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Conference

The Triological Society 2025 Combined Sections Meeting

Document Type

Poster

Publication Date

1-2025

Description

Educational Objectives: At the conclusion of this presentation, the participants should be able to (a) understand the benefits of simplifying EMR order-sets; (b) simplify a commonly used procedure or order set which includes identifying stakeholders who should contribute to the discussions; (c) identify and overcome barriers that would inhibit implementation and efficiency Objectives: Usability of electronic medical records has been linked to concerns for patient safety and provider wellness. One concern is that an order set’s “end user” may be inexperienced with the complexities associated with the tracheostomy patient continuum. The formation and utility of an intuitive workflow in the entire care continuum has not been investigated. This quality improvement project aimed to (a) Improve order set usability; (b) Create a multidisciplinary process to overhaul a clinical order set at a single institution with stakeholder engagement across service lines; (c) Address barriers to implementation and dissemination with processes and stakeholder groups. Study design: A quality improvement project focused on the multidisciplinary creation and analysis of the impact of simplification on a process within the EMR at a single institution. Methods The workflow of a self-organized multidisciplinary working group was documented and end users were identified. An implementation plan was crafted and use was tracked. Special attention was made to unintended consequences. Results Six multidisciplinary meetings took place. Each meeting included suggestions for improvements and discussions regarding the impact of each change on the many stakeholders. We found opportunity to defer practice to hospital policy. We also found opportunity to remove education from the order set. Feedback and analyses from this intervention revealed improved efficiency with 42% fewer clicks and 60% fewer clinical decisions required for completion of the order set. More importantly, residents at both the junior and senior levels commented that the increased simplicity and efficiency has improved workflow during times when they are on call and most fatigued. Barriers to implementation included some hospitals within the system not wishing to move forward and turnover of end users in an academic institution. Conclusion Assembling a multidisciplinary team to improve the usability of a tracheostomy order set provides an opportunity for seamless implementation of hospital policies across service lines. This may be a generalizable pathway to a standardized care continuum without a dedicated tracheostomy team.

Improving the Usability and Usage of a Tracheostomy Order Set

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