Quality improvement: challenges related to transitioning from hybrid documentation model to exclusive EHR Public Deposited

This project assessed the various barriers to implementation of an exclusive EHR documentation system in the small clinic. The project focused on encouraging the use of existing EHR and to empower the employees to help sustain the change. Evaluation of the history of the clinic’s documentation system was made, which revealed that the clinic moved from paper to an EHR and paper (a hybrid) documentation system in the previous 12 years. Literature review was conducted to reveal the likely barriers such as human behavioral factors, leadership factors, and organizational factors. Shadowing experience in exclusive EHR documentation clinic was provided to staff. Analysis revealed staff exposure to exclusive EHR documentation system, led to staff attitude improvements from resistance to acceptance of exclusive EHR. Analysis of variation of paper and EHR patient records revealed 8% discrepancy of lab result entry as well as 23% discrepancy in dose documentation entry. Calculated cost for non-value-added material was $651.46 annually. Extrapolated annual labor cost of clinic staff for time spent handling the paper documentation equaled to $27,696.12 Identification of barriers and collaboration improved staff acceptance of the acceptance of the EHR adoption. De-implementation of a non-value-added process from healthcare setting improves patient safety, healthcare information sharing, and reduces waste.

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