PATIENT

Patient calls for an

appointment
NO NO
Dental
Admission? services? Check-up?

Emergency?

Patient arrives at
ASF Hospital
TRIAGE
NURSE
Triage nurses record all
Ascertains clients’
clients who went
service and
through him/her in a
provides them
triage logbook, where
instructions about
the names of the clients
what to do next.
are written down
according to the
services
DENTAL
NURSE

Client receives a dental Another nurse will

priority number and are receive the client and Nurses in the dental Forwarded for
directed to proceed to conduct initial evaluation department write down the records room
the dental section. and vital signs taking. all the clients who for sorting and
received dental services storage.
in the dental logbook.
OPD
NURSE

nurse creates Record number is kept in a

Does the
Clients are directed to a new record logbook. New record numbers are
client have
the OPD receiving area a record?
and assigns a listed in the logbook by the nurse
new record who makes a new record to a
number to the new client and assigns a new
record number to the client.

Nurse retrieves record

Forwarded for the
records room for

Nurse conducts
initial assessment The client is OPD nurses write down
accompanied to the lab OPD clients’ record entry
for specimen in the OPD logbook where
extraction. the chief complaint,
records the client’s chief diagnosis, and treatment
complaint, takes vital modalities are listed.
signs and anthropometric Lab request form sent to
measurements Lab dept.

nurse performs final

health education and
accompanies and instruction to the client
The nurse then carries
endorses the client to
out the orders
the physician
ER NURSE

new admission
Clients are directed to the Are they made
record is produced to sign a HAMA
emergency department
and filled out while form?
together with their records
the nurse carries out
and are received by the ER Sent home
the admission order
nurse.
number to the
client.
The patient is wheeled

Client is
ER nurses are in charge of
immediately
the admission logbook,
wheeled to the
Refers client in where entries for clients
emergency room.
advance who are admitted are
recorded.

Admitted Treated as Referred to Are there Client is asked for

emergency higher vacant a new hospital of
OPD case institution rooms? choice. The
patient is then
brought to the
Calls the hospital referral hospital.
Nurse prepares of patient’s choice
once the condition is a referral form
stabilized are later
sent home on the
same day

The record of
once the condition is once the condition is the client is
stabilized are later stabilized are later retrieved, and
sent home on the sent home on the the ER form is
same day same day attached
PROVIDE
R

The dentist then sees the Physician then performs Once the lab results are
client to assess the type the checkup and sends ready, these are
of dental service the the patient back to the forwarded to the

Due to the pandemic,

only tooth extraction
services is offered by the
dental department.
1. Nurses receiving clients from the triage section have to re-conduct the initial interview to ascertain the health concern of

the client. Oftentimes, clients complain that they must explain themselves again after explaining their concern to the triage

nurse just a few minutes ago.

Nursing informatics can address this concern by improving Patient throughput which is the movement of patients from one

part of a healthcare delivery system to another. There can be many initiatives aimed to improve patient throughput, one of which is

Six Sigma or Lean with information technology to yield data, which can inform processes and assess effectiveness of changes in

throughput. This software solution improves the scheduling of procedures and surgeries and locate equipment using electronic

monitoring. This can monitor for hourly rounding and countless other activities that can be used to understand and improve

throughput.

2. Some clients in the dental department have to leave the hospital unattended because only tooth extraction is offered.

They complain that it was a waste of time having to enter the hospital and wait for nothing.

Nursing informatics can address this workflow problem by incorporating a type of hospital management system which is, the

patient portal. One example of this is MedFusion. Patient portals provide a platform where patients can access their health-related

data using any device. It includes all the information stored in an HER and it also allow users to schedule appointments, view bills,
and make payments online. So instead of having to wait in line for hours to schedule an appointment, a patient can now simply log in,

check their doctor’s availability and also, have a look at their lab reports.

3. OPD clients complain that OPD nurses are often not in their posts because they seem to be wandering around. There is

an increase in client waiting time in the OPD because of the absence of the OPD nurse in the OPD area. OPD nurses

mention that the reason for this is the amount of work they have to do which involve walking to different areas of the

hospital. They retrieve client records, accompany clients to doctors’ offices, forward lab requests, etc.

This indeed affects workflow. But with the help of Nursing Informatics, specifically an electronic health record (EHR) such as

CureMD or Care360, this problem can be addressed. Instead of having to document every medical detail of the patients on paper.

Doctors and Nurses can simply fill out all the information on the EHR system. Additionally, it can be accessed instantly using a

mobile or computer and enables doctors to easily share data across different departments, allowing them to stay on post and not

wander around. Hence, EHR increases efficiency by eliminating paperwork and giving immediate access to patients’ data and

improves the quality of patient care.

4. Creating new records for new clients and recording them in the record logbook takes a lot of time.

This inefficiency in workflow can be addressed with the use of Information Technology such as Master Patient Index (MPI).
This software aims at connecting patient records from more than one database. Instead of creating new records for new clients and

recording them in the record logbook, nurses can now electronically enter data regarding their patients. Once stored, it can be used

for future references by any institute sharing the database. This MPI creates an index of all medical records for a specific patient,

which is easily accessible by all departments. Hence, it reduces duplication of patient records and provide timely and efficient care.

5. There are cases of misassessment in the ER because nurses spend too much information in the creation of ER records.

They spend less time in the assessment of the patient because of this.

This can also be addressed by Master Patient Index (MPI) as it aims at connecting patient records from more than one

database and reduces the time in creating records thus increases time for assessment of the patient. It reduces duplication of patient

records and also to avoid inaccuracy of information that can result in wrong treatment.

6. Retrieval of records from the records room in ER cases is time-consuming. ER nurses have to walk from the ER to the

records room to retrieve records. There have been reported cases where the ER nurse is not around to attend to patients

arriving in the ER because the nurse is retrieving records from the records room.

This inefficiency in workflow can also be addressed by EHRs. EHR’s allows centralized chart management, quicker access to

patient information from anywhere, faster and trackable communication with other clinicians, insurance providers, pharmacies and
diagnostic centers hence, ER nurses can attend to patients and do not have to walk from the ER to the records room to retrieve

records. The features of EHR generate significant time savings, leading to greater productivity.

7. Recording on logbooks are very prone to errors and is time-consuming. Nurses complain of the redundancy of having to

input the same data in different places.

This inefficiency can also be addressed by Master Patient Index (MPI). The problem of recording on logbooks and having to

input the same data in different places can now be recorded through entering data on MPI. Once stored, it can be used for future

references by any institute sharing the database. This MPI creates an index of all medical records for a specific patient, which is

easily accessible by all departments, hence eliminates redundancy of having inputting same data in different places and reduces

time in creating logbooks and avoid inaccuracy of information that can result in wrong treatment.

8. Nurses complain that physicians’ handwriting is difficult to read and will have to consult the physician for clarification.

Sometimes, errors occur in transcribing medications.

Nursing informatics can address this workflow problem through E-prescribing software. One of the best examples of e-

prescribing software is DrFirs.. Errors in transcribing medications due to failure in deciphering the physicians hand writing can be

avoided as it enables doctors to generate prescriptions electronically. It allows them to directly send prescriptions to the pharmacy in

just a few clicks, and when the patient gets there, the store is already ready with their supplements.
9. It takes time having to wait for lab results and pasting them in client records. Patients suggest performing laboratory

procedures before the day of the consultation.

This inefficiency can also be addressed by Patient Portal. One good example is MedFusion. Instead of having to wait for lab

results and pasting them in client records, this software provides a platform where patients can access their health-related data using

any device. Patients can now simply log in, and have a look at their lab results.

10. Patients tend to not show up during follow up consultations because they either forget their schedules, or lose the

appointment slips.

Nursing informatics can address the workflow problems through the use of Urgent care application. It is a type of health

management information system that keeps track of patients that might require immediate attention. It provides patients with

knowledge about health-related queries, informative health articles, and even let them track their medical care status, hence

increasing the rate of patients showing up during follow-up consultations.

11. There is no system for monitoring the admission status of clients who are admitted coming from checkup. Nurses have

to call the doctor to inform that the patient was wheeled to the room already.
 This inefficiency can be addressed because according to one study, EHR contributes to more efficient admission decisions
and reduces the number of avoidable admissions. Hence, EHR is a system that can monitor the admission status of clients from
check-up. And because it enables doctors to easily share data across different departments, they are able to provide quick and
accurate treatment and improves the quality of patient care since the same information is shared across all departments.

12. Nurses complain to not have enough resources to be able to conduct health education to clients. They mention that the

time for them to prepare their health teaching for patients coming from checkup is so short that they are not able to

research and prepare what to teach the patients.

This inefficiency can be addressed by Journey PX. The struggle to provide the best possible care to patients because of a

lack of proper patient education tools and language barriers can make it incredibly difficult to provide patients with the knowledge and

instructions they need to ensure that treatment is as effective as possible. Thus, this innovative software system can address this

inefficiency. It is easy to implement into virtually any facility, especially with assistance from the talented team of professionals at

MDM Healthcare.
PATIENT
Patient calls for an
appointment
NO NO
Dental
Admission? services? Check-up?

Emergency?

Patient arrives at
ASF Hospital
TRIAGE
NURSE
Triage nurses record all
Ascertains clients’
clients who went
service and
through him/her in a
provides them
triage logbook, where
instructions about
the names of the clients
what to do next.
are written down
according to the
services
DENTAL
NURSE

Client receives a dental Another nurse will

priority number and are receive the client and Nurses in the dental Forwarded for
directed to proceed to conduct initial evaluation department write down the records room
the dental section. and vital signs taking. all the clients who for sorting and
received dental services storage.
in the dental logbook.
OPD
NURSE

nurse creates Record number is kept in a

Does the
Clients are directed to a new record logbook. New record numbers are
client have
the OPD receiving area a record?
and assigns a listed in the logbook by the nurse
new record who makes a new record to a
number to the new client and assigns a new
record number to the client.

Nurse retrieves record

Forwarded for the
records room for

Nurse conducts
initial assessment The client is OPD nurses write down
accompanied to the lab OPD clients’ record entry
for specimen in the OPD logbook where
extraction. the chief complaint,
records the client’s chief diagnosis, and treatment
complaint, takes vital modalities are listed.
signs and anthropometric Lab request form sent to
measurements Lab dept.

nurse performs final

health education and
accompanies and instruction to the client
The nurse then carries
endorses the client to
out the orders
the physician
ER NURSE

new admission
Clients are directed to the Are they made
record is produced to sign a HAMA
emergency department
and filled out while form?
together with their records
the nurse carries out
and are received by the ER Sent home
the admission order
nurse.
number to the
client.
The patient is wheeled

Client is
ER nurses are in charge of
immediately
the admission logbook,
wheeled to the
Refers client in where entries for clients
emergency room.
advance who are admitted are
recorded.

Admitted Treated as Referred to Are there Client is asked for

emergency higher vacant a new hospital of
OPD case institution rooms? choice. The
patient is then
brought to the
Calls the hospital referral hospital.
Nurse prepares of patient’s choice
once the condition is a referral form
stabilized are later
sent home on the
same day

The record of
once the condition is once the condition is the client is
stabilized are later stabilized are later retrieved, and
sent home on the sent home on the the ER form is
same day same day attached
PROVIDE
R

The dentist then sees the Physician then performs Once the lab results are
client to assess the type the checkup and sends ready, these are
of dental service the the patient back to the forwarded to the

Due to the pandemic,

only tooth extraction
services is offered by the
dental department.