Performance improvement methods to optimize clinical workflow: a practical approach.

This is part 3 of our 4-part series on the role of the clinical nurse specialist (CNS) in electronic health record (EHR) implementation and optimization. In part 1, we outlined the role of the CNS as an essential spoke in the wheel-driving change and adoption of new technology and optimizing processes at the departmental level. Part 2 focusedon the critical importanceof clinicalworkflowmapping to ensure that systems are designed and implemented for effective synergy of technology and workflow. Inpart 3 of the series,wewill take theworkflowmapping a step further and look at how to apply performance improvement (PI) techniques when workflows have been identified as inefficient or wasteful and/or barriers are discovered thatwillmake standardization acrossmany clinical areas difficult as new technology processes are introduced for processes likenursing clinical documentation, barcodemedication administration, and medication reconciliation. As discussed in part 2 of our series, documenting clinical workflowprovides the necessary requirements to guide the technical teams as they begin to build the new technology systems. Converting inefficient or ineffective paper-based workflows to the newdigitalworkflowspresentsmany risks for the organization, such as decreased patient satisfaction, staff frustration anddisengagement,missedopportunities for revenue capture, and challenges in improving quality and safety.Wheneverworkflows are examined in depth,we inevitably discover opportunities for improvement. The ability to take advantage of these opportunities depends on the capabilities of the organization around PI.