clinical decisional support, clinical nurse specialist, electronic health record, outcomes, population



  1. Whitman, Nathan DNP, RN, PMHCNS-BC
  2. Purvis, Suzanne DNP, RN, GCNS-BC


Purpose/Objectives: This article describes a stepwise model to develop timely reports from the electronic health record (EHR), which can be used to improve outcomes for high-risk patients.


Background: The literature is beginning to describe the use of reports and decisional support tools to identify high-risk populations to affect outcomes. The clinical nurse specialist is in a unique position to optimize use of the EHR to create reports and decisional supports to improve individual nursing practice, standardize clinical workflows, and enhance patient outcomes.


Rationale: These reports identify patients at high risk for complications and can be utilized by the clinical nurse specialist to implement targeted interventions early in the patient's hospital stay, resulting in improved outcomes for selected patient populations.


Description: A stepwise process used to develop these clinical informational reports is described as a model that is clinically relevant to a wide range of clinical nurse specialist roles, populations, and settings who use EHR.


Outcomes: This model was utilized to create reports to target the highest-risk patients in the organization including patients with high fall risk, alcohol withdrawal syndrome, and the need for sitters.


Conclusions: The basic idea of reports described by this model can significantly alter healthcare outcomes by making it possible for clinicians to adjust the way patient data are viewed at the bedside. These reports assist the clinical nurse specialist in reducing patient safety events, transfers to higher levels of care, sitter usage, or readmissions


Implications: Clinical nurse specialists can create reports targeting highest-risk patients in the organization and address reportable outcomes resulting in improvement in both financial and patient outcomes. This model can also bring relevance, value, and visibility to the clinical nurse specialist within the system by placing the clinical experts at the bedside of greatest need.