Nursing Workflow is loosely defined as the set of tasks grouped in order according to time that nurses, with the support of people and resources, need to complete in a standard work day. 

In the experience of the RNs and clinicians on our team, within hospitals some nursing workflows are designed, but quite often they develop organically over time.  The manner in which healthcare facilities accomplish their clinical workflows varies dramatically often by unit, area of practice, type of task and even time of day. 

When evaluating an individual workflow process it can appear quite sensible and efficient in serving to achieve the end goal.  However, it is through the observation of complex interactions between processes that difficulties are often revealed.

Why is Nursing workflow is a critical concern for today’s clinicians?  The key factors include:

• Technology being used at the patient bedside to improve patient safety and streamline clinicians’ work
• The participation of a growing array of professionals in a patient’s care team, and new definitions in their roles
• Initiatives to ensure patient safety
• Implementation of changes to make the care team more patient-focused
• Cost and efficiency pressures to improve patient flow
• The challenge of coordinating care for the chronically ill

Bedside technology has the potential to improve medication safety, nursing documentation and order entry, but it can have a major effect on nursing workflow.   Disruptive workflows can lead to nurses taking longer to document and/or administer medications; this could divert nurses from other important patient care activities, which could effectually lead to decreased care and poorer patient outcomes.

In addition, the lack of sufficient time to document and/or administer medications might encourage nurses to bypass the bedside documentation or medication verification step and greatly diminish the intended impact of this technology on patient safety.

When considering mobile technology integration for bedside point of care and access to the EMR, it is essential to involve the bedside clinician and have interdisciplinary involvement in all aspects of workflow analysis and implementation including:

• Current workflow analysis/mapping
• Future workflow mapping
• Understanding interactions between practice areas and the workflow process
• Identifying variations between workflow processes by unit, clinical area and shift
• Evaluation/Selection of mobile technologies to augment both current and future workflows
• Implementing new technologies and clinical processes
• Ongoing training and quantifying results

It is important to remember that no one technology will be the answer for every area as workflows will vary by unit for the same processes.

Integrating technology into existing and future workflows will result in greater success with technology adoption and achieving goals of improving patient outcomes and satisfaction, increasing nursing time with patients and patient care activities, decentralizing areas in which to chart and moving this to the point of care, and entering timely, accurate data at the point of care.