Skilled Nursing Facility | Scappoose, Oregon
The nurses of Columbia Care Center (CCC), a rural Nursing Facility in Scappoose, Oregon, have identified the job stressor of consistently not being able to complete their assigned documentation duties prior to the end of their scheduled shift, leading to nurses reporting off to the oncoming nurse, then staying at work to complete their documentation. A root cause analysis identified that the documentation was unable to be completed during the nurses shift due to an Electronic Health Record (EHR) system being in place that lacks basic essential functions a nurse must have to allow for multi-tasking, for example, draft progress notes, auto-saving progress notes as drafts, and the ability to be within several residents records in different windows at the same time.
The inability to complete all assigned duties during a nurses shift with internal and external pressure to do so leads to decreased overall well-being, such as decreased time available to take care of basic human needs for the nurses, like getting adequate sleep, obtaining groceries, preparing/cooking food, spending time with family/friends, and taking care of personal medical needs. The proposed solution is to transition to a new EHR system that supports the multi-tasking CCC nurse, this will reduce the time wasted on progress notes and other documentation that is lost when a nurse is pulled away from their charting to address tasks that are deemed more critical in that moment.
We expect that implementing a new EHR system will lead to nurses completing their documentation prior to the end of their shift, enabling them to leave once they have given report to the oncoming nurse, which will have a direct positive impact on the well-being of the nurses of CCC. Naturally, not only will transitioning to an improved EHR system effect nurses, but it will also have a positive impact on much of the staff, including Certified Nursing Assistant and Certified Medication Aids, Activities, Social Services, Dietary, Administration, Medical Records, and outside providers. Nurses will benefit from the improved coordination between departments, the intuitive processes and ease of use will bring less reliance on nurses to provide other departments with records they may need from the EHR as they will be able to obtain them independently with the appropriate training. Success will be measured by the nurses perceived time spent after their scheduled shift completing required documentation, and the nurses numerical rating of their over-all well-being.