Mention the term “clinical workflow management” to most healthcare executives, and you’ll hear a myriad of reasons why it’s important and how their hospital or health system stacks up.
Clinical workflow management is the act of setting up systems and processes to create efficiencies across the healthcare organization. When automated, configured, and executed appropriately, clinical workflows help ensure smooth, seamless experiences for clinicians and patients by minimizing errors and complications, while also ensuring high quality care. Each health system will customize workflows to fit their own goals and demands.
While workflows are designed for use in every clinical setting, there are two primary types of workflows at the clinical level:
In either scenario, the clinical workflow may include the introduction of electronic health record (EHR) alerts - patient-specific, visual cues that provide recommended actions for providers.
EHR alerts, which are triggered based on information in the patient’s health record, are recommendations and precautions that “fire” (pop up on screen) for a clinician to review as they interact with that patient’s care throughout their visit. Alerts are based on the patient’s existing diagnoses and medications, plus all other documented data in their EHR. These alerts empower clinicians to provide the best course of treatment, and they enable more efficient clinical workflow management.
Let’s take a look at a few common clinical workflows that incorporate EHR alerts, and which are used across the board in inpatient healthcare settings:
Without automated clinical workflows, the process of admitting and discharging patients can be burdensome, creating long wait times, waiting room bottlenecks, and for those patients ready and waiting to go home, significant frustration.
In this scenario, a clinical workflow might include EHR alerts highlighting missed steps in the complex process, indicating whether they had been seen or admitted more than three times in the past 90 days, or reminding providers to dispense at-home care plans for patients prior to their discharge.
By automating the clinical workflow management with EHR alerts, healthcare providers can create a more efficient and safe process for the clinicians and their patients.
As we discussed in a previous post, some EHR alerts are designed to identify drug interactions, to warn about a patient’s known drug allergy, or to recommend medication(s) for specific conditions.
Including an EHR alert in the automated clinical workflow not only ensures clinicians order the correct lab tests and prescribe the right medications; the workflow can be set up to advise around unsafe medication prescriptions, alert lab technicians and additional clinicians about those orders, and can notify the hospital’s pharmacy about potential red flags in the patient’s history.
Clinical workflow management serves not only to make ordering and prescribing less daunting and time-consuming for providers; it also aids health systems in avoiding costly errors and safety risks.
Managing patients with diseases and conditions like diabetes, sepsis, and venous thromboembolism (VTE), can severely tax a health care system if not managed appropriately. With many health systems struggling to produce high quality care, they find themselves initiating quality improvement (QI) projects to increase efficiency and boost patient outcomes in these populations.
However, providers can get ahead of problems - including poor patient outcomes - before they begin by putting clinical workflows into place long before a QI project is ever initiated. Clinical workflow management provides a roadmap for common conditions; adding EHR alerts can further enhance that workflow by alerting a provider to a patient’s current medications, comorbidities, and anything else that might relate to their treatment. Alerts can also prompt the clinician with a call for an order set - a curated menu of recommended actions associated with the condition. In doing so, the clinical workflow reduces risk to the patient and can speed up the process by which a patient is admitted, seen by a provider, treated, and discharged.
As you can see, EHR alerts are a necessary and effective tool in clinical workflow management. They provide a guide for clinicians and take the guesswork out of making optimal decisions that impact patient safety and quality of care. Plus, automating repeatable processes, as clinical workflows strive to do, can put health systems ahead of the game when it comes to meeting their clinical quality measure (CQM) goals.
As with any organization, automated workflows in healthcare can save time, reduce costly errors, and positively impact the people who rely on them. For health system IT teams, quality and safety groups, and providers, incorporating EHR alerts into clinical workflow management can improve quality and outcomes when implemented judiciously and intelligently with an iterative approach.