The Surgical Ambulatory Care Units at our large metropolitan hospital completed major redesign and renovation of the outpatient surgical clinic area. The design and architectural drawings were initiated in 2002 with the space finished and finally occupied in May 2005. An informatics nurse was not assigned to the project. The registered nurse manager for the nursing services in these surgical clinics found the lack of planning for informatics support and supplies for the clinic areas to be an impediment that prevented a smooth move into the new spaces and transition to new business processes. The absence in the existing clinical information system patient education documentation form of post surgical procedure teaching information created significant problems. The surgical clinic nurse requested assistance from the nursing informatics department to modify the form to include documentation of the patient education, a request due in part to fulfill the documentation requirements from the Joint Commission on Accreditation of Hospital Organization (JCAHO). Other issues needed the attention of an informatics nurse.