Optimizing Nursing Care Plans Through EHR Migration: A Crosswalk for an
EHR Implementation in a Major Healthcare System
Eric Wyatt, BSN, RNC-NIC, MSN-HCI Student
Faculty advisor: Brenda Boone, PhD, RN, NEA-BC
BACKGROUND
• Healthcare organizations depend highly on electronic health record (EHR)
systems to record and aid in care delivery (Barrett, 2018).
• Care plans are an important feature within EHRs
(George et al., 2021).
▪ Capture nursing interventions
▪ Assist in coordinating care
▪ Promote interdisciplinary collaboration
• This is especially true for patients in the neonatal intensive care unit
(NICU) (Vos et al., 2020).
• When an organization transitions from one EHR to another, it is important
to maintain standards of care (Colicchio et al., 2018).
• A crosswalk is a process by which a comparison is conducted of similar
information or functionality across two systems (Huang et al., 2020).
Optimizing Nursing Care Plans Through EHR Migration: A Crosswalk for an
EHR Implementation in a Major Healthcare System
Eric Wyatt, BSN, RNC-NIC, MSN-HCI Student
Faculty advisor: Brenda Boone, PhD, RN, NEA-BC
PURPOSE
• A major healthcare system in Southern California with three NICUs
representing 109 beds changed from one EHR to another.
• Care plans are an important part of the EHR because of their
potential to promote interdisciplinary collaboration and capture
important nursing interventions (Cuttini et al., 2020).
• Migrations between EHRs can be challenging for healthcare
organizations to implement and may disrupt continuity of care
(Colicchio et al., 2018).
• Because an EHR plays a vital role in any healthcare organization,
ensuring that its functionality aligns with the organization’s
standards of care is an important component of an EHR migration
(Rossi et al., 2022).
• Crosswalks with relevant stakeholders of every clinician-facing
functionality can ensure a smooth transition between EHRs (Huang
et al., 2020).
Optimizing Nursing Care Plans Through EHR Migration: A Crosswalk for an
EHR Implementation in a Major Healthcare System
Eric Wyatt, BSN, RNC-NIC, MSN-HCI Student
Faculty advisor: Brenda Boone, PhD, RN, NEA-BC
PROJECT APPROACH
• A crosswalk was done to
compare care plans between
EHRs and categorize
interventions to identify
discrepancies and gaps.
• Stakeholders, including clinical experts and EHR
representatives, collaborated to review and validate care
plan content, ensuring any modifications were aligned with
organizational standards and clinician needs.
Optimizing Nursing Care Plans Through EHR Migration: A Crosswalk for an
EHR Implementation in a Major Healthcare System
Eric Wyatt, BSN, RNC-NIC, MSN-HCI Student
Faculty advisor: Brenda Boone, PhD, RN, NEA-BC
DISCUSSION
Evaluation of EHR Functionality
• Stakeholders assessed destination EHR's care plan functionality to be more
concise, organized, and user-friendly than the legacy EHR.
Consensus on Modifications
• Stakeholders felt that the care plan functionality aligned well with standards
of care and that only 10 modifications were required within the nursing
interventions of 6 subsections (or problems).
Impact on Clinical Practice
• Stakeholders felt that the documentation options within the care plan
functionality would streamline documentation processes and enhance staff
compliance.
Organizational Standards
• Stakeholders felt that the destination EHR supports the healthcare's
organization's mission, vission and core values with the ultimate benefit of
potentially improving patient outcomes.
Optimizing Nursing Care Plans Through EHR Migration: A Crosswalk for an
EHR Implementation in a Major Healthcare System
Eric Wyatt, BSN, RNC-NIC, MSN-HCI Student
Faculty advisor: Brenda Boone, PhD, RN, NEA-BC
OPPORTUNITIES & NEXT STEPS
• Ensure that NICU leaders guide and support staff in
effectively navigating and utilizing the care plans that
promote quality documentation.
• Collect feedback from clinicians who utilize care plans
and leverage their input to identify further areas for
improvement.
• Commit to continue monitoring the use of the care
plan feature and assess whether its use aligns with
regulatory requirements and promotes compliance.
• Evaluate the impact of the care plans on patient
outcomes and interdisciplinary collaboration using
performance indicators to measure effectiveness.
Optimizing Nursing Care Plans Through EHR Migration: A Crosswalk for an
EHR Implementation in a Major Healthcare System
Eric Wyatt, BSN, RNC-NIC, MSN-HCI Student
Faculty advisor: Brenda Boone, PhD, RN, NEA-BC
REFERENCES
Barrett, A. K. (2018). Electronic health record (EHR) organizational change: Explaining resistance through profession,
organizational experience, and EHR communication quality. Health Communication, 33(4), 496–506.
[Link]
Colicchio, T. K., Del Fiol, G., Scammon, D. L., Facelli, J. C., Bowes, W. A., & Narus, S. P. (2018). Comprehensive methodology
to monitor longitudinal change patterns during EHR implementations: A case study at a large health care delivery
network. Journal of Biomedical Informatics, 83, 40–53. [Link]
Cuttini, M., Forcella, E., Rodrigues, C., Draper, E. S., Martins, A. F., Lainé, A., Willars, J., Hasselager, A., Maier, R. F., Croci, I.,
Bonet, M., & Zeitlin, J. (2020). What drives change in Neonatal Intensive Care Units? A qualitative study with physicians
and nurses in six European countries. Pediatric Research, 88(2), 257–264. [Link]
George, R. R., Winden, T. J., Manos, L., Herrman, A., Campos, M., & Dittrich, C. B. (2021). Improving coordination during
care transition between ambulatory and inpatient care facilities: Evaluating the utilization and scope of EHR facilitated
longitudinal plan of care. International Journal of Nursing Education, 13(3), 153–160.
[Link]
Huang, C., Koppel, R., McGreevey, J. D., Craven, C. K., & Schreiber, R. (2020). Transitions from one electronic health record
to another: Challenges, pitfalls, and recommendations. Applied Clinical Informatics, 11(05), 742–754.
[Link]
Rossi, L., Butler, S., Coakley, A., & Flanagan, J. (2022). Nursing knowledge captured in Electronic Health Records.
International Journal of Nursing Knowledge, 34(1), 72–84. [Link]
Vos, J. F., Boonstra, A., Kooistra, A., Seelen, M., & van Offenbeek, M. (2020). The influence of electronic health record use on
collaboration among medical specialties. BMC Health Services Research, 20(1). [Link]
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