CLINICAL WORKFLOW KEYS
By Shaina Hood & Elisa McIntosh
Healthcare organizations spend millions of dollars on care provider order entry (CPOE) and clinical
documentation systems with objectives including enhancing patient safety and saving money. So, why do
activations fail to achieve these goals when care providers refuse to use the tools developed to support
their practices? Various reasons have contributed to unsuccessful implementations. A common contributing
factor is omitting workflow analysis and redesign that identifies where improvement opportunities lie, risks
exist, and ultimately how the system will be used, where and by whom.
What can organizations do to prevent such mistakes? Although often overlooked on many system
implementations, workflow analysis and redesign is a critical element to a successful implementation
embraced by all intended end users. Without this important step many organizations end up automating their
current redundant processes and even introducing new unwanted inefficiencies without capitalizing on the
opportunities for standardization and utilizing clinical decision support tools.
Whether performed in house or by external consulting resources, workflow analysis supports the
organization in transforming from current state to an improved future state. Those performing the analysis
require lean thinking skills coupled with an ability to analyze processes from an external perspective.
Lean thinking aims at identifying roadblocks to efficient and effective processes including redundant tasks
and steps performed by care providers and management unnecessarily. The ability to employ creative problem
solving leads to removing the roadblocks to produce a finer tuned process.
Developing and determining future state involves a range of decisions from hospital wide policies to
configuration and design, all leading to the ultimate goal of improving and maximizing clinical processes.
Involving a group of diverse and representative decision makers as well as end users who develop ownership
over the system will more readily promote adoption of the tools developed to support the care they provide.
The importance and applicability of workflow analysis was realized at Presbyterian Intercommunity
Hospital (PIH) in California as they strive towards their ultimate goal to become a paperless institution.
PIH recognized the need for workflow analysis to ensure the system they built did not replicate their
current inefficient and redundant processes. The choice was made to bring in Vitalize Consulting Solutions,
Inc. (VCS) to perform this analysis and redesign as PIH recognized the importance of experience and training
in lean thinking, the value of an external perspective as well as the benefit of application knowledge.
The use of the workflow methodology developed by Vitalize Consulting Solutions’ has been a key success
factor to the implementation of Eclipsys products at PIH. Through a series of interviews and observation
sessions with all clinicians and ancillary departments, the current clinical processes are documented and
reviewed with working groups devised of system design team members, and clinical and administrative
representatives.
VCS consultants bring valuable application knowledge to the future state development providing clinical
and administrative personnel with design options and recommendations that will best meet the needs for that
specific clinical environment. Understanding of the various ways the system can be utilized, while
recognizing the system’s limitations will provide more tangible recommendations for design.
The future state design and development phase involved VCS’s workflow team analyzing the current state
to uncover decisions relating to policies and procedures, human resources, design and adoption that must be
made in order to develop the most effective future state. VCS’s workflow methodology views the development
of future state as a collaborative process to promote adoption of the recommended future state. At PIH, the
lead Clinical Analysts worked closely with VCS’s workflow team throughout the future design and development
phase. She “believes that the Vitalize Workflow Analysis has been instrumental in [their] facility's ability
to move forward with the build of the eMD system. Without this analysis, in all its entirety, the build
team would have had trouble focusing in on all of the aspects that need to be covered in a build, from
policy practice changes, to the detail needed in a structured note for the physicians.”
The workflow process along with documentation of key training areas, policies and procedures and
configuration steps all lead to a better planned and thorough implementation that has a much higher chance
of success and clinical adoption. We would be happy to discuss this further or give you additional
information on our Clinical workflow team. Please contact us at
vcs@getvitalized.com or
call our corporate office at 610-444-1233.