Date of Conferral

10-6-2025

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Services

Advisor

Kourtney Nieves

Abstract

Access to clinical informatics specialist (CIS) consultations is essential for optimizing electronic health record (EHR) use in acute care hospital systems. Limited availability of CIS support contributes to clinician burnout, workflow inefficiencies, and patient safety risks. The purpose of this integrative review was to identify strategies to improve access to CIS consultations in acute care settings. A comprehensive literature search across multiple databases yielded 656 articles, with 24 meeting inclusion criteria based on relevance and methodological rigor, evaluated using the Johns Hopkins Nursing Evidence-Based Practice appraisal tools. These studies, published between 2019 and 2024, underwent thematic analysis guided by the Prosci Awareness, Desire, Knowledge, Ability, and Reinforcement (ADKAR) model. Four themes were identified: training and education, emphasizing training deficits, competency improvement, and confidence building; the role of informatics and access to consultation, highlighting evidence-based consultation and decision-making support; usability and workflow optimization, underscoring documentation burden reduction and healthier EHR relationships; and support systems and accessibility, highlighting EHR support teams and real-time communication. Findings demonstrate that addressing training gaps, embedding consultative pathways, and strengthening support infrastructures are strategies that increase consultation engagement, optimize workflows, and enhance safety outcomes. Improving CIS access fosters equitable engagement with informatics resources and advances patient-centered care, contributing to positive social change through safer, more efficient, and inclusive healthcare delivery.

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