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1. Develop care plan content. First and foremost, care plan content must be based on current research and guidelines. There also must be a mechanism whereby content is routinely updated. In addition, the content must represent the unique contributions of every discipline involved in patient care. And as the content is reviewed and made ready for EHR deployment, redundancies or discrepancies in care provided by the team must be identified to ensure not only high quality, but also coordinated care. 2. Integrate care plan content into an EHR. Effective integration of care plans requires the collabora- tion of the interdisciplinary team with teams from informatics and IT. This streamlines the process for deploying customized evidence-based clinical content through the EHR and to the point of care in a usable way that truly supports clinical decision making, rather than requiring tasks in the EHR that do not assist the clinician. 3. Test care plan usability. Often a missed opportunity for hospitals and health systems, each member of the interdisciplinary team should have the opportunity to test the content for its usability in their own unique care processes, as well as in the coordinated

work of the whole interdisciplinary team on behalf of the patient and family. This testing should take place prior to the system go-live. 4. Promote adoption. Interdisciplinary team participa- tion during the CDS design and development phase plays a significant role in ensuring clinical adoption. Under the leadership of the CNO, a thorough un- derstanding of the research basis for the plan-of-care content provides care team members with the “why” for practice change.

Through the use of evidence-based CDS, clinicians and healthcare systems will gain a critical opportunity to improve quality and cost outcomes. At the same time, no CDS tool will be successful if developed outside of a collaborative team.

Care is not delivered in a vacuum and therefore cannot be standardized in disjointed, solitary efforts. A hospital’s ability to thrive in the era of reform is dependent on the close, effective collaboration of nurse leaders, interdis- ciplinary clinicians and informatics and IT experts. HMT

* Hillestad R., Bigelow J., Bower A., et al. Can electronic medical record systems transform health care? Potential health benefits, savings, and costs. Health Affairs (Millwood). 2005 Sep-Oct; 24(5):1103-1117.

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