How Paper Workflows Threaten Patient Safety and Hospital Revenue

How Paper Workflows Threaten Patient Safety and Hospital Revenue

22 pages. Per patient. Per day.

That’s the average number of sheets of paper that clinicians print in the course of providing care for one patient, every 24 hours. 

This dependence on paper makes standardization nearly impossible, causes inefficient workflows, and promotes unclear or incomplete documentation.  

The EHR: So. Much. Paper.

It’s 2021. Why is so much paper still involved in providing care at modern hospitals? The answer, ironically, is related to the electronic health record (EHR).

 It’s true that the EHR is an important asset developed with good intentions. But here’s the thing about the EHR: It was designed to support billing functions rather than the clinical workflow. 

 That means that in practice, busy clinicians must rely on printouts from the EHR to manage teamwork – from jotting down tasks to tracking new symptoms to providing handoff guidance.  

 The unintended consequences of all this paper? More errors and less efficiency.

    A Paper Trail that Leads to Problems

    The problems associated with paper workflows transcend saving the trees (and saving on printing costs). 

    In essence, paper workflows limit a hospital’s ability to (1) provide safe, high-quality care and (2) operate at a sustainable margin.  

    Although the effects of paper workflows fall into these two major “buckets” – clinical risks and monetary impacts – these buckets include many sub-problems that overlap and intertwine. 

    Let’s take a more in-depth look at the problems created by paper workflows.

    Paper Workflows and Patient Safety Risks

    Communication Gaps and Clinical Errors

    The care plan is always evolving, and paper can’t keep up. Patient care is a team effort … but paper is not a team-oriented tool. Too often, it stays with individuals, trapped in pockets and easily misplaced, with 7.5% of paper documentation lost completely.

    Paper creates data silos, and crucial clinical information slips through the cracks. For example, a busy attending physician may jot down a note to check a patient’s hemoglobin. The attending is called away, and the note never makes it into the patient’s chart. Scenarios like this play out every day in U.S. hospitals.

    In fact, 70% of preventable clinical errors result from communication failures.

    Compromised Quality of Care

    A printed patient chart is inaccurate after three hours – but is typically used for up to 12 hours. That means providers routinely base important patient care decisions on outdated information. Frightening, right? This can lead to delays in care, poor outcomes, prolonged length of stay and hospital re-admission.

    Physicians deal with a daunting cognitive load. The need to remember to transcribe tasks and other patient care notes in multiple places just adds to the burden – and detracts from time spent with patients and clinical effectiveness.

    Paper Workflows and Loss of Revenue 

    Inefficient Documentation = Missed Charge Capture

    To meet EHR documentation requirements, front-line healthcare workers end up re-writing the same information in multiple places. Aside from being time-consuming, this practice often leads to incomplete documentation in the EHR … and lost revenue opportunities.

    Particularly in a large enterprise, papers slip through the cracks (or get stuck in pockets and forgotten). What happens when a diagnosis stays on paper and doesn’t get recorded in the EHR? Charge capture leakage – the diagnosis never gets coded or billed.

    Provider Turnover

    Paper workflows create additional complexity and time constraints in an already stressful environment for clinicians. Frustration and wasted time means more burnout, less time spent providing one-on-one care … and higher turnover rates. That’s an expensive problem to fix. AMA estimates that the cost of replacing one physician is $500 thousand to $1 million.

    Malpractice Claims

    As mentioned, paper workflows create silos that lead to communication failures and clinical errors. The average 500-bed hospital loses $4 million per year in malpractice claims that arise from miscommunication, reports CRICO.


    The Solution? Replace Paper with a Shared Digital Workspace

    Modern patient care is a team effort involving multiple providers across many settings. CareAlign brings team technology to healthcare. CareAlign improves team collaboration and handoffs by bringing the entire care team together in a single platform and incorporating evidence-based practices into a digital workspace. 

    CareAlign is physician-designed specifically to support clinical needs. It’s the only EHR connected application that provides a holistic view of the clinical workflow that can be accessed by all of a patient’s front-line caregivers, at any time. 

    Users have everything they need to manage their entire shift, all in one place and from any device. Collaborative rounding lists provide a place to note team tasks, shared handoffs and a dynamic care plan. 

    A Paperless Workflow Improves Patient Safety and Solves Costly Problems

    CareAlign removes paper from the clinical workflow, eliminating the need for clinicians to copy their notes in multiple places. With CareAlign, providers can write it once and use it for their rounding list, progress note and more. 

    Here’s what taking paper out of the equation does for patient safety, provider happiness, and a hospital’s bottom line:

    Improve Communication with Real-Time Access to Critical Data. . With a shared digital workspace, all members of the patient care team can make updates in real time. This enables caregivers to access the most relevant, up-to-date information on a patient. 

    Prevent Errors and Improve Care Outcomes. A patient’s entire clinical team can access up-to-the-minute progress notes, vitals, test results, medications, new diagnoses, and discharge summaries that empower informed decision-making at the point of care.

    Improve Efficiency. Caregivers can make on-the-fly updates right on their smartphones instead of wasting time printing from the EHR. And CareAlign is compatible with any EHR, which means that clinicians only have to enter data in one place, and use it multiple times one time, cutting documentation time in half. 

    Reduce Burnout. Less time spent on documentation reduces stress for time-strapped clinicians, enables more one-on-one care, and prevents burnout and related errors. 

    Improve Billing with More Complete Documentation. With CareAlign, clinicians are able to capture more diagnoses that would otherwise be trapped on paper lists. Hospitals that use CareAlign report increasing revenue by an average of $480 per admission.  



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