Workflow
This week’s resources focus on the analysis and design of systems by critiquing the workflow process. The term workflow is interchangeable with the word process (McGonigle & Mastrian, 2012). It describes tasks and events that, when used in a sequence, benefit the organization’s activities (McGonigle & Mastrian, 2012).
Workflow Tools
Concepts and tools have been identified that would impact and improve the workflow process (U.S. Department of Health & Human Services, n.d.b.). Utilization of these concepts can assist the user in redesigning a workflow for optimal use in an organization.
Checklist
Checklists are often used to identify specific tasks that were done during a procedure or occurrence. They provide information at a glance and can act as a reminder for responsibilities prior to beginning a procedure. Currently, at my facility, we use a checklist for central line insertions. Many times this checklist is overlooked because it is a single sheet of paper that must be retrieved from a drawer prior to the procedure. Because the checklist is a valuable tool, I would redesign the workflow to have these checklists available with the consent forms. A patient or family member must consent to the procedure before the physician can begin. By keeping these checklists with the consent forms, the nurse and physician decreases the risk of not using the form.
Usability Evaluation Tool
The Usability Evaluation Tool assesses the ease with which a system is navigated and utilized (U.S. Department of Health & Human Services, n.d.b.). It is often used prior to implementation or after implementation to assess for improvement areas. I would utilize this tool to assess my organizations current charting system to review improvement areas. This tool could also be provided to our informatics nurse to assist in possible development of a new charting system.
Critical Incident Technique
The concept uses interviews to assist participants in recollecting activities or thoughts during a critical incident (U.S. Department of Health & Human Services, n.d.b.). This process is important to understand why certain things occurred and to avoid negative outcomes in the future. I would utilize this concept to assess interactions during a Code Blue situation. Often these Code Blues do not occur without incidents. For example, last week the Doppler that we trying to use had a dead battery. No other Doppler was available. Interviews can identify why the Doppler was not charged and what we can do to assure that this does not occur in the future. It also illustrated to management that there is a need to order more equipment for the nursing staff.
Article Summary
The article I chose explores the effect that using computer-generated reminders to physicians has on obtaining advance directives from patients (Dexter, Wolinsky, Gramespacher, Zhou, Eckert, Waisburd, & Tierney, 1998). Physicians in a primary care practice received these reminders for patients with scheduled visits. These reminders were reviewed before meeting with the patients. The control group was physicians who received no reminder, verses physicians that received reminders to discuss advance directives with the patient. Discussions were initiated by 77 percent of the physicians that received reminders to discuss directives (Dexter, et al., 1998). This article illustrates the success of using computer-generated reminders. I would find this type of reminder useful in reminding the physician to obtain the checklist I described earlier during the central line insertion. This reminder would improve compliance and ensure that proper procedures are utilized.
Monitoring the effect of technology on workflow
It is important to monitor the effect of technology on workflow to assess any need for changes (McGonigle & Mastrian, 2012). Often technology must be changed to adapt to the workflow process in order to complement the process itself. However, while monitoring the effects of technology, it may be discovered that the processes in the workflow must be adapted to meet the technology. Leaders should assess the impact of technology on workflow to determine if transformation has occurred and to ensure the optimization of the workflow and technology (McGonigle & Mastrian, 2012).
Dexter, P. R., Wolinsky, F. D., Gramelspacher, G. P., Zhou, X. H., Eckert, G. J., Waisburd, M., & Tierney, W. M. (1998). Effectiveness of computer-generated reminders for increasing discussions about advance directives and completion of advance directive forms: a randomized, controlled trial. Annals of Internal Medicine, 128(2), 102-110.
McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge (Laureate Education, Inc., custom ed.). Burlington, MA: Jones and Bartlett Learning.
U.S. Department of Health & Human Services. (n.d.b). Workflow assessment for health IT toolkit. Retrieved, July 14, 2015, fromhttp://healthit.ahrq.gov/portal/server.pt/community/health_it_tools_and_resources/919/workflow_assessment_for_health_it_toolkit/27865
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