When an organization owns one nursing facility, the electronic health record is configured by whoever is on hand. When it owns five, the same approach produces five slightly different systems. One building has custom assessment templates, another uses different order wording, a third has its own naming for user roles. Staff who float between buildings must relearn the system. Reports from one facility cannot be compared with another. Every fix has to be repeated by hand.
Governance, which simply means deciding who makes configuration decisions and how, is the antidote. This post covers practical ways multi-building operators can standardize their EHR setup, including PointClickCare, without ignoring the real differences between facilities. It describes the approach in general terms, so check with your vendor about which settings your system makes available.
Staff mobility. People who work in several buildings or move between them are productive faster.
Training. One training approach and one set of materials can serve everyone.
Reporting and analysis. Comparing facilities only makes sense when data is entered and defined the same way.
Quality and compliance. Consistent documentation practices support consistent care.
Efficiency. A change made once can apply to every building.
Acquisitions. A defined standard makes onboarding a new facility far easier.
Not everything should be identical. A skilled nursing facility, a memory care unit and an assisted living community have different needs. Start by sorting settings into three groups:
Must be standard. Items that affect safety, compliance, billing or comparison across buildings, such as user role definitions, key assessment schedules, order naming and critical alerts.
Standard by default, local exceptions allowed. Preferred practices that a facility can adjust with approval and a documented reason.
Local choice. Preferences that do not affect other buildings, such as certain layouts or unit-specific lists.
Write the list down and revisit it when needs change.
Form a group with clinical, operations, compliance, finance and IT representation. Include at least one person from a frontline role who knows how work really happens. The committee approves changes to standard settings and reviews requests for exceptions.
Name one person as the system owner and, ideally, a backup. This person coordinates changes, keeps the documentation and serves as the main contact with the vendor. A system that belongs to everyone belongs to no one.
Create a simple way to request a change, such as a form or shared mailbox. Each request should say what is needed, why, who is affected and how urgent it is. The committee reviews requests on a regular schedule and handles urgent items through an agreed shortcut.
Where possible, test changes with a small group before wide release. Announce changes ahead of time, explaining what is changing and why, and give staff a place to ask questions.
Maintain a living reference describing your standard configuration: user roles and permissions, templates, order sets, alert settings and who approved each. Keep a change log showing what changed, when and by whom. This is invaluable when something stops working and you need to know what was altered recently.
Standard role definitions help ensure each person has only the access they need. Review user accounts regularly, remove access promptly when staff leave and make sure administrator privileges are limited and protected with multi-factor authentication where available. Consistent access practices support HIPAA's expectations around access control.
Even with a good standard, buildings drift over time. Schedule a periodic comparison, such as quarterly, to check whether settings still match the standard and whether exceptions are still needed. Ask local teams about workarounds they have created, since those often reveal unmet needs the standard should address.
Standardization imposed without listening tends to fail. Invite administrators, directors of nursing, unit managers and bedside staff to share what works and what does not. When a local practice is better than the standard, adopt it everywhere.
Choose one or two high-value areas, such as user roles or order wording.
Compare how each building handles them today.
Agree on a standard and a timeline.
Implement, document and review after a few weeks.
Move on to the next area.
Consistent configuration works best on consistent infrastructure: reliable connectivity between buildings, secure remote access and standard devices. UnityCare IT supports multi-site healthcare operators with that foundation and can help document and review settings, so every building runs on the same solid footing.
Keeping PointClickCare and other EHR systems fast, connected and available.
Call or text: 405-285-3845
New customers: start@unitycareit.com
Existing customers: support@unitycareit.com
Address: UnityCare Technologies, 2524 N Broadway Ste 554, PMB 947974, Edmond, Oklahoma 73034-4172