Clinicians do not surface EHR friction until it causes a workaround | Healthcare & Life Sciences

What it costs you today

Your clinical team has found workarounds for several recurring EHR workflow problems. Those workarounds are now standard practice. Nobody officially reported the original problem because reporting takes time and nobody was sure it would change anything. The workaround introduces compliance and documentation risk that nobody in leadership knows about.

How RadRoot is used here

RadRoot runs a quarterly anonymous pulse with clinical staff. Five questions about where the EHR is getting in the way, what workarounds have become routine, and how confident they are that the right information is being captured.

The file you would upload

A Epic EHR - Active Employee Roster export. One row is one clinical staff member. RadRoot reads the whole row, so every question can name something the person already knows is true.

Employee ID	Staff Name	Job Title	Department	Primary Unit	Shift Pattern	Hire Date
E-10472	Rachel Timmons	Registered Nurse	Medical/Surgical	4 West	Nights 7p-7a	2021-03-12
E-10583	Marcus Okonkwo	Nurse Practitioner	Emergency Dept	ED Main	Rotating	2019-07-22
E-10691	Jennifer Caldwell	Registered Nurse	Intensive Care	ICU-2	Days 7a-7p	2018-01-08
E-10734	Brian Lassiter	Licensed Practical Nurse	Pediatrics	Peds 2 North	Days 7a-7p	2022-09-14
E-10819	Aisha Patel	Registered Nurse	Labor & Delivery	L&D Suite A	Nights 7p-7a	2020-05-19

First 5 of 20 rows, first 7 of 13 columns. RadRoot interviewed the clinical staff member on each row, and 7 of 20 answered.

One interview, exactly as it ran

Six options every time, including the ones that reflect badly on whoever sent it. Each question was written after the answer above it landed.

Q1You work nights in Labor & Delivery Suite A. How often do you encounter lab or test results that require immediate attention during your shift?

·Rarely, maybe once or twice a week
·Once per shift on average
✓A few times per shift on average
·Several times per shift, it is a regular part of my workflow
·Constantly, critical results come in throughout the entire shift
·Almost never, most results are routine and do not require immediate action

Q2When you receive a critical or abnormal result, what steps do you take to route it to the right provider?

·I rely on the EHR alert system to notify the provider automatically
·I send a secure message through the EHR and wait for acknowledgment
·I document it in the chart and mention it during the next provider check-in
✓I call the attending directly because the EHR alert does not always go through
·I page the on-call provider and follow up with a note in the chart
·I tell the charge nurse and let them handle the escalation

Q3How did you learn that the EHR alert does not always reach the provider?

·I was told during orientation that the alerts are unreliable
·A senior nurse warned me when I started in this unit
·I noticed myself that alerts were not being acknowledged in a timely way
·A provider told me they often do not see the alerts until much later
✓A critical magnesium result sat unacknowledged for over an hour once
·Multiple staff members have mentioned it as a known issue over time

Q4Do other staff in your department follow the same manual call practice?

·Everyone does it, it is the standard practice here
·Most staff do it, we all know the alerts are not reliable
·About half do it, the rest still rely on the EHR alerts
✓Most do, but not everyone knows it is necessary
·A few of us do it, but most staff trust the system
·Almost no one else does it, most staff assume the alerts work

Q5In the past three months, have you personally witnessed a case where the manual relay step was missed?

·Yes, within the past month
✓No, not that I am aware of
·Yes, but it was several months ago
·Yes, more than once in the past three months
·I am not sure, I may have but did not realize it at the time
·Yes, and it resulted in a delay that affected patient care

The verdict it produced

Written for whoever ran the campaign. The respondent never sees it.

Aisha describes a critical gap in the EHR alert system for abnormal lab results in Labor & Delivery. She manually calls attending physicians because alerts do not reliably reach providers. She witnessed a critical magnesium result sit unacknowledged for over an hour due to this failure. Most staff follow the same workaround, but not everyone knows it is necessary. She has not personally seen the manual step missed recently, but the reliance on informal knowledge and manual relay introduces significant safety risk.

documentation delay positive low confidence

No documentation delay was identified in this interview.

workaround risk negative high confidence

This nurse manually calls attending physicians to relay abnormal results because EHR alerts do not reliably reach providers.

compliance exposure negative high confidence

A critical lab result once sat unacknowledged for over an hour due to alert failure.

workflow friction negative high confidence

The EHR alert system for abnormal lab results does not reliably notify the responsible provider.

reporting confidence mixed low confidence

The interview did not gather enough information to assess this clinician's confidence in formal reporting.

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