Ask the Nursing Expert about ... EHR transitions

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Judi Kulus, VP of Curriculum Development, AADNS
Judi Kulus, VP of Curriculum Development, AADNS

My company just announced the purchase of a new electronic health record system. As the director of nursing, how can I smooth the nursing department's transition to it?

Nothing, except maybe surveyors walking in, could be scarier and more disruptive to the nursing department than an overhaul of the medical record system.

As a nurse leader, you play a key role in advocating for nurses' needs. Ask to be involved in the development of the project charter, which precedes creation of the project plan and generally lists team members, risks, key stakeholders, assumptions, deliverables, milestones, scope, objectives, problem statement and mission statement. 

Next, play an active role in the project plan. Designate a nurse informaticist to represent the nursing perspective with the software company. Having the right person in this role will help tailor the software to your residents' care needs as much as possible. Find out what types of clinical decision support protocols are possible, ensure that they are evidence-based, and review them with the medical director and quality assurance agency team.

Figure out how the new system will impact workflows. Ask the informaticist to work with the nursing team to create a workflow diagram; this will help identify gaps and ine‡fficiencies, minimize surprises, and establish a quality training program for staff . Anticipate frustrations from staff and keep a positive attitude. Using an effective change-management process will help ensure buy-in from your team.

While new software offers the potential for more e‡fficient charting, better QAA reporting, reduced medical errors, and sophisticated dashboards, the transition itself is never easy. Your leadership during the implementation of new software is critical to its success.

Please send your nursing-related questions to Judi Kulus at