AMIA2014 Workflow Paper (Monday) Clinical Workflow Observations to Identify Opportunities for Nurse, Physicians and Patients to Share a Patient-centered Plan of Care

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1:45 Monday

“We conducted observations on a critical care and specialty unit to understand the plan of care activities and workflow documentation requirements for nurses and physicians to inform the development of a shared patient-centered plan of care to support patient engagement. We identified siloed plan of care documentation, with workflow opportunities to converge the nurses plan of care with the physician planned To-do lists and quality and safety checklists. Integration of nurses and physicians plan of care activities into a shared plan of care is a feasible and valuable step toward interprofessional teams that effectively engage patients in plan of care activities.

The aims of this study are to: 1) Describe current clinical plan of care activities and workflow, 2) Identify opportunities to integrate the care teams’ plan of care activities and workflow for care team engagement with patients and families, and 3) define workflow requirements for a plan of care that is integrated across the care team and shared with patients.

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We found that there are common Plan of Care concepts that should be shared among interprofessional care team members, but data entry requirements appear to require tailoring to fit with workflow, data reuse, and minimize duplication of current documentation. Plan of care activities are distributed among a variety of care processes and formal methods of clinical communication. This distributed nature of planning in the care setting and the distribution of plan of care identification among different members of the care team (professional and patient) require the ability to document plan of care components separately while preserving the ability to unify that data for an integrated shared patient centered plan of care.”

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