Attendees will be able to describe our multidisciplinary approach to keeping patients with cognitive deficits safe using an elopement screening and technology solution.
Patients who are identified as cognitively impaired can be at risk for injury, and leaving the hospital before medically cleared puts them at even greater risk for injury. Implementing a screening process for all patients admitted to the hospital has helped to keep patients and staff safe during their stay. This is accomplished by having thorough communication among caregivers, providing enhanced safety for staff and patients, and capturing high-risk behaviors during unit transfers.
When a patient is deemed to have a cognitive impairment, an effort is made to aggregate to a nursing unit that utilizes elopement technology. The current screening process has recently undergone an update to include a rescreening process to include a multidisciplinary approach to determine if the patient is still at risk for elopement and can be removed from the elopement technology. The patient is rescreened using the screening tool in the electronic health record as well as a multidisciplinary meeting occurs to review the patient case to determine if the patient can be safely removed from elopement precautions.
The elopement technology used to keep the patient safe includes placing a band on the patient that will send alarms to the staff if the patient attempts to leave and alarms on the unit. Audible alarms along with lights are also utilized on the unit to alert staff. In addition, notifications are sent to mobile phones, security staff, and doors that can be locked.
In conclusion, by combining these efforts, both patients and staff are able to be protected. Better collaboration amongst the care team can occur because a multidisciplinary discussion is occurring to ensure the best outcome for the patient.

Purpose: Early identification of pediatric sepsis remains a persistent challenge in the interfacility transport environment. Transfer centers and transport teams serve as a critical first clinical touchpoint for many children presenting from community hospitals, yet limited decision-support infrastructure has traditionally constrained timely recognition. This quality initiative aimed to design, deploy, and evaluate a novel electronic “our practice advisory” (OPA, formerly known as BPA) integrated into an interfacility transfer center workflow to support earlier sepsis identification and intervention at the initial point of contact.
Description: Using a multidisciplinary approach, pediatric sepsis screening criteria were adapted for pre-transfer triage and embedded within the electronic medical record (EMR). The OPA triggers based on vital sign inputs and prompts targeted screening questions related to perfusion, high-risk conditions, and mental status for patients with signs and symptoms of infection. A positive screen activates scripted communication pathways and initiates a telephonic “sepsis huddle” between the referring clinician and a Lurie Children's pediatric specialist.
Baseline analysis included manual chart reviews and staff knowledge assessment to identify gaps in recognition, treatment timing, and referral communication. Implementation included clinician education, workflow integration, and iterative usability refinement. Integration with organizational data, insights, and AI resources will enable data validation, reporting optimization, and visualization enhancements to support sustained improvement and real-time learning cycles.
Evaluation/outcome: Since launch, the OPA has triggered 734 times, with 54 positive sepsis screens identifying clinically concerning patients and prompting earlier treatment prior to transport arrival. Manual chart review validated accuracy and informed continuous logic refinements. Early findings demonstrate improved recognition consistency and more timely escalation from referring facilities. Staff feedback highlighted increased confidence in structured sepsis decision support and improved communication clarity during high-risk consultations.
Lessons learned: Hard-stop logic strengthens fidelity of screening compliance. Structured communication scripts improve reliability and reduce variation in sepsis escalation pathways. Sustained success requires purposeful informatics partnership, strong clinician adoption support, robust data governance, and proactive monitoring of false-positive and false-negative events. Future enhancements include refining alert sensitivity and leveraging automated dashboards to reduce manual audit burden and accelerate feedback loops.
Implications for practice: This project demonstrates the value of nurse-driven informatics, clinical decision support, and transport-specific workflow design in improving early sepsis recognition. By blending traditional bedside assessment with modern digital tools, transport programs can extend evidence-based sepsis protocols upstream, influence care before patient arrival to Lurie Children’s Hospital, and improve outcomes across the pediatric care continuum.

Learning outcome: Recognize gaps in electronic health record (EHR) care plan utilization and explore informatics-driven research to enhance alignment between documentation tools, clinical practice, and nursing education.
Background: Nursing care plans are an important tool in nursing education and practice. A research gap exists focusing on United States nursing students’ perceptions of both academic care plans and care plans in the EHR.
Methods: Qualitative phenomenological research was conducted involving interviews with 14 undergraduate nursing students. Transcripts were analyzed using a modified Giorgi approach.
Results: Four themes were identified: Academic care plans help students to begin to think like a nurse, there is a disconnect between academic care plans and care plans in practice, students view care plans as busy work in nursing school, and students view care plans as useless in the acute care setting.
Conclusions: This study showed mixed perceptions on nursing care plans in undergraduate nursing education, suggesting a gap in educational objectives and clinical realities.
Informatics implications: An unexpected yet significant informatics related finding from this study emerged in themes three and four: students view care plans as busy work in nursing school and students view care plans as useless in the acute care setting. Participants observed that EHR systems often automate much of the care planning process by offering pre-populated nursing diagnoses and standardized interventions, which nurses can select and modify. While some EHR automation is beneficial, there can be concerns for data accuracy. Study participants reported rarely seeing registered nurses personalizing care plans during clinical rotations. Instead, participants noted nurses frequently appeared to "click through" care plan templates. Although concerning, this is not an unexpected finding as EHR documentation requirements are often connected to burnout and work-related stressors.
These findings underscore a disconnect between the intended functionality of care plans within EHR systems and their use in practice. They raise important questions about how informatics tools are integrated into nursing workflows, and how their design and implementation may impact patient care, safety, and experience. This issue is especially relevant considering the 21st Century Cures Act (2016), which enables hospitalized patients to view care plan documentation in real time. When acute care nurses do not document as intended—and that documentation is immediately visible to patients—it can lead to significant confusion. This prompts a critical question: do these findings reflect a flaw in EHR care plan design, or an opportunity to improve education around system functionality? Further research and quality improvement initiatives are needed to explore this issue in depth.

Purpose: Downtime can be a stressful situation for bedside clinicians due to complex processes and unfamiliarity with them. Following the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, electronic health records (EHR) have been broadly implemented in most US hospitals. Fifteen years later, nursing documentation is removed from paper charting and often even the most senior nurses on a unit have no paper charting experience. Nurses’ anxiety related to the EHR is fed by patient safety concerns that information is getting missed. The collection of laboratory specimens during an EHR downtime introduces unique challenges in communication between disciplines, failure of which results in delays in patient care.
Description: We performed an exhaustive search of both nursing and laboratory policies and existing forms. We surveyed critical care, float pool, and transition-to-practice nurses on their confidence in their understanding of the downtime specimen collection process. We chose these groups since these nurses covered the widest range of patient populations and types of specimen collections that nurses encounter. Critical care nurses often collect their own specimens whereas float pool nurses work on the medical-surgical and step-down units where phlebotomists tend to collect specimens. We worked with bedside nurses in these units to identify their workflows. Finally, we collaborated closely with the laboratory department to understand their workflow during downtime and their steps during recovery.
Evaluation/outcome: We created a new form and process for downtime specimen collection in collaboration with laboratory. We brought our expertise of the EHR to our project ensuring that the new form provided the critical information required during downtime recovery. Multiple interdisciplinary meetings and a tabletop discussion with our laboratory department were held to ensure each step was vetted and accurate for each department’s workflow. We assessed the usability of our form by gathering feedback on each draft. Finally, all laboratory staff and nurses were educated on the new process using a flowchart, tipsheets, and the organization’s learning management system resulting in improved understanding and confidence as measured by a pre- and post-survey. Understanding of existing specimen workflow: Confident and very confident responses increased from 11 to 34, a 209.1% increase. Understanding of new specimen workflow: confident and very confident responses increased from 8 to 38, a 375% increase.

The role of nursing informatics in hospital-based patient care policy review and alignment within electronic medical records (EMRs) is critical for ensuring high-quality patient care and operational efficiency. This poster explores how nursing informatics facilitates the integration and standardization of patient care policies within EMRs, thereby improving compliance, reducing errors, minimizing build/maintenance costs, moderating impacts to clinical staff workflow and enhancing patient outcomes. The alignment of patient care policies within EMRs also supports interdisciplinary collaboration, as it ensures that all members of the healthcare team have access to the most current and accurate information. This integration not only enhances the consistency and quality of patient care but also supports continuous improvement initiatives and regulatory compliance. Additionally, the alignment of policies with medical record documentation and workflows is essential for maintaining a cohesive and efficient healthcare environment. It ensures that documentation practices are in line with established workflows and policies, thereby promoting a seamless and coordinated approach to patient care. A review of the literature revealed a gap in articles highlighting the role of nursing informatics in patient care policy review and EMR alignment from a quality and regulatory compliance standpoint. The findings underscore the importance of nursing informatics in bridging the gap between clinical practice policies and information technology incorporation, ultimately contributing to safer standards and compliant and more effective patient care.
Learning objective: A review of the literature revealed a gap in articles highlighting the role of nursing informatics in patient care policy review and EMR alignment from a quality and regulatory compliance standpoint. The purpose of this abstract is to demonstrate the critical and potentially underused role of nursing informatics in patient care policy review and alignment within EMRs. We aim to highlight the importance of informatics in making suggested revisions to policies and/or updating the EMR to ensure alignment with practice, workflow and documentation. Nursing informaticists are crucial for avoiding unnecessary application builds, complicated workflows, and policy language that could inadvertently make it easier to fall out of regulatory compliance.

Background: As the electronic health record (EHR) continues to shape clinical care delivery, its integration into daily workflows presents persistent challenges that often go unnoticed or unaddressed. This presentation shares insights from regularly scheduled clinical informatics and information technology leadership rounds alongside department leaders, which have become a foundational part of our leadership approach. Conducted across both direct patient care areas and ancillary departments, these rounds are designed to bring leaders into the clinical environment to observe, listen, and engage with front-line staff in real time.
Leadership visibility through rounding is essential to building trust, surfacing operational barriers, and fostering a culture of responsiveness. By embedding informatics and IT leaders directly into care settings, we gain firsthand insight into how technology functions in practice, beyond what help desk tickets or system analytics can reveal. These rounds consistently uncover themes related to workflow inefficiencies, infrastructure limitations, and cultural patterns around technology use. While specific challenges will be explored during the presentation, the focus is on how rounding itself enables proactive identification and resolution of issues.
Methods: Our structured walking rounds that directly interface with front-line staff allow us to have a greater impact on the department locally and offer practical strategies for other organizations seeking to embed informatics and IT leadership more deeply into clinical operations. As a result of rounding, department leaders gain a better understanding of the technical environment in which their staff operate.
Results: Staff often express appreciation for the presence of leadership and the opportunity to share their experiences informally. This engagement not only validates their concerns but also encourages collaborative problem-solving and continuous improvement. Rounding has proven to be a powerful tool for reducing burden, improving EHR usability, and optimizing clinical workflows while reinforcing shared accountability across teams.
Conclusion: By bridging the gap between digital strategy and clinical reality, leadership rounds support a more stable, equitable, and responsive care environment, one where technology works for the people who use it, and not the other way around.

Purpose: Artificial intelligence (AI) is rapidly transforming health care through predictive analytics, clinical decision support, and personalized care delivery. Alongside its promise, AI introduces complex ethical and operational challenges related to bias, equity, and transparency. Because algorithms learn from existing data, they may unintentionally reinforce inequities already embedded in healthcare records, leading to biased predictions and unequal outcomes. Examples such as stigmatizing documentation language in patient notes demonstrate how subtle biases can affect care delivery and trust. For nurse informaticists, these issues highlight an ethical and professional responsibility to ensure that technology aligns with nursing’s core values of justice, beneficence, and patient advocacy.
Description: AI bias occurs when algorithms replicate or amplify existing inequities in the data used to train them. Bias in healthcare decision-making and risk assessment can become magnified when embedded in predictive models. Nurse informaticists play a pivotal role at the intersection of ethics, data, and patient care. Guided by the nursing code of ethics and informatics standards of practice, they evaluate technology for safety, efficacy, and fairness. Their unique combination of clinical expertise and data literacy enables them to recognize sources of bias, interrogate model transparency, and collaborate with interdisciplinary teams to ensure equitable data governance.
Mitigation strategies: Addressing AI bias requires both technical and cultural interventions. Evidence-based strategies include using fairness algorithms and balanced datasets to correct skewed inputs, incorporating diversity within AI development teams to broaden cultural and clinical perspectives, and applying auditing tools to monitor outcomes for equity. Governance mechanisms such as ethical oversight committees, transparency reporting, and equity dashboards strengthen accountability and public trust. Frameworks focused on AI literacy, equity by design, and responsible governance provide practical methods for identifying, mitigating, and monitoring bias throughout the AI lifecycle. Nurse informaticists can lead these initiatives through workflow redesign, education, and policy advocacy to ensure that AI enhances, rather than hinders, equitable care.
Evaluation: Despite rapid technological progress, gaps persist in workforce readiness, AI literacy, and policy oversight. Promoting interdisciplinary collaboration and ethical awareness is essential to support equitable implementation. Nurse informaticists can translate emerging evidence into practice by connecting ethics, technology, and patient safety to guide responsible AI integration. Their leadership ensures that innovation in healthcare remains consistent with the values of transparency, fairness, and patient-centered care.
Learning outcomes: Identify common sources and impacts of AI bias on patient equity and outcomes. Recognize tools and frameworks that promote responsible, transparent, and fair AI adoption in health care. Apply informatics-based strategies to mitigate AI bias through ethical governance, collaboration, and continuous quality improvement.

Identifying opportunities to improve clinical and financial processes in the perioperative department has a direct impact on achieving financial goals. Accurate procedure scheduling and efficient charge coding are critical to success within perioperative departments. Scheduling orders must include the procedure code, full procedure description, and the CPT code for the planned procedure. Our team's project involved reviewing over 2,800 procedure codes and corresponding CPT codes for proper mapping in the perioperative electronic health record. This review reduced our procedure codes by 40% by eliminating duplications and outdated procedures, allowing for more accurate surgery scheduling and reducing scheduler challenges. We also evaluated the workflows of the surgeon and hospital departments responsible for obtaining preauthorization to align individual goals while maintaining efficiency in the process. Preauthorization of accurate CPT codes for planned procedures ensures post-surgical reimbursement to the hospital and reduces financial loss. Reviewing the charge codes generated by perioperative event times and confirming all available billable codes were being posted also identified missed opportunities for increased revenues. Implementing additional charge rules to capture anesthesia facility charges and phase two recovery charges resulted in increased billable charges. Informatics and analyst evaluation of workflows, build, charge posting, and reporting provided operational leaders and revenue teams with specific tasks and steps to address standardization across the health system. Aligning charge levels based on procedure performed across the academic medical center and eight regional hospitals provided consistency in billing and revenue. The collaboration of perioperative leaders and staff, finance and revenue teams, and information systems experts provides a multidisciplinary approach to meet clinical and financial goals.

Background: Healthcare clinicians and organizations are increasingly recognizing the importance of identifying health-related social needs (HRSN) to provide care that is informed by social risks and aimed at addressing these needs. This approach ultimately improves patient health outcomes. HRSN initiatives gained prominence in health system accreditation when The Joint Commission (TJC) introduced new requirements in January 2023 to reduce healthcare disparities. Similarly, MassHealth launched the quality and equity incentive program (MQEIP), which aims to enhance health equity by offering financial incentives to health systems to improve demographic data completeness, strengthen organizational capacity for equity efforts, adopt more equitable practices, and ultimately reduce health disparities among its members. Recognizing and responding to individual patients' requests for help with HRSN may serve as a cornerstone for pediatric healthcare systems to advance health equity for all.
Introduction: Our pediatric healthcare organization implemented the HRSN screening tool in the inpatient setting in late 2024. Initial audit reports showed a low compliance rate of 24.8%, falling short of the MassHealth performance benchmark of 30% for HRSN screening in 2025 (PY3). In response, the HRSN workgroup developed strategies to improve screening completion rates and to document post-screening actions in alignment with the health equity goals and quality standards of the MQEIP. The questionnaire is available in multiple formats: a written paper form in 19 languages, verbally during the nursing admission assessment, and via the patient portal for those who prefer privacy and additional time to complete it. This questionnaire is standardized across inpatient and outpatient settings and is soon to be implemented in the emergency department.
Methods/strategies: In May 2025, HRSN screening was integrated into the required 24-hour nursing admission assessment documentation. A 90-day lookback logic was incorporated to check whether screening had already been completed, helping to avoid duplicate documentation. To support nurses in responding to positive screens, educational points were automated for easier documentation, along with corresponding information sheets with the option to attach to the discharge summary. Staff education and training on the new workflow were delivered through refresh and reframe sessions, SBAR announcements, newsletters, tip sheets, clinical informatics council meetings, and Informatics rounding.
Results: Through EHR reports, we observed a significant increase in completion rates following the implementation of improvement strategies—from 24.8% to 72.5%. A notable 60% completion in self-reporting was observed when the HRSN screening was added to the patient portal. As screening rates improved, the education and distribution of community resource sheets also increased. In September 2025, an update was introduced that records information sheets attached to the discharge summary and makes it viewable within the HRSN history tab, making it easier to keep track of actions taken to help our patients.
Next steps: Ongoing optimization efforts aim to further improve our screening processes and reporting. A new dashboard has been developed to visualize compliance and trends in positive screenings. Electronic screenings are currently being translated into additional languages. We will continue to assess our patients’ needs beyond the screening process to better align resources and support services accordingly.