Overcoming Care Plan Obstacles

In response to the emergence of outcomes-based reimbursement models, many healthcare organizations are deploying tools to provide clinicians with the best available medical evidence at the point of care, including access to scientific methodology, best practices and clinical decision support. While order sets often dominate the discussion of clinical decision support tools, evidence-based care plans also play a critical role in care standardization. In fact, care plans that address nursing and other disciplines are required by the Joint Commission and CMS for provider certification.

For years, care plans have been used by nurses to identify expected outcomes and strategies for care. But they have seen their fair share of obstacles when it comes to adoption and use at the point of care.

Paper Problems

Health professionalFor example, paper-based care plans require a great deal of collaborative writing and editing to complete, which is complicated by the cumbersome formatting processes that must be addressed. Keeping care plans current with the latest evidence is also a challenge. As a result, paper-based care plans are rarely updated, as noted by a focus group conducted by Wolters Kluwer Health which indicated some hospitals’ care plans had not been updated since 1999.

Even once they are in place, electronic and paper-based care plans face an uphill battle. Because templates often go years without updating, many nurses don’t trust the content. Others reject care plans simply because they are resistant to change.

Mired in Maintenance

Nurses often don’t have time to adequately address care plan maintenance. They also acknowledge the difficulty they encounter interpreting and applying research findings, noting that research is “too complicated, too scholarly, excessively statistical, and ambiguous.”

Care plan content management systems streamline the time-consuming processes of drafting and customizing care plans by providing the interdisciplinary team with a library of predefined care plan templates. Features such as prebuilt links to the latest evidence-based guidelines provide clear parameters for effective patient care, which has been proven to reduce work stress for nurses.

Content and Collaboration

These systems also simplify the process by which care plans are reassessed and updated. For example, once a care plan has been approved and released within the EHR, authors can use reassessment rules within the care plan tool to set up alerts when it is time to review and reassess that particular care plan. Authors are then notified via email when their plan is due for reassessment, thus mitigating the risk that care plans will go years without updating.

Electronic care plan management systems also allow organizations to define a standard review-and-approval process for care plans. By providing a central web portal for the interdisciplinary team to collaborate and fine-tune details of each care plan, the system eliminates the need for large group meetings.

Overall, care plan management technology helps eliminate the obstacles to broad adoption and use by enabling current, concise evidence and cross-discipline collaboration when authoring care plan templates. By providing nursing staff with a database of evidence-based care plans that can be put into the EHR system, hospitals can position clinicians across the care continuum to meet the quality expectations of the future.


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