EHR Optimization: Rapid Clinical Workflow Workshop Kit

Purpose

This workshop kit helps clinical teams run a tightly scoped, rapid EHR workflow workshop that produces data-backed, implementable fixes. The goal is to reduce documentation burden, remove wasteful clicks, improve usability for specific high-value workflows, and produce a short prioritized list of pilot changes with owners and success metrics.

Before the Workshop — Pre-work & Data Extract Checklist

Request these extracts and artifacts at least 1 week before the workshop so the facilitator and participants can prepare.

• Usage metrics: time-in-chart (by role), clicks per encounter/workflow, average documentation time per visit type, order entry time.
• Frequency lists: most-used orders, most-used note templates, most-ordered labs/imaging for the target workflow.
• Audit logs: recent high-frequency alerts or interruptive CDS firings and suppression rates.
• Template inventory: current note templates and their usage rates for the target clinicians.
• Problem-list and medication reconciliation stats: number of active problems per chart, medication list edits per visit.
• Error/incident reports: recent usability-related incidents or clinician complaints relevant to the workflow.
• Current baseline: sample screenshots or short screen-capture videos of the current workflow (2–3 minute clips).
• Stakeholders: list of attendees, primary contact in IT/clinical informatics, build/resource constraints, and preferred change windows.

Facilitator Checklist & Logistics

• Room with projector, whiteboard, sticky notes, and a timer.
• Facilitator (neutral), clinical lead (physician or NP), nursing lead, frontline clinicians (2–4), IT/clinical informatics observer, scribe.
• Distribute pre-reading summary (data extracts + objective) 48 hours prior.

4‑Hour Workshop Agenda (Suggested)

1. Welcome & Goal Setting (15 mins) — State the measurable aim for the session (e.g., reduce documentation time for discharge notes by 20% for hospitalists).
2. Data Review (30 mins) — Walk through pre-work extracts: time-in-chart, clicks, frequency lists, and incident summaries. Clarify uncertainties.
3. Workflow Mapping — Current State (40 mins) — Small groups map the current workflow using the mapping template. Capture pain points and who performs each step.
4. Define Desired State & Constraints (25 mins) — Groups propose a leaner desired workflow and list technical or regulatory constraints.
5. Idea Generation & Quick Wins (40 mins) — Brainstorm changes that are safe, low-effort, and high-impact. Use dot-voting to prioritize.
6. Design Pilots & Acceptance Criteria (45 mins) — For the top 2–3 items, define pilot scope, metrics, owners, test cases, and rollback criteria.
7. Governance & Handoff (15 mins) — Confirm build owner, ticket IDs, and post-pilot governance path.
8. Wrap-up & Next Steps (10 mins) — Assign immediate actions, timelines, and communication plan.

Mapping Template (Use during mapping exercises)

Each row is one step in the workflow.

• Step #
• Actor (role)
• System Screen/Module
• Action
• Pain (why slow/error-prone)
• Data/Click Count
• Desired change

Quick-Win Change List (Template)

Capture prioritized items during the brainstorming session.

• Change description
• Why this helps
• Estimated effort (low/medium/high)
• Owner (clinical + build)
• Acceptance criteria / success metric
• Target pilot window

Example quick wins: remove redundant clicks on a common order, change a default dropdown, pre-populate vitals in admission note, reduce interruptive alerts by tuning thresholds, consolidate duplicate templates.

Pilot Evaluation Plan (What to measure)

Define at least one primary outcome and 2–3 supporting measures.

• Primary outcome: e.g., median documentation time for the target note type (pre vs post).
• Process measures: clicks per workflow, time-on-screen, CDS firings per encounter.
• Balancing measures: number of missed orders, turnaround time for results, clinician-reported errors.
• User acceptance: short post-pilot survey (5 questions) measuring perceived time savings and confidence.
• Sample size & duration: recommend at least 2 weeks or 30 encounters per provider depending on volume.

Governance Handoff Checklist (To IT / Clinical Informatics)

• Submit build ticket with scope and acceptance criteria.
• Provide test cases and test data for QA team.
• Confirm build window and rollback plan.
• Define monitoring dashboard and owner for post-deploy metrics.
• Document change in local governance log and link to decision rationale.

Sample CDS Test‑Cases (Use these as templates)

Each test case should include scenario, steps, expected behavior, and acceptance criteria.

• Scenario: High-severity drug–drug interaction should trigger non-dismissible alert when both meds are active. Acceptance: Alert fires only when both active meds present and provides clear action choices.
• Scenario: Order set default pre-selected duplicate lab avoided when previously ordered in last 24 hours. Acceptance: System suppresses duplicate prompt and surfaces last-order timestamp.
• Scenario: Weight-based dosing auto-calculation for pediatric med. Acceptance: Dose is calculated correctly from documented weight and shows unit checks.

Facilitator Tips

• Invite both physician and nurse champions; clinicians who actually perform the workflow are essential for realistic mapping and test-case design.
• Keep the scope narrow. Solve one concrete workflow per workshop to preserve momentum.
• Use screen-capture clips to ground discussion in reality rather than hypotheticals.
• Emphasize testable acceptance criteria—avoid vague wishes like “make it easier”.
• Record pilot baseline data before making any changes so impacts are measurable.

Packaged Deliverables (What the workshop should produce)

• Prioritized quick-win tracker with owners and estimated effort.
• Pilot plan for top items with metrics, test cases, and timeline.
• Governance handoff checklist and ticket references for IT.
• Short communication draft to affected clinicians describing the pilot.

Suggested Next Steps After the Workshop

1. Open build tickets and schedule QA testing within 5 business days.
2. Collect baseline metrics during the next 1–2 weeks.
3. Deploy pilot during a low-activity window and monitor closely for 2 weeks.
4. Review results with clinicians, iterate, and plan broader rollout if successful.

Optional: Make Pre‑work Interactive

Turn the pre-work checklist into a short interactive form so teams can submit extracts and the facilitator receives structured responses (e.g., key metrics, stakeholders, sample screenshots). This supports automated aggregation and a faster workshop start.