The nurses of Columbia Care Center (CCC), a rural Nursing Facility in Scappoose, Oregon, have identified the job stressor of consistently not being able to complete their assigned documentation duties before the end of their scheduled shift, leading to nurses reporting off to the oncoming nurse, then staying at work to complete their documentation. A root cause analysis identified that the documentation was unable to be completed during the nurse shift due to an Electronic Health Record (EHR) system being in place that lacks basic essential functions a nurse must have to allow for multi-tasking, for example, draft progress notes, auto-saving progress notes as drafts, and the ability to be within several residents records in different windows at the same time.

The inability to complete all assigned duties during a nurse shift with internal and external pressure to do so leads to decreased overall well-being, such as reduced time available to take care of basic human needs for the nurses, like getting adequate sleep, obtaining groceries, preparing/cooking food, spending time with family/friends, and taking care of personal medical needs. The proposed solution is to transition to a new EHR system that supports the multi-tasking CCC nurse; this will reduce the time wasted on progress notes and other documentation lost when a nurse is pulled away from their charting to address tasks deemed more critical at that moment.

We expect that implementing a new EHR system will lead to nurses completing their documentation before the end of their shift, enabling them to leave once they have given report to the oncoming nurse, which will have a direct positive impact on the well-being of the nurses of CCC. Naturally, transitioning to an improved EHR system will affect nurses and positively impact much of the staff, including Certified Nursing Assistants and Certified Medication Aids, Activities, Social Services, Dietary, Administration, Medical Records, and outside providers. Nurses will benefit from improved coordination between departments, and the intuitive processes and ease of use will bring less reliance on nurses to provide other departments with records they may need from the EHR as they can obtain them independently with the appropriate training. The nurses will measure success, perceived time spent after their scheduled shift completing the required documentation, and the nurse’s numerical rating of their overall well-being.