
- Receptionist: Arrival of Patients
- The Triage Nurse’s Assessment
- Assessing the Nursing Needs of Assigned Nurse
- Medical Evaluation by a Physician
- Diagnoses based on lab and/or imaging
- Patients’ Disposition: Admitting to the Floor or Discharging to Home
Professional Development Exercise #2: Workflow analysis and Clinical Information Systems
Inefficient paper-based processes in clinical information systems can negatively impact patient care. Workflow analysis allows nurses to find inefficiencies within the healthcare system, and improve patient care. Through analyzing the workflow of nurses, they can enhance communication, decrease delays and improve patient care.
Because it would limit the technology’s potential, it is impossible to integrate paper-based workflows with clinical information systems. Paper-based workflows are prevalent in hospitals throughout the United States due to a fear of electronic systems, and lack of integration. Utilizing technology in order to deliver seamless care is the most effective way to transform clinical workflows from paper to electronic.
INS can use several strategies to ensure a smooth transition. First, staff should be educated and trained on the benefits of electronic records and how to transition away from the paper-based system. Second, implement a gradual transition where departments migrate in phases to an electronic system. 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.