Standardizing Order Names and Content During the Implementation of a New Multi-Hospital Electronic Health Record: A Clinical Quality Improvement Initiative

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Publication Date

7-24-2025

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Presentation: 40:46

Abstract

This project took place in a health system that comprises a tertiary care medical center with an associated medical college, three community hospitals, and 125 ambulatory sites. The goals of this quality improvement project were to achieve alignment and standardization of the nursing, supply, and consult orders; improve EHR usability, EHR effectiveness, and staff efficiency; and describe the change management methods used to achieve stakeholder consensus. This paper will describe the change management methods that were utilized to develop stakeholder consensus for the standardization of nursing, supply, and consult orders. In the pre-transition state, there were twelve electronic health records (EHR). In the post-transition state, a single instance of a new EHR was utilized at all sites. Timely project completion required compromises from all facilities, and the team was able to standardize the orders with a limited number of site-specific variations. Post-implementation surveys of the project team and physician and nurse stakeholders showed the combined results for the EHR usability, EHR effectiveness, and staff efficiency questions rose to 94% comprising somewhat improved and improved to a great extent. Free text comments were used to identify problem orders. The paucity of survey responses about problem orders and orders that needed to be changed showed that the team accomplished the goal of achieving alignment and standardization across the health system over the required fourteen-month period. The health system and the project team were able to utilize evidence-based change management steps to implement this project, keep it progressing at the expected pace, and achieve the anticipated outcomes.

Language

English

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