1. 1. QUESTION

   Week 7: Systems Design and Workflow
   Consider a clinical process or task that you perform on a frequent basis. Do you do it the same every time? Why do you proceed the way you do? Habit? Protocol? Each day nurses complete certain tasks that are considered routine, but have you ever stopped to reflect on why things are done the way they are? Perhaps you have noticed areas where there is a duplication of efforts or an inefficient use of time. Other tasks might pass seamlessly from person to person. In order to design the most efficient flow of work through an organization, it is useful to understand workflow and the ways it can be structured for the most optimal use of time and resources.

   This week, you examine the concept of workflow and how the design of the workflow impacts the effectiveness and quality of an organization. You analyze a current workflow design and formulate a new workflow design to improve a process.
   Learning Objectives
   Students will:
   Analyze the effect of system design and workflow on health care quality
   Analyze the steps in a current workflow design
   Formulate a new workflow design to improve a process
   Photo Credit: [IAN HOOTON]/[Science Photo Library]/Getty Images
   Learning Resources
   Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
   Required Readings
   McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones and Bartlett Learning.
   Chapter 13, “Workflow and Beyond Meaningful Use”

   This chapter reviews the reasons for conducting workflow analysis and design. The author explains specific workflow analysis and redesign techniques.
   Huser, V., Rasmussen, L. V., Oberg, R., & Starren, J. B. (2011). Implementation of workflow engine technology to deliver basic clinical decision support functionality. BMC Medical Research Methodology, 11(1), 43–61.
   Retrieved from the Walden Library databases.

   In this article, the authors describe an implementation of workflow engine technology to support clinical decision making. The article describes some of the pitfalls of implementation, along with successful and future elements.
   Koppel, R., & Kreda, D. A. (2010). Healthcare IT usability and suitability for clinical needs: Challenges of design, workflow, and contractual relations. Studies in Health Technology and Informatics, 157, 7–14.
   Retrieved from the Walden Library databases.

   This article points to many health information technology designs and workflow decisions that limit their value and usage. The authors also examine the structure of the conceptual relationships between HIT vendors and the clinical facilities that purchase HIT.
   U.S. Department of Health & Human Services. (n.d.b). Workflow assessment for health IT toolkit. Retrieved, June 18, 2012, from http://healthit.ahrq.gov/portal/server.pt/community/health_it_tools_and_resources/919/workflow_assessment_for_health_it_toolkit/27865

   This article supplies a toolkit on the planning, design, implementation, and use of health information technology. The sections of the website provide a definition of workflow, examples of workflow tools, related anecdotes, and research.
   Document: Sample Workflow of Answering a Telephone in an Office (Word document)
   Note: You will use this document to complete this week’s Assignment.
   Required Media
   Laureate Education (Producer). (2012f). System design and workflow. Baltimore, MD: Author.

   Note: The approximate length of this media piece is 7 minutes.

   This video provides an overview of how workflow modeling can be used in a health care setting to target areas for revising current practices and procedures. The video also shows how technology and informatics can be used to improve workflow efficiency and increase the quality of care.

   Accessible player
   The following document gives credit for Laureate-produced media in this course: Credits (PDF)
   Discussion: Understanding Workflow Design
   As you explored last week, the implementation of a new technology can dramatically affect the workflow of an organization. Newly implemented technologies can initially limit the productivity of users as they adjust to their new tools. Such implementations tend to be so significant that they often require workflows to be redesigned in order to achieve improvements in safety and patient outcomes. However, before workflows can be redesigned, they must first be analyzed. This analysis includes each step in completing a certain process. Some systems duplicate efforts or contain unnecessary steps that waste time and money and could even jeopardize patient health care. By reviewing and modifying the workflow, you enable greater productivity. This drive to implement new technologies has elevated the demand for nurses who can perform workflow analysis.
   In this Discussion you explore resources that have been designed to help guide you through the process of workflow assessment.
   To prepare:
   Take a few minutes and peruse the information found in the article “Workflow Assessment for Health IT Toolkit” listed in this week’s Learning Resources.
   As you check out the information located on the different tabs, identify key concepts that you could use to improve a workflow in your own organization and consider how you could use them.
   Go the Research tab and identify and read one article that is of interest to you and relates to your specialty area.

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