Date of Graduation

Fall 12-7-2020

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

First Advisor

Shirley Kedrowski

Second Advisor

Robert Patterson

Abstract

Electronic Health Record (EHR) in-basket results (e.g., lab results, pathology reports, etc.) must be reviewed and acted upon in a timely manner by clinical staff in order to provide safe and effective care to ambulatory patients. Delays in reading results are significant contributors to medical errors. A large backlog of in-basket results that have never been appropriately filed is both a safety concern and a symptom of other clinical workflow issues. EHRs have shifted a greater proportion of administrative and triage roles onto providers, contributing to provider burnout. This paper synthesizes some of the best evidenced-based practices available for the management of provider in-basket results to address the in-basket results backlog at a large, tertiary medical center. The framework outlined is intended to provide concrete recommendations. However, it is intentionally broad so that it can be applied to any of the 200+ diverse clinics of the Medical Center, regardless of specialty or clinic structure. The framework emphasizes collaboration and utilizes registered nurses as part of the clinical team to improve the safety and efficiency of the process. Nurses serve a unique function because their critical thinking skills and broad scope of practice bridge the gap between providers and medical assistants (MAs). By using the plan, do, study, act (PDSA) cycle and gradually expanding the nursing role, more effective clinical teams can be built to meet the needs of both clinicians and patients.

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