BACKGROUND: Optimal use of Guideline Directed Medical Therapy (GDMT) is the cornerstone of reducing mortality and morbidity in heart failure patients with reduced ejection fraction (HFrEF). Interventions targeted at increasing GDMT use are necessary to improve outcomes. Integration of a pharmacist in specialty clinics may improve GDMT use; However, the potential benefit may be underrealized due to constraints in technology use and workflow.
PROJECT INTENT: To understand existing processes and explore workflow optimization opportunities to enhance use of GDMT prescription for patients with HFrEF.
METHODOLOGY: Teams of 2 researchers performed contextual inquiry4 during in-situ, 2-hour observations with 5 physicians, 3 nurse practitioners and 1 pharmacist, with attention to workflow during patient visits and interaction with a mock patient record (with HFrEF) in the EHR.
RESULTS: Proposed solutions based on the following identified challenges (see figures): 1) communication gaps, 2) unorganized data, 3) variable workflow, which contribute to redundancy in workflow.
CONCLUSIONS: Workflow standardization and EHR documentation should be optimized together for process improvement. The design and workflow recommendations could be applied to care plans for other conditions and clinical domains.
2020 American College of Cardiology Quality Summit
Robertson, Roy MD; Ahmed, Ryan; Toscos, Tammy PhD; Cornet, Victor P. MS; Wagner, Shauna; Colletta, Sarah; Daley, Carly; and Mirro, Michael MD, "Technology and workflow recommendations to improve use of guideline directed medical therapy for heart failure with reduced ejection fraction." (2020). Health Services and Informatics Research. 30.