Enhanced Nursing Workflow: The Role of Electronic Health Records

This report explores the implementation of communication and information technology, specifically Electronic Health Records (EHR), to improve workflow in the primary healthcare sector, ultimately enhancing patient satisfaction and healthcare service quality. It identifies common problems such as inefficient appointment procedures and long waiting times, and contrasts the existing workflow with a new system that utilizes online appointments and EHR for streamlined information storage and access. The report emphasizes the importance of metrics like registration error rates and ticket resolution speed for workflow improvement. A flowchart visually represents the proposed new workflow, highlighting the roles of various healthcare professionals and the use of EHR systems. The conclusion underscores the potential of technological advancements to enhance communication, patient care, and overall organizational efficiency, advocating for a focus on continuous improvement in work processes to deliver significant results.

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Introduction
The communication and information technology can be implemented in the primary
healthcare sector in order to improve the process of the existing workflow. This is turn will
help to increase the patient satisfaction and thus will help to elevate the health service quality
provided to the patients through the healthcare organizations. Workflow can be defined as the
set of tasks that are grouped in and chronological manner into various processes. There is a
need of people and resources required in order to achieve the goals (Jones et al., 2014).
The term workflow reflects a set of task that are performed in a chronological process.
There are a defined set of people or resources who are required for the task in order to
accomplish a give goal (Cresswell, Bates & Sheikh, 2013). Although there are challenges in
the process of designing the workflows in healthcare organizations, there is a need for the
workflow design because of the following factors which includes: introducing new
technologies into healthcare, participation of a growing unit of medical professionals in the
patientccare team, provision of initiatives for patient safety, increase efficacy in pressures to
make patient flow efficient and finally implement changes to make the care team patient-
centred (Bardhan & Thouin, 2013).
This paper aims to generate a workflow diagrams that describes the new and
improved system of workflow. The objective was to remove the current system and improve
it by implementing the electronic health record systems.
Common problem
One of the most common problems that is faced in the healthcare organizations
include the complaints of the patients regarding the inefficient appointment procedures. Most

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of the processes that exists include filling out and updating a registration form that is related
to their health history. After this is done, the patients have to wait in the waiting rooms for
their appointments with the respective doctors.
When the patient arrives, the receptionist follows the predetermined steps and
conducts a query of the social security number and the name of the patient. The patient is
then provided with a paper encounter form which requests past medical history information,
health concerns experienced currently and the reason for hospital visit. This is needed to be
completed during the patient is waiting to be placed in an examination room. The workflow
then continues with the second part which involves the physician’s physical exam along with
the laboratory testing, radiologic and other testing followed by discharge of the patient
(Badgett et al., 2013).
Existing workflow in the system
In the hospital setting, the general workflow related to the above mentioned problem
begins with the patient visiting the hospitals which involves request for appointment,
followed by patient registration, a formality including history taking and then the clinical
examination begins. The existing workflow involves the patient contacting the hospitals
through phone call or walk-in appointments can also be made by contacting in person
(Lindberg et al., 2013). Both the processes involves the receptionists taking down the
personal information of the patient which includes the date of birth, patient age, home address
along with social security number. The emergency contacts and information about the
insurance provider are also needed to be mentioned. The information that is collected is then
entered in the component of demographics and insurance of the electronic registration
system. After these formalities are conducted, the new patients receive a schedule for forty-

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five minute appointment. Later the patient is provided with a patient identification number.
The patient is then scheduled for another appointment of 20 minutes after which the
registration is completed (Przybylo et al., 2014). New paper chart is then made by the file
clerk who registers the information which is printed and later placed in the chart.
New workflow in the system
The healthcare workflow system that is recently finding importance in the healthcare
organizations is different from the existing workflow. This new workflow system implements
information technology that enables the patients to make appointments through the online
systems. This system provides more flexibility in the process. The need to speak up with the
patient is also eliminated in the new system. The use of the electronic health record (EHR)
provides opportunity for storage of patient information in one place where it can be viewed
together with all the existing information on the patient. It can accesses the central database
(Abrahams & Crane, 2013).
One of the problems which the patients complain about is the need to wait in the lobby for
hours to complete the formalities of filling out the forms which includes the past medical
histories of the patients. However is more reasonable to have a personable experience of the
patients with the nurses in order to review this information. This enables the immediate
clarification of questions the patient or nurse may have regarding PMH (Przybylo et al.,
2014).
Metrics used to improve the workflow
Application of efficient metrics enable the patients to receive elevated quality of care.
Several metrics like the operational and the informational technology metrics can be
implemented in the organizations in order to analyse the performance metrics on a daily

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basis. The metrics that can be implemented for improving the workflow related to the
discussed problem, it includes the registration or the admission error rate improvements. The
data errors should be determined related to the registrations and the admissions. The error
prone data that are present at the front end disrupts care and revenue cycle processes
downstream. The ticket resolution speed can also be increased (McGonigle & Mastrian,).
Workflow flowchart

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Explanation of the diagram
This step is conducted mainly by the clerk of provider and the scheduler, in
association with the nurses who are responsible for taking in the past medical history of the
patients. The online method of appointments with the help of the electronic health record

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(EHR) system is used. In order to execute this step, information of the patient’s details is
required like the name, age, address, the social security number and the insurance number
along with the preferred time of appointment. The information required also includes the past
medical histories of the patient along with the current health status and the reason of
appointment.
The metrics that can be currently used for the improvement of the workflow includes
the operation and the information metrics. Improvements can be conducted in terms of
improving the registration or the admission error rate along with the increase in the ticket
resolution speed (Koppelc& Kreda, 2010). Improvements can be brought about by addressing
the complaints of the patients related to the fact that they have to wait for long hours in the
lobby in order fill out the formalities. This can be avoided if the online system can address
these formalities prior to the arrival of the patient in the hospitals. It is required to understand
the flow so that work can be progressed in a chronological method.
Summary
For better communication and sharing of information, it is required to implement the
progress in technology. This in turn will help to increase the fate of healthcare that will be
determined in an innovative manner. Inside an organization, the technological advancements
has the capability of enhancing the various parts of work process. It is required for an
association to be aware of the stream of action that goes on inside the association. This takes
place because of the encouragement of consciousness to make an adjustment in the
workplace that will be helpful for patient care. This advancing technology of EHR can be
really useful to the organization in terms of communication between the hospitals and the
patients for making appointments and taking in of medical records of the patients. The study

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focusses on the change of the existing communication process that are essential to delivering
quality patient care. It should be kept in mind that the final goal is to make upgradations in
the present work process. In order to deliver significant results for the organization, a
flowchart is expected to outline the plan and represent it in a diagrammatic form.

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