# “Covering provider”: an effort to streamline clinical communication chaos

## TL;DR

This paper presents a solution to reduce confusion in provider assignments by creating a standardized workflow and exclusive roles in a hospital system.

## Contribution

The novel contribution is a standardized workflow with exclusive provider roles to improve clarity in clinical communication.

## Key findings

- A standardized workflow with exclusive provider roles reduced confusion and provider identification errors.
- User satisfaction among nurses and residents increased with the new workflow.
- The workflow showed sustained uptake over time after implementation.

## Abstract

This report describes a root cause analysis of incorrect provider assignments and a standardized workflow developed to improve the clarity and accuracy of provider assignments.

A multidisciplinary working group involving housestaff was assembled. Key drivers were identified using value stream mapping and fishbone analysis. A report was developed to allow for the analysis of correct provider assignments. A standardized workflow was created and piloted with a single service line. Pre- and post-pilot surveys were administered to nursing staff and participating housestaff on the unit.

Four key drivers were identified. A standardized workflow was created with an exclusive treatment team role in Epic held by a single provider at any given time, with a corresponding patient list column displaying provider information for each patient. Pre- and post-survey responses report decreased confusion, decreased provider identification errors, and increased user satisfaction among RNs and residents with sustained uptake over time.

This work demonstrates structured root cause analysis, notably engaging housestaff, to develop a standardized workflow for an understudied and growing problem. The development of tools and strategies to address the widespread burdens resulting from clinical communication failures is needed.