The current workflow at my workplace is characterized by physicians giving the healthcare team, which nurses are part of, orders that are expected to provide directions to the practitioners. Among the instructions that nurses on the team receive on physician orders outline the type of medications that patients need, the procedures for carrying out specified care tasks, patient treatment and therapy as well as required lab tests and the nutritional requirements that a patient may have. The physician orders establish the medical necessity for the services that are provided, a factor that supports the payment that patients are required to make after receiving the care they need (University of Miami Health System, 2019). Therefore, without physician orders, nurses cannot perform any care tasks that are associated with administering medication to patients or testing them as well as making them undergo care procedures.
The problem that affects the workflow described above is the fact that at my workplace, physician orders are hand-written. Some of them are illegible, and when they are returned to the doctors for clarification, they take days before the instructions are re-issued. First, the illegibility of the orders makes it difficult for nurses to decode the message within them, a factor that minimizes the ability of the named practitioners to remain productive in executing their professional duties. Resultantly, patient satisfaction is also negatively impacted because of the long wait periods that are associated with seeking clarification to determine the contents of the messages in the physician orders. According to the University of Miami Health System (2019), a valid physician order must be dated, signed, timed and legible. The unreadability of the instructions impedes the communication process between physicians and nurses, consequently impacting the quality of the care patients receive adversely. Moreover, the delay of feedback when clarification is sought further diminishes the capacity of nurses to deliver consistent and standardized services.
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Revised Workflow
Increasing the efficiency of the workflow process above will require the computerization of the entry of physician orders. Computerized physician order entry (CPOE) is a process that facilitates the electronic issuance of doctors’ instructions regarding the treatment of patients. Hence, the implementation of CPOE will allow the entering and communication of physician orders over a computer network, ensuring that the nurses receive legible orders that they can execute to fulfill their care roles to patients. In turn, the efficiency of service delivery will increase as a result of enhanced productivity among nurses, leading to a boost in patient satisfaction (Schiff et al., 2015). Thus, the CPOE system will increase the ability of the nurses working in the healthcare institution to realize productivity goals and facilitate the enhancement of the care services that patients receive.
Among the benefits that will be realized as a result of implementing the CPOE system are financial gains. When nurses can read and understand physician orders immediately they receive them on computers, which have standardized and legible fonts that can be adjusted to fit individual preferences, they can attend to patient needs quicker. The latter will result in allowing more patients to be treated, which will translate into increased financial gains for the care institution (Simon et al., 2013). Therefore, the enhancement of the physician-nurse communication process is crucial to enabling the attainment of financial goals within healthcare institutions.
Moreover, the implementation of the CPOE system will enhance patient satisfaction with the care services provided. Research has proven that the engagement of nurses to their jobs, which facilitates the delivery of crucial care roles, requires that the practitioners have proper support within their working environments. Positive nursing working environments have been deemed to foster better patient experiences, characterized by higher client satisfaction rates (Pannick, Sevdalis & Athanasiou, 2016). Therefore, the implementation of the CPOE model will better the working conditions for nurses by easing the communication process between the named practitioners and physicians. Resultantly, nurses will be better placed to focus on service delivery, a factor that will enhance their interaction with patients and translate into higher patient satisfaction levels.
Furthermore, implementing the CPOE model will have compatibility advantages because it will allow efficient decision-making on the physicians’ end when they are prescribing medication. Nurses will also have an easier time when seeking clarification on prescription errors, and the communication between nurses and physicians will be enhanced. Additionally, the system will facilitate the realization of relative advantages associated with eased management of paper records, time efficiency in service delivery, reduced risk of prescription errors and increased patient safety (Amiri, Rahimi, & Khalkhali, 2018). Thus, the implementation of CPOE will improve the efficiencies of both physician and nursing practices, a factor that will enhance the care services delivered and result in the betterment of patient well-being.
The use of a workflow map in hospitals facilitates the betterment of job design and enhances the efficiency of patient care technology because the plan increases practitioner insights on the care processes that are involved. When nurses and physicians understand their roles better, especially concerning the implementation of tech solutions to enhance the type of care that is delivered to patients, their productivity increases. Secondly, workflow maps make it easy to identify redundancies in the care process, a factor that enables the reduction of patient wait time and translates into increased patient satisfaction with the care services that are delivered. Thirdly, mapping the workflow in care institutions increases the accountability of practitioners and reduces the need for micromanagement. Increased responsibility among practitioners enhances the rate of realizing patient care goals, whereas less micromanagement increases job engagement and motivation among practitioners, a factor that boosts their efficiency in service delivery. Thus, implementing workflow maps in clinical settings is vital to enhancing the care process through the betterment of practitioner working conditions
References
Amiri, P., Rahimi, B., & Khalkhali, H. R. (2018). Determinant of successful implementation of Computerized Provider Order Entry (CPOE) system from physicians’ perspective: Feasibility study prior to implementation. Electronic physician , 10 (1), 6201.
Pannick, S., Sevdalis, N., & Athanasiou, T. (2016). Beyond clinical engagement: a pragmatic model for quality improvement interventions, aligning clinical and managerial priorities. BMJ Qual Saf , 25 (9), 716-725.
Schiff, G. D., Amato, M. G., Eguale, T., Boehne, J. J., Wright, A., Koppel, R., ... & Bates, D. W. (2015). Computerised physician order entry-related medication errors: analysis of reported errors and vulnerability testing of current systems. BMJ Qual Saf , 24 (4), 264-271.
Simon, S. R., Keohane, C. A., Amato, M., Coffey, M., Cadet, B., Zimlichman, E., & Bates, D. W. (2013). Lessons learned from implementation of computerized provider order entry in 5 community hospitals: a qualitative study. BMC medical informatics and decision making , 13 (1), 67.
University of Miami Health System. (2019). Importance of Physician Orders | Office of Billing Compliance at Miller School of Medicine. Retrieved 27 August 2019, from http://obc.med.miami.edu/awareness/obc-tips/importance-of-physician-orders
