During the height of the COVID-19 crisis, healthcare facilities have had no choice but to cut regularly scheduled procedures and surgeries. This meant cutting staff hours. As our country's facilities are now in reboot and recovery, healthcare leaders are trying to balance staffing hours to benefit individuals who may have been severely cut back or even furloughed.
Facilities have created new staffing scenarios to help with recovery efforts as well as sustain and retain staff. Many are redeploying staff from their "home" departments into other areas to provide clinical staff augmentation but also provide much-needed work hours to individuals impacted by reduced work hours. Cath lab nurses are working in ICU units. Endoscopy nurses taking shifts on Med/Surg floors. Recovery nurses are helping in emergency departments.
This leaves a challenge for those maintaining security and access in the Epic EHR to adapt to these changing moments. How do you make sure that the EHR is supporting the recovery efforts and not hindering them? When a floating nurse walks onto the new unit, how do you ensure a nurse can log in and be guided through the work that this area supports with the help of not only staff on the unit but by the EHR system itself – and as quickly and efficiently as possible.
Epic has many options available for supporting patient care. For supporting staff mobilized to an area outside of their primary department, creating a foundation of robust User (EMP) templates will facilitate this effort as well as yield other benefits such as making processes efficient for newly hired staff. Here, we discuss some of the features and options that can be utilized for this foundation:
Nursing templates can be augmented with multiple role overrides to provide the screens and activities needed on login for each specific department. Utilizing Epic's capabilities for logging in using different templates, users can quickly be given the correct security for interacting in the OR/ER/L&D or other departments with additional templates applied to their user records. Our recommendation for these templates is to base them on years of experience working with both large and small facilities. For one of our clients, we adapted our Nursing and Therapy templates to allow users to function on multiple units as the staff was mobilized into needed areas.
The EHR system should guide float staff through the documentation needed for the location they are working. Within the Epic solution, Admission and Shift navigators should walk through the various assessments and tools specific to the unit. Work Engine Rules can be utilized as creative solutions to direct users to the correct navigators for the patient type. The required documentation should point the user to any essential missing information. Worklist tasks should recognize credentials and prompt users for action. Best Practice Advisories should also help to guide and support practice. Supporting one of our clients with units that were converted due to COVID, we optimized Epic to have navigators change to an ICU, IMC, and Med/Surg type for each patient based on their care levels, not just one navigator for the whole unit. The result is a robust system where the nursing staff is moving from unit to unit with very little discomfort.
Optimizing patient care through template and structural changes not only supports the recovery efforts our facilities face but also enhances the user experience. In a recent review of help desk feedback, user satisfaction ranked from "Satisfied" to "Very Satisfied." Applying these strategies will help facilities not just survive, but thrive in the "new normal".
Epic Consulting Analyst, CereCore
Epic Consulting Analyst, CereCore