WBB's Thought Leadership

Hospital EHR Optimization Reduced Required Documentation for Nurses

April 21

Carolinas HealthCare completed a three-year optimization of its Cerner EHR, saving 35,000 hours in documentation time
The project also improved medication administration and improved the quality of nursing assessments, generating third-party cost savings of $60,000 per year.

Excerpt: “In an industry populated with physicians bemoaning too many clicks, healthcare organizations need to create a culture that believes IT will do more than just improve patient care. Electronic health records and other technologies need to help clinicians improve workflow.

“For Carolinas HealthCare System, that meant first zeroing in on its nursing team.

“CHS went live with a three-year optimization project in May 2016 to simplify the EHR in the acute care venue. The health system has used Cerner technology for over 10 years and needed to update the systems to make things easier and give nurses a hand in using the technology.

“The goal? To reduce documentation, remove duplicate records and organize the tech in a user-friendly system.”

“By leveraging nursing informatics, Carolinas Healthcare reduced documentation time for head-to-toe assessment by 20 percent, which is equivalent to about 35,000 working hours returned to nurses directed back to patient care.

“Additionally, CHS saw a 14 percent improvement in on-time medication administration, equal to about 400,000 eliminated clicks within the EHR. In total, CHS eliminated 5.8 million nursing tasks and reduced clicks by 17.8 million - or three or more clicks per task.

“CHS also improved the quality of each assessment with 10 new screening tools, which generated third-party annual costs savings of $60,000.

“The organization automated a clinical decision support tool to better identify patients at-risk of deteriorating conditions, Fox explained. Now, when nurses collect medical history during admission, it uses EHR and that data to automatically evaluate the risk level of the patient using established criteria.

“While the nurses can use their own judgement, the program is designed to catch patients that would usually fall through the cracks, she continued.

“We used a lot of analytics to drive design, [Carolinas HealthCare assistant vice president Becky] Fox said. We also had a great partnership with bedside nurses, nursing managers, IT and our vendors. It was a significant change for clinicians.”

Source: Healthcare IT News

WBB Take: As the article states, the loudest voices in the industry seem to be those complaining bitterly about their EHR. To be fair, there are many healthcare providers whose experience with EHR has been dismal – additional work, unstable systems, agonizing repetition, and abysmal navigation. They are justifiably angered by systems that were perhaps bought by their CIO and CFO in order to take advantage of the Meaningful Use incentives, rather than by the CMO to improve things for providers. EHRs were often implemented in a rush, and layered on top of existing workflow.

However, there is a quieter and far more satisfied population of providers whose EHR systems were used to find ways to reduce administrative work, and to free up time for higher-value activities – such as patient care. A key to taking advantage of EHR capabilities is, of course, to have the clinical team play a meaningful role in setting the requirements prior to purchase. A second way is to ensure that the clinical and administrative workflow is optimized and uses the EHR functionality to its greatest potential. Facilities that optimized their workflow to free providers from repetitive and low value work have seen significant operational improvements, as well as increased patient access and outcomes.

Jerry Stefanko

Jerry Stefanko



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