Rooting WOC nurse productivity into the electronic medical record (EMR)

Laura Phearman, BSN, RN, CPNP1, Patricia Pezzella, BSN, RN, CWON2, Julia Langin, BSN, RN, CWON, CMSRN3, Michelle Greve, BSN, RN, CWON, CMSRN4, Elizabeth Culver, BSN, RN, CWON2 and Linda Abbott, DNP, RN, CWON, AOCN5, (1)University of Iowa Children's Hospital, Pediatric Skin / Wound Care Nurse, Iowa City, IA, (2)Nursing, University of Iowa Hospitals and Clinics, Iowa City, IA, (3)Nursing, University of Iowa Hospital and Clinics, Iowa City, IA, (4)Nursing, University of Iowa Hosptials and Clinics, Iowa City, IA, (5)Nursing, University Of Iowa Hospitals and Clinics, Iowa City, IA


The purpose of this project is to improve documentation by the WOC nurses for more effective communication and tracking of productivity.  


The WOC nurses quantify work by tracking productivity.  Productivity was tracked through a computer spreadsheet program requiring team members to document in addition to documenting in the electronic medical record (EMR).  With increases in volume and complexity of patients at a Midwest academic medical center, the need for tracking productivity with increased efficiency arose, not only to maintain current staffing, but to support additional staff.  There were concerns that the spreadsheet may be subjective and could miss work.

Strategy and Implementation

A mechanism for tracking productivity used by other nursing services served as a template for the WOC nurses.  The team identified necessary data to be captured through regular meetings.  The WOC team developed a new documentation system, or “navigator,” within the EMR to provide one location for all needed documentation.   WOC nurses collaborated with informatics staff to build the “navigator” and to create an automatic monthly report.  The WOC nurses modified the “navigator” after viewing the first few reports.  The report illustrates work volume as well as complexity for each WOC nurse and time spent with each patient.


The WOC team receives a monthly report of patient related activity including volumes, time spent, and services performed. The new EMR captures all necessary variables for reporting HAPIs to streamline skin surveys.  Aggregate data is available for administrative planning and also as individual productivity reports used for performance evaluations and goal setting. The reports provide information on trends and changes in demographics for the service. Though non-patient care activities are not captured in the navigator, it illustrates the demands on the team supporting an addition of 1.5 FTE’s for the WOC service over the past 2 years.