Standardizing Emergency Department Lab Result Follow-Up Documentation Using a Task-Based EHR Workflow: A Process Improvement Project

Date of Doctor of Nursing Practice Project Completion

Spring 2026

Faculty Advisor

Juliana J. Brixey, PhD, MPH, MSN, RN, FAMIA

Abstract

Purpose: This process improvement project aimed to standardize emergency department (ED) documentation for positive laboratory culture follow-up using a task-based electronic health record (EHR) workflow.

Background: ED patients are often discharged with pending cultures requiring follow-up. At the project site, documentation workflows were manual and inconsistent across paper records and unstructured EHR entries, creating communication gaps and patient safety risks.

Methodology: Using the Plan–Do–Study–Act (PDSA) cycles, the intervention was implemented from January 22, 2025, to June 30, 2025, and included workflow standardization, staff education, Smart Phrase integration, and sustainment during staffing disruptions. Existing EHR tools (In Basket and Telephone Encounters) were utilized. A time-series evaluation and manual audit of 167 records were conducted.

Results: Task closure remained 100% across all cycles. Telephone Encounter documentation improved with education, but varied with staffing changes. Smart Phrase use was associated with improved documentation completeness. Overall documentation completion improved but remained variable.

Implications: Task-based EHR workflows can improve documentation standardization and support closed-loop communication. Sustained improvement requires ongoing reinforcement and workflow integration.

Keywords

electronic health record, documentation standardization, task-based workflow, process improvement, emergency department, lab result notification, callbacks

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