NURS 6421 Workflow Redesign Week 7 Discussion

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After conducting a thorough gap analysis, the next step in the systems development life cycle (SDLC) is to target potential solutions to the gaps. There may be many potential solutions that can help to address workflow issues and inefficiencies, or there may be one seemingly obvious solution that could address almost all of the gaps in the current-state workflow. The challenge lies in selecting the most appropriate course of action from potential solutions that also works within organizational constraints.

In this Discussion, you revisit the scenarios from the Week 3 Discussion. You determine the possible avenues for workflow redesign and consider the constraints and factors that might impact your decision.

Scenario 1:

Stephanie is a nurse practitioner at Central Care Hospital who is often involved in administering prescribed medications for patients in the general care ward. When a physician sees a patient, he or she uses the hospital’s electronic health record (EHR) to document findings and recommendations for treatment but submits medication and drug orders by faxing prescriptions to the hospital’s pharmacy. Before Stephanie administers the medications from the pharmacy, she must cross-check the medication and dosage with the physician’s notes and patient information in the EHR. In doing so, Stephanie often identifies problems with the medication the physician prescribed; patients are sometimes prescribed a medication to which they have a known allergy or one that conflicts with another medication they are currently taking. In addition, the pharmacy sometimes sends the wrong medication or the wrong dosage. Furthermore, for patients who have been transferred from other parts of the hospital, such as the intensive care unit or the maternity ward, Stephanie often encounters duplicate drug orders or incorrect medications sent from the pharmacy.

Scenario 2:

General Health Hospital is implementing new outreach programs and preventative care support groups for patients with certain conditions or health risks, such as diabetes, smoking, and obesity. Philip, a nurse leader, is the manager of a team of nurses to organize these programs and groups and to identify patients who would be eligible and interested in being involved in these opportunities. However, Philip and his team have run into a variety of challenges and problems as they attempt to complete these tasks. In identifying patients to contact about the outreach programs and support groups, Philip’s team has had to browse the hospital’s entire electronic health record (EHR). The team has also run across significant holes in the EHR as they try to contact patients; many patients’ contact information is inaccurate or out of date. Furthermore, Philip’s team has partnered with the hospital’s Appointments Desk personnel in sending reminders about meeting dates and times to patients who express interest. However, the Appointments Desk often either neglects to send out these reminders or sends duplicate reminders to only a few patients because the personnel does not have a way of tracking who should be contacted and when.

Scenario 3:

Robert works in the medical records office at Garden View Hospital. Because the hospital does not have a policy of providing clinical summaries to patients after each visit, Robert frequently receives calls from patients requesting copies of their health information (such as test results, vital statistics, diagnostic information, and medication lists and dosages). For every request, Robert must retrieve the patient information from the hospital’s electronic health record (EHR), print out hard copies of the records, and then either mail the records or wait for the patient to retrieve them in person. Additionally, Robert’s hospital often receives lab test results for patients from certified third-party providers. These results are not automatically transferred from the provider’s EHR to the hospital’s EHR, so Robert often must contact the providers before responding to a patient’s request. Robert also finds that he and his colleagues in the office spend a considerable amount of time printing, mailing, and faxing immunization records to patients’ workplaces, schools, and volunteer organizations, which can be disruptive to the office’s other responsibilities.

To prepare:

    • Review this week’s Learning Resources on workflow redesign. Then select one of the scenarios listed above to consider for this Discussion.

Note: You may choose to examine the same scenario you were assigned for the Week 3 Discussion, or you may select a different scenario.

  • Identify one specific workflow issue (gap) in the scenario you selected. Formulate at least two distinct solutions for this workflow issue.
  • Of the two solutions you developed, which would you recommend for redesigning the current-state workflow in the scenario you selected? Why?
  • Reflect on the solution you would recommend. What two organizational constraints (budget, time, resources, personnel, IT expertise, resistance to change, lack of leadership, stakeholder buy-in, etc.) would most significantly impact the implementation of the solution? How would they impact the solution?

By Day 3

Post the scenario you selected and a description of the two solutions you developed for this workflow issue. Identify the solution you would recommend, and explain how this solution would address the workflow issue. Identify two organizational constraints that might impact the workflow redesign and explain their impact.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days. Respond to colleagues who selected different scenarios than you did. Critique your colleagues’ solutions and feasibility within a health care organization. Identify further problems or constraints that could impact the solution.

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