University of Wisconsin–Madison

Workflow Toolkit: Incorporating Health Information Technology Into Workflow Redesign

  • Overview: Health information technology (IT) provides computerized clinical information to clinicians and/or patients. These technologies have been heralded as the saviors of healthcare quality and patient safety, although evaluations of their impact on quality and safety show mixed results. Due to a lack of integration of health IT into clinical workflow, many health IT systems do not support workflows between and within organizations, within a clinic visit, nor do they support the cognitive work of clinicians. Health IT must be designed to fit the contexts of clinical practice and patient types if they are to achieve their objective. Without standard descriptions of care process workflow, organizations implementing health IT systems lack guidance about integration.

    Aims: The outcome of this contract is a toolkit that healthcare organizations and decision makers can use to help them assess their workflows and determine when and how health IT may be used.

    Findings: The Workflow Toolkit and the Final Report

    Included in the final toolkit is:

    • summaries of existing research that offers evidence on the impact of health IT on workflow, its linkage to clinician adoption, and its links to the safety, quality, efficiency, and effectiveness of care delivery;
    • a list of resources for workflow assessment in healthcare and proven workflow analysis methods and instruments used in the field of human factors and ergonomics that can be applied in healthcare settings; and
    • a synthesis of commonly used methods for workflow assessment, that includes: the purpose of each method, how to implement it, the advantages and disadvantages of each approach, and available resources for more in-depth information on each tool.

    Funding: Agency for Healthcare Research and Quality (AHRQ)

  • UW Project Team

    Pascale Carayon, PhD
    Procter & Gamble Bascom Professor in Total Quality
    Department of Industrial and Systems Engineering
    Director, Center for Quality and Productivity Improvement
    University of Wisconsin-Madison

    Ben-Tzion Karsh, PhD
    Department of Industrial and Systems Engineering
    University of Wisconsin-Madison

    Randi Cartmill, MS
    Researcher, Center for Quality and Productivity Improvement
    University of Wisconsin-Madison

    Peter Hoonakker, PhD
    Research Scientist, Associate Director of Research
    Center for Quality and Productivity Improvement
    University of Wisconsin-Madison

    Ann Schoofs Hundt, PhD
    Research Scientist, Associate Director of Education
    Center for Quality and Productivity Improvement
    University of Wisconsin-Madison

    Teresa Thuemling
    Research Specialist
    Center for Quality and Productivity Improvement
    University of Wisconsin-Madison

    Tosha Wetterneck, MD, MS
    Associate Professor of Medicine
    School of Medicine and Public Health
    University of Wisconsin-Madison

    Project Consultants

    Patricia Flatley Brennan, RN, PhD
    Lillian S. Moehlman-Bascom Professor of Nursing and Industrial and Systems Engineering
    Theme Leader, Living Environments Laboratory
    University of Wisconsin-Madison

    James Walker, MD, FACP
    Formerly Chief Health Information Officer
    Geisinger Health System, Danville, PA

    AHRQ Project Officer

    Teresa Zayas Cabán, PhD
    Senior Manager, Health IT
    Agency for Healthcare Research and Quality
    Center for Primary Care, Prevention, and Clinical Partnerships

  • Carayon, P., Cartmill, R.S., Hoonakker, P., Hundt, A.S., Karsh, B.-T., Krueger, D., et al. (2012). Human factor analysis of workflow in health information technology implementation. In Carayon (Ed.). Handbook of Human Factors and Ergonomics in Patient Safety, (2 ed., pp. 507-521). CRC Press: Boca Raton, FL.

    Carayon, P., Karsh, B-T., Cartmill, R.S., et al. (2010). Incorporating Health Information Technology Into Workflow Redesign. Summary Report, AHRQ Publication: Rockville, MD.

    Carayon, P. & Karsh, B.-T. (2010). Workflow toolkit and lessons in user centered design. Paper presented at the 2010 AHRQ Conference, Washington D.C.

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