Pre HIT: Goals, Workflow Redesign, Data Standardization, and Clinical Decision-Making

“Assist leadership in developing a plan and establishing foundation for future HIT implementation. Major objectives of Pre HIT Planning include 1) business case for HIT, 2) increased awareness by leadership and staff of where and how HIT can result in added-value, and 3) long range plan with milestones and timeline that meets organization’s goals. Specific aims of the process are to analyze information and form content at the data element level, identify all users of information, and facilitate the transforming of a facility’s culture from “forms culture” to “data culture”.

Multi-facility organization: 4 nursing home providers ( Ohio)

Facilitated collaboration across four facilities to develop common CNA documentation for organization: incorporated standardized data elements into clinical documentation to include best practice elements for pressure ulcer prevention; streamlined documentation, reduced total number of CNA forms; emphasized inclusion front-line staff, multiple disciplines in documentation redesign.

Redesigned clinical workflow to implement process improvements: increased front-line staff accountability; improved communication across disciplines: Charge nurses, CNA staff, MDS nurses and dietary; integrated use of weekly reports into clinical operations to support multi-disciplinary team approach to resident care planning and delivery.

Facilitated the development of business goals and objectives supported by new technologies: established metrics to evaluate process improvement initiatives; developed facility-specific plans for sustainability of new initiatives, including strategies for future technology.

Hospital owned long term care provider ( Washington, DC)

Consolidated and r edesigned CNA documentation forms to reduce number of forms completed each day and incorporate standard elements of best practice. Implemented standardized documentation on paper for all CNAs house-wide in preparation for clinical IT system. New process well received by staff, i mproved documentation completeness, and reduced redundancies in documentation.

CCRC 200+ bed provider ( Arizona)

Redesigned CNA documentation to incorporate best practice elements for pressure ulcer prevention resulting in: streamlined CNA documentation: redundant documentation eliminated; reduced CNA documentation from 7 disparate forms to one comprehensive document; clinical data elements for CNA documentation defined and ready for integration into clinical application; implemented standardized PU Tracking sheet for wound coordinator; integrated use of weekly Pressure Ulcer status report into facility team conferences; eliminated need for time-intensive data collection to compile weekly PU status report for facility leadership.