Optimizing and Understanding the Basics of Clinical Workflows

Healthcare systems need to provide effective patient care in efficient and optimized ways. Healthcare providers require access to clear healthcare analytics, alerts, and the latest evidence in real-time so that they can optimize and personalize clinical decisions while reducing staff burnout and improving patient outcomes.

Building a streamlined and optimized clinical workflow can help organizations bring efficiency and accuracy into clinical systems. The right clinical workflow solutions can be of immense help in setting up effective clinical workflows that can standardize the decision-making process and provide evidence-based information at the point of care.

Read on to understand what a clinical workflow is, and efficient clinical workflow management methods. 

What is a Clinical Workflow?

A clinical workflow or a clinic workflow may be defined as a process that involves a series of tasks performed by various people within and across work environments to deliver care. Accomplishing each task in the clinical workflow may require action from one person or a group of people working across multiple organizations, and can occur sequentially or simultaneously. A study conducted by National Centre for Biotechnology Information revealed that there were 4 key workflow phases in a hospital workflow.

The phases in a clinic workflow are –

Identifying patients needing integrated care

For identifying patients that require integrated care, healthcare providers use medical and behavioral health screening tools that identify patient needs. Patient screening intervals need to be based on standards and protocols within the healthcare system. Healthcare providers also need to schedule regular team huddles to review the clinical schedule and strategize around patient care. To accomplish all these tasks, the team requires an Electronic Health Record (EHR) system and proper documentation protocols for screening integrated care data. 

Engaging patients and transitioning to the integrated care team

This phase involves the development of protocols for transitioning patients between integrated care team members, namely, primary care clinicians, behavioral health, and other supportive staff. Healthcare providers also need to develop methods and physical structures that enable behavioral health and primary care clinicians to quickly brief each other about patient needs. A shared EHR system enables seamless sharing of patient information across care providers. 

Providing integrated care treatment

Healthcare providers need to conduct rapid assessments and determine the appropriate level of patient care, in order to provide tailored, problem-focused treatments to patients. They also need to facilitate additional linkages using established clinical pathways to provide additional services like traditional mental health, substance use treatment, or psychiatry. 

Monitoring immediate treatment outcomes and adjusting treatment

During the course of providing routine primary care, you need to follow up with the patients on their appointments and schedules. The clinical workflow must include a framework that identifies when the patient’s treatment needs to escalate to higher levels or specialty health services. Complete details on the treatment plan including relevant adjustments in level of care, and patient encounter details need to be recorded in the EHR system. 

Leading healthcare technology and cloud solutions embedded into clinical workflows can transform the healthcare experience and health outcomes of patients. Clinical workflow solutions like clinical workflow automation standardize the clinician decision-making process and provide evidence-based information at the point of care.

Automating the clinical workflows also empowers patient partnerships, alleviates the burden of clinicians and support staff, and accelerates administrative processes. Mapping the clinical workflow helps identify existing inefficiencies, influence care decisions, and minimize health inequities. 

When manual systems are used for gathering clinical data and running clinical systems, health, and patient information is siloed, unstructured, and difficult to access. Siloed clinical systems create work barriers and impede evidence-based decision-making.

Health organizations with optimized clinical workflows can achieve better resource utilization, streamlined communications, smoother patient experiences, lower infection rates, resource efficiencies, and improved patient health outcomes. From data operability to surveillance – clinical workflows can support building optimized workflows that enable informed decision-making and improved health outcomes.

Types of Clinical Workflows

A clinical workflow includes all those steps and interactions that occur between staff and patients. Each clinical workflow works within a multidisciplinary team that spans multiple facets of healthcare. For example, a clinical workflow for a wound care nurse could include the following steps –

• Chart review
• Wound assessment
• Communication with other disciplines
• Wound care delivery
• Education for the caregiver on carry-over and follow-up

Several systems support a clinical workflow, including, electronic health records, mobile computer stations or laptops, instant messaging services, and wound care timing alerts. Depending on the activities, organization, environment, people, and technologies, clinical workflows can be classified into 4 types. 

1. Inter-organizational workflow

These workflows facilitate communication between a practitioner and an emergency physician. Sharing of health information about a given patient can be efficiently carried out with the help of an inter-organizational workflow. The workflow between the patient’s primary physician and the pharmacist, for example, must complete information about the treatment and medicines to prepare and provide to the patient. 

2. Clinical-level workflow

These workflows relate to the flow of electronic or paper information related to the patient’s healthcare. Clinical-level workflows are created within clinical practice, or in general between professionals such as nurses, doctors, and patients as well. 

3. Intra-visit Workflow

The intra-visit workflow is related to patient consultations. The rules and protocols established by the facility need to be followed by the intra-visit workflow. 

4. Cognitive workflow

The cognitive workflow is part of the process that happens in the mind. The cognitive process is an integrative component for developing expert decision-based actions. This workflow is an important part of modern medicine. 

Clinical workflows are meant to serve as clinical decision support (CDS) that compares patient data with the data within a computerized data source for targeted recommendations. There are diverse forms of CDS systems, from knowledge-based to non-knowledge based.

Knowledge-based systems use “if-then” statements, while non-knowledge systems may use clinical workflow automation based on advanced technologies like artificial intelligence, machine learning, or statistical pattern recognition. Some of the capabilities that clinical workflow automation brings to hospital workflows are –

• Follow up with clinicians for scheduling testing or patient follow-up for appointments
• Aid in coding, administrative tasks, and patient triads
• Identify cheaper medications and better insurance coverage options

Need for Assessment of Clinical Workflows

Manual hospital workflows are ridden with redundancies and inefficiencies that can be addressed by automating the clinical workflow. To know how to improve clinic workflow requires knowledge of when and how to assess workflows. A workflow assessment should be one of the first steps in implementing a process improvement initiative.

A clear understanding of how clinical work is done makes it possible to identify potential issues and inefficiencies. Mapping out existing workflows also ensures that new initiatives do not interfere with the current workflows of clinicians or other professionals. BPM healthcare workflows need to be reviewed regularly to remain effective and efficient. The frequency of reviewing a clinical workflow depends on the practice setting but should be conducted annually at least, if not more often. 

Why should you assess clinical workflows? 

• To spot the most frequent, error-prone, and the most time-consuming tasks in a clinical workflow, you need to evaluate the flow. 
• To identify potential problems and areas of improvement that can be made to decrease unwarranted clinical variations.
• To assess the cost and quality implications of the small clinical workflow changes. 
• To foster the integration of data across clinical systems that are scattered across healthcare organizations for informed decision-making
• To come up with solutions for standardizing clinical workflows and adopting automation solutions. 

How to Assess Clinical Workflows

How to assess a hospital workflow? Assessment of workflows can be carried out in different ways, one method is to use observations, interviews, or focus groups to understand the perspectives of the current workforce. This method helps understand the clinical workflow from the current staff’s perspective and identify potential problems and inefficiencies.

Although these methods gather the perspective of clinical staff, they run the risk of bias due to the subjective nature of the survey. Some of the other assessment methods that are more quantitative and objective are-

1. Log file analysis

EHR log files are used for analyzing a clinical workflow. These audit logs can be a valid source for clinical workflow analysis by providing an objective view of clinicians’ behavior, multi-dimensional comparisons, and a highly extensible analysis framework.

2. Time-motion studies

Time motion studies are considered the golden standard for clinic workflow analysis. These studies can be used to ascertain how long it takes for a skilled person to complete a task with a specific level of quality. Time study helps in the selection of different job execution options, and also in determining the workforce required for a certain task. T&M study is considered the most reliable approach for assessing the impact of health IT implementation on clinical workflows. 

3. Computational ethnography

This analysis method is used when assessors use data already collected by computerized processes for analyzing workflows. Although these methods provide a more objective understanding of clinical workflows, they do not have the subjective input from clinicians that is useful in identifying potential or current issues in clinical workflows.

4. Benchmarking

This workflow analysis method involves the evaluation of best practices of other organizations. For benchmarking analysis, you need to communicate with peers in similar organizations that are considered successful in the objective being analyzed and determine whether these lessons can be applied to clinical workflows within clinical workflows in your organization.  

5. Check sheets

This is a structured way of analyzing clinical data about a specific work or function. Check sheets are highly useful in documenting observational data about specific tasks in a workflow. 

Flowcharts or process maps

Flowcharts have been used for a very long time to analyze or map out a workflow. A flowchart visually demonstrates specific steps in a work process that is arranged sequentially. Users can get a good understanding of the overall process and identify improvement areas with the help of a flow chart. 

The most effective way of assessing clinical workflows is to adopt a method that combines qualitative and quantitative methods. Such comprehensive analysis methods help healthcare organizations and interdisciplinary teams understand the objective clinical workflows and clinicians’ subjective perspectives and opinions. 

How to Improve Clinical Workflows?

While we focus on improving clinical workflows, we need to bear in mind the inherent limitations within the workflows first. 

Eliminating waste from clinical workflows

Improving clinical workflows is all about eliminating waste. More than dictating how clinical staff carry out their work, clinical workflow improvements must eliminate redundancies and automate repetitive steps. Healthcare workflow automation is the most effective way to eliminate redundancies and accelerate clinical workflows. 

Updating communication systems

One of the biggest drains of productivity in healthcare is siloed systems that do not talk to each other. Healthcare systems are among the slowest in adopting modern communication systems, mainly due to the scale and complexity involved in implementing advanced communication systems.

Improvement of clinical workflows should, therefore, begin with replacing these outdated systems with modern communication systems that are mobile-friendly. Making this transition will reduce wait times and ease bottlenecks that slow down the patient flow, accelerate admissions and discharge, enable faster clinical decisions, improve patient safety, and achieve better patient outcomes with fewer readmissions. 

Incorporating leading health technology and cloud solutions into clinical workflows can transform the healthcare experience and health outcomes of patients. Clinical workflow solutions can standardize and optimize clinical workflows by integrating siloed systems for a single source of truth.

Siloed, unstructured, and difficult-to-access patient and health data systems can be integrated seamlessly by clinical workflow automation. Healthcare organizations with optimized clinical workflows can achieve better bed utilization, streamlined communication, smoother patient journeys, and improved patient health outcomes. 

How to Automate a Clinical Workflow

Enhanced patient automation and self-service bring a high level of personalization into clinical workflows. Clinical workflow automation optimizes the time and efforts of clinical staff and increases the scope of patient engagement outreach. Here is a guide to clinical workflow automation. 

1. Use value-stream maps

Visual mapping helps understand the process better and spot opportunities to improve workflows. Value-stream maps are useful for pinpointing workflow process improvement potential. The concept of value stream mapping is simple and highly effective in identifying the complete process flow for various conditions. A value stream map can be used for evaluating the flow and determining the best practice for each task in the workflow. 

2. Analyze each step

Every step in the value stream map must be analyzed to identify waste and repetition. While analyzing each step in the workflow, ask yourself whether that step adds value to patient care. Mark each step to indicate whether it delivers value or not. 

3. Identify dependencies and peripheral effects

A workflow is rarely completely independent of other processes in the practice. In the majority of cases, one activity will overlap or depend on the execution of another activity or process. Automation of clinical workflows must be done by factoring these interdependencies between clinical workflows. 

4. Leverage technology to streamline and automate tasks

Communication and patient care can be turned around by using the right technology for automation. The clinical workflow solution must accelerate clinical workflows and ensure that they deliver top-notch patient care by optimal use of resources. A workflow automation solution like Cflow helps healthcare organizations improve the quality of patient care and resource utilization. The dependency on paper documentation can be brought down by using a no-code BPM solution like Cflow. 

5. Review and monitor

Once the automation solution is implemented, you need to review the performance of the automated workflow regularly.  Establish key performance indicators (KPIs) that help measure the performance of the automated clinical workflow. Based on the performance metrics, you can fine-tune the workflow to achieve the expected outcomes. 

Clinical Workflows that are Prime for Automation

Not all workflows are suitable for automation. Some of the clinical workflow examples that are suitable for automation include:

Appointment scheduling process

Patients expect a seamless experience when it comes to healthcare. An automated appointment scheduling system helps patients book appointments by themselves, which saves a lot of time, and makes scheduling more efficient. 

Patient admission and discharge process

This is one of the clinical workflows that entails voluminous paperwork and data entry and verification. By automating the patient admission and discharge process, you can further simplify the process and save medical staff from the manual burden of filling out forms and creating bills. A medical assistant workflow enables clinical staff to manage the admission and discharge process efficiently. 

Health record management

Proper updation and maintenance of patient data is a must for regulatory compliance and the delivery of efficient healthcare. An automation solution integrates the EHR platform so that you can automatically transfer lab reports and other information into the EHR for accurate diagnosis and treatment. 

Patient communication

Patient-healthcare provider communication happens throughout the healthcare journey. Automation helps improve patient engagement with the help of call reminders, email automation, and SMS to share self-care tips and treatment options. 

Staff and doctor onboarding

Hiring the right staff and clinicians and onboarding them is a time-consuming process. Automating the onboarding process can save the time and effort involved in form filling. 

Conclusion

Healthcare organizations are better off automating critical clinical workflows for improved efficiencies. Clinical workflow automation not only reduces staff burnout but also improves patient outcomes significantly. Automating the clinical workflow with a no-code workflow automation solution like Cflow provides several benefits to healthcare organizations.

For starters, you don’t have to write a single line of code to create workflows. All you need to do is drag and drop the workflow elements as per the requirements of the clinical workflow you are designing.

You can start exploring Cflow right away by signing up for the free trial. We are all ears! Just tell us your requirements and we’ll create fully customized workflows for you!