Challenges in Workflow from a Nursing Perspective

Workflow Analysis of a Clinical Setting

In a clinical setting, the workflow for a typical patient care episode requires exchange between clinical and administrative personnel. IT helps with supporting this exchange by assisting with more efficient data access and retrieval and the potential for improved patient satisfaction. A typical patient care episode would look like this: it begins with patient admission. When a patient arrives at the clinic, he is greeted by the receptionist, who verifies his identity and insurance information. The receptionist then enters the patient's details into the EHR system as staff makes sure all necessary forms are filled out and consent given. These are the initial steps needed before the patient’s clinical assessment can begin (Ozkaynak et al., 2022).

The next phase of the workflow is the assessment and triage conducted by the nursing staff. A nurse calls the patient and escorts him to the examination room, where blood pressure, temperature, and other vitals are recorded. The nurse documents the patient's medical history and reason for the visit in the EHR. All of this is necessary for determining the urgency of the patient's condition and establishing priority.

Following the assessment, the patient is seen by a physician for a clinical examination. The physician reviews the patient's EHR, including the nurse's notes and the patient's medical history. The physician then conducts a physical examination and could order diagnostic tests such as blood tests or X-rays. The physician might at this time discuss potential diagnoses and treatment plans with the patient or hold off until diagnostics are back.

If diagnostic tests are required, the patient is directed to the appropriate department, i.e., the laboratory or radiology, for example. Lab technicians or radiologists perform the necessary tests and upload the results to the EHR. The nurse can assist in preparing the patient for the tests and making sure that samples or images are correctly labeled. Once test results are available, the physician finalizes the diagnosis and prescribes treatment. The nurse then provides instructions on how to take medications or perform home care and can even administer initial treatments. Administrative staff schedule any necessary follow-up appointments. The patient is then given detailed instructions and plans for treatment.

The final steps before discharge involve administrative staff preparing discharge paperwork and making sure that all clinical notes and instructions are properly documented. The billing department processes the patient’s charges by coordinating with insurance providers if necessary. The patient receives a summary of the visit, including treatment plans and follow-up instructions, and settles any outstanding payments before leaving the clinic.

Some issues in this workflow that can be addressed via IT solutions might be failure to use EHR systems and the lack of real-time data access, which can cause delays in diagnostic test results and treatment plan. Inefficiencies in scheduling and follow-up can also arise from a lack of automation (Diaz-Garelli et al., 2021).

To address these problems, an EHR system should be used that integrates all patient information from initial registration to discharge (Perry et al., 2020). This would establish access for all clinical and administrative personnel. Automated systems for uploading diagnostic test results directly into the EHR can reduce delays and manual errors. A patient portal where patients can view their medical records, tests, follow-up appointments, etc., and communicate with healthcare providers would also help. Scheduling software can automate appointment bookings, send out reminders about follow-ups, and allow for re-schedulings.

Overall, it is important to use IT in the clinical setting to support workflow, as this allows for coordinated care, better communication, improved patient satisfaction, and efficient care delivery. A good EHR system can support the whole process from start to finish.