1. Banner, Laura BSN, RN
  2. Olney, Christine M. MS, RN

Article Content

Purpose: Implementation of an electronic health record system (EHRS) into healthcare settings is an inevitable change for the management of healthcare information. Due to the relative newness of EHRS, monitoring the effectiveness of EHRS is necessary to ensure that the technology enhances the care and safety of patients.


As part of its initiative to be recognized as the top heart facility in the southeastern United States, Pepin Heart Hospital and Dr. Kiran C. Patel Research Institute is implementing a clinical information system to support more efficient and effective care delivery. The overall purpose of our study was to assess the effectiveness of our newly implemented EHRS by measuring changes in efficiency, quality of care, and nurse satisfaction in a progressive cardiac care unit.


Methods:Efficiency was measured with a time-in-motion study (adapted from Wong et al, 2003). Quality of care was measured through an evaluation of chart audits in terms of quality indicators. Nurse satisfaction with the EHRS was measured using a developed instrument specifically for EHRS implementation (instrumentation development was presented at the 2005 Magnet Conference). Pre-EHRS implementation measurements of efficiency, quality of care, and nurse satisfaction were completed by October 15, 2005. Post-EHRS measurements were completed by November 5, 2006.


Results: Electronic clinical documentation improved the quality of nurse documentation in 56.6% of the indicators studied. Nurses spent less time on administrative tasks and more time on patient care activities. Researchers saw an increase in nurses' satisfaction with the quality of patient data available and with the effect of their documentation activities on patient care.


Conclusion: These results have created a framework for our organization to use in focusing its education initiatives, implementing changes in workflow and protocols, and continuing to improve the efficiency and effectiveness of nurses.


Acknowledgments: We thank Dr. Linda E. Moody, PhD, MPH, FAAN, and Laura Smith, MSN, RN, GE, Healthcare, Clinical Project Leader, for their assistance. We also thank Pepin Heart Hospital & Kiran C. Patel Research Institute, University Community Hospital; Dana Alexander, RN MSN MBA, Chief Nurse Officer; GE Healthcare Integrated IT Solutions; and Intel for funding of this project.