NUR 514 Benchmark – Electronic Health Record Implementation

NUR 514 Benchmark – Electronic Health Record Implementation

NUR 514 Benchmark – Electronic Health Record Implementation

Description:

One way informatics can be especially valuable is in capturing data to inspire improvements and quality change in practice. The Agency for Healthcare Research and Quality (AHRQ) collects data related to adverse events and safety concerns. If you are working within a practice setting to implement a new electronic health record (EHR) system, this is just one of the many considerations your team would need to plan for during the rollout process.

In a paper of 1,500-1,750 words, discuss the following:

1. Consider an opportunity for tracking care improvement. What key information would be needed in the database? Example: Time lapse from medication order documented in the EHR to delivery of medication to the patient for the cardiology service.
   2. Describe the role informatics plays in the ability to capture this data. What type of project management strategies and methodologies can be implemented to support informatics initiatives to help improve quality within the clinical practice?

Role Informatics Plays in Ability to Capture Data

Information is vital to patient care, and health informatics has advanced in the past years to focus on the acquisition, storage, and utilization of data in health care, emphasizing technology. Informatics can capture the key data needed to assess fall risk by obtaining and managing data from multiple sources, including patient tracking devices, electronic medical records, and fall assessment tools (Estiri et al., 2018). Informatics facilitates the transfer of data systems to enable information sharing across health units and organizations. Besides, informatics will capture data including all patient encounters, medications ordered, diagnoses, and diagnostic tests performed. It will capture the data from multiple sources in various formats and convert it to a single format compatible with the EHR database.

Project management strategies are approaches the informatics project manager applies to address various challenges and to enable every party to understand the needs of an informatics initiative or project. The strategies that can be used to foster informatics initiatives include defining the initiative’s goals early and keeping them adaptable. The informatics project leader should keep the team adaptable through frequent, clear communication about the project scope, expectations, and proposed changes (Naseer et al., 2022). In addition, the informatics project manager should have a deep understanding of the informatics initiatives, which guides the allocation of resources and gives a more realistic view of the project’s timeline. The project manager should also encourage teamwork, manage the project risks, and ask for team feedback to promote the informatics initiatives’ success.

3. Discuss which systems and staff members would need to be involved in the design and implementation process. What is the role of the advanced registered nurse in promoting evidence-based practice and leading quality and performance improvement initiatives within this setting?

1. Outline strategies for implementing the new EHR proposal. Consider communication changes, transitioning to the new EHR, and managing resources (human, fiscal, and health care resources).
   5. Discuss what professional, ethical, and regulatory standards must be incorporated into the design and implementation of the system.
   6. Describe the measures and steps you would take to evaluate the success of the EHR implementation from a staff, setting, and patient perspective to measure effectiveness and ensure continuous quality improvement in practice?
   7. Explain what leadership skills and theories would be needed to facilitate collaboration with the interprofessional team and provide evidence-based, patient-centered care?

You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Course Materials if you need assistance.

Benchmark-Electronic Health Record Implementation Paper SAMPLE

Health informatics comprise one of the most effective ways to enhance quality care and patient outcomes. Patients receive better medical care if health care providers have access to complete and accurate information. Many studies demonstrate that electronic health records (EHRs) can enhance the ability to diagnose diseases and reduce and prevent medical errors that leads to optimal patient outcomes (Hansen et al., 2019). Implementing an electronic health records system in a health care facility is one of the critical aspects of attaining quality care and increasing patient satisfaction. The benefits of EHRs as a form of health informatics are broad. On this basis, the paper explores the role of nurse practitioners in different situations in implementing an EHR system in their facilities.

Tracking Opportunities based on the Database

An effective electronic health record system provides the basis for an organization to develop a functional health information system to enhance efficiencies. However, an EHR enables nurse practitioners to track healthcare settings opportunities through an array of information available in such systems. Health data comprises patient information, demographic data, administrative data, health status, medical history, current medical interventions and management, and information on outcomes (Health IT.gov, 2017). A detailed database will comprise current and potentially sensitive information concerning individual patients and families or group populations. Health providers frequently enter clinical and laboratory data into the system as an electronic record for patient care.

The information sources in the database may differ. For instance, data comes from hospital discharge abstracts, self-completed patent respondents’ questionnaires, submissions of insurance claims, employees’ files, and computerized pharmacy records. Personally identified data contained pieces of information or facts that refer to an individual, which allows for identification. Information can also come from the electronic medical records (EMRs) of patients (Aldosari, 2017). EMRs contain medical information, while EHRs contain data related to the health of an individual.

Therefore, opportunities arise from nurses and providers’ ability to use data from EHRs to make effective decisions using frameworks like the Clinical Decision Support (CDS). CDS opportunities include improved quality and health care outcomes through avoiding errors and adverse effects, reduced costs and enhanced efficiency, and patient satisfaction. Again, data from the EHRs system allow practitioners to use Computerized physician order entry (CPOE), which entails automation of the medication ordering process. The use of CPOE improves patient safety and efficiency in care when incorporated with CDSs and EHRs.

Role of Informatics in Capturing Data

Health information technology allows facilities to collect data monitoring the effects of a new EHR to enhance performance. Health informatics manages health information and utilizes information technology tools to organize health records to improve health outcomes. Informatics nurses must manage, interpret, and communicate health information with the primary purpose of improving care quality. Informatics has improved care through better documentation, improved care coordination, and minimization of medical errors (Yen et al., 2017). Caring for patients begins with collecting data on the patient’s medical history, clinical symptoms, history of allergies, and the current list of medications. Nurses collect this data and document it in the electronic database. Nurses and other health professionals can retrieve and record information in the system in real-time to reduce medication errors by effectively integrating alerts for medical reactions and allergies. The implication is that informatics nurses have a critical role in capturing data included in the electronic health record system for patients in their facilities.

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Systems and Staff Members Involved in Designing and Implementation Process and Team

The selection and design of an EHRs system rely mainly on the organizational needs, However, while corporate needs should influence the system selection, the organization and its management must develop an effective implementation strategic plan consisting of many experts and professionals from different areas and departments within the entity. The system should demonstrate the ease of interaction between other users, especially patients and care providers, and should not impede communication between the critical stakeholders.

The multidisciplinary approach in initiating the EHR system indicates the need for stakeholders to understand the new framework, ensuring consistency based on protection and security, structure work processes, and preparing group consideration (McCororie, 2019). Practical training on EHR usage allows practitioners to adjust to the new model that benefits patients, nurses, doctors, and other healthcare providers. The implication is that the organization must have an effective team that understands or designs an implementation process based on an information strategy that emphasizes information governance.

The organization should create an execution group or team from different departments, design the product or system, identify equipment needs, share information, and enhance pre-dispatch processes. Successful implementation will entail having an effective team and having insight and expertise in their respective areas. As a new project in the organization, the EHR system should have a leader, project manager, and top users, mainly nurses, and patients. The lead physicist connects health care professionals and other staff using the system. The project manager is in charge of the entire project and ensures that all deliverables are attained (Bjarnadottir et al., 2017). Nurses, top users of the new system, and IT experts in the organization, and administrative staff and physicians will provide essential inputs in designing and implementing the system. Collaboration is a crucial aspect of the successful implementation of the new system, and all these individuals are critical to the plan.

Professional, Ethical & Regulatory Standards in Designing and Implementation of the System

It is essential to consider different ethical, professional, and regulatory requirements and standards in designing and implementing the EHRs system. Professional standards entail requirements set by professional associations that guide decisions of nurse practitioners in different settings. The American Nurses Association emphasizes the need for safety and positive patient outcomes in deploying information technologies in health care (Balestra, 2017). The association asserts that informatics nurses should ensure data accuracy and proficiency when collecting, storing, scrutinizing, and reporting information. Ethical principles are also essential and consist of different areas related to privacy, confidentiality, and security. Health care providers must design, execute, and evaluate the EHR system’s use within their health care settings.

The integration of regulatory requirements by existing federal legislation like the Health Information Technology and Clinical Health Act (HITECH and Health Insurance Portability and Accountability Act (HIPAA) is a critical aspect of compliance. Health care organizations must protect patient’s health data and personal information. Privacy, security, confidentiality requirements should also be considered to attain practical and effective use of electronic health information. The HITECH regulations emphasize the need to comply with HIPAA standards and increase the legal responsibility for entities that fail to comply with set requirements on data use and security.

Order Sets as part of the New Record

Health care entities are deploying evidence-based practices to improve quality care. The use of clinical order sets based on evidence-based guidelines within the EHR system reduces errors and enhances patient outcomes. Consequently, to attain useful and current order sets, the team should incorporate these components into their design. Therefore, to achieve success in this model, get a buy-in from the main stakeholders, and satisfaction from providers, the team needs to have a lead physician’s formal governance structure (Balestra, 2017). Imperatively, clinical order sets should have the best practices and organizational standards that entail identifying and selecting data content sources, reviewing content, and maintaining and updating these resources. The team should establish a process to identify and replace content that can impact patient safety or care quality if the content is not current.

Communicating Changes

Managing change requires the deployment of principles, techniques, and prescriptions that allow people to accept the transition and improve overall implementation. Kotter’s change model is sufficient, and the team must use it to generate leadership and momentum for change. Health care providers may possess different responses to change processes in the organization, as some may accept, while others may require time. Therefore, it is essential to communicate these changes by laying out how the team will roll out the EHR system. The unit can use Kotter’s 8-Step Model to communicate the changes based on the steps that include creating an urgency for transformation, forming a powerful coalition, and developing a vision for the changes. The team should then communicate the vision, remove any hurdles, and create short-term wins while building on the changes (McCororie et al., 2019). Finally, they should incorporate the change as part of their organizational culture. The team can communicate the changes using different layers of communication channels that include banners, posters, and creating flyers and emails to individual practitioners.

Evaluation of the EHR Implementation from a Staff, Setting, and Patient Perspective

Before the implementation of the project, a set of parameters of what constitutes success should be created. Kotter’s 8-Step Model for change can offer guidelines for milestones at each step of the implementation. Short achievement and developing milestones are some of the goals established in the initial plan before implementation. For instance, the team can set milestones and goals like assessing the stakeholders’ readiness to transition and plan on how to launch the EHRs system based on the assessment and attainment of meaningful utilization. Secondly, keen preparation at the start is critical to the successful implementation of the EHR, but having realistic anticipations and a manageable time frame is essential (Laukka et al., 2020). Once the performance is complete, continual tracking is critical in assessing how internal users deploy the new system. The monitoring is essential as it will ensure the successful implementation of the EHR system.

Leadership Skills and Theories to Facilitate Collaboration with Inter-Professional Team

The implementation of the EHRs system is intricate and presents significant challenges. Therefore, practical leadership skills are essential for successful implementation. Leadership skills will enhance the Lead physician and team’s ability to attain buy-in from users and other stakeholders. The requisite skills include excellent communication attributes, critical thinking, problem-solving skills and techniques, and project management skills.

Communication skills are essential because the team and management must engage employees and other stakeholders like patients on the system’s benefits. Importantly, successful designing and implementing the EHRs system requires staff participation from diverse expertise, perspectives, and experiences. Therefore, communication skills are a critical aspect of the overall project’s success (McCororie et al., 2019). The team and its leadership require effective project management and technical skills to ease the understanding and deliverable of the expected outcomes.

Transformative and contingency leadership theories will be appropriate in designing and implementing the EHRs system in the facility. Transformational leadership will ensure that stakeholders collaborate to attain a common goal. Leaders have to motivate, stimulate, and inspire all providers to embrace the innovative way of interacting with customers. The situational leadership model means that leaders will make decisions based on the circumstances and enhance all stakeholders’ effective participation. These theories implore leaders to nurture their subordinates and provide directions based on the situation.

Conclusion

Implementing the EHR system is a critical aspect of improving care quality and getting different opportunities for providers, primarily through the deployment of CDSs and CEOs. Therefore, healthcare organizations’ leaders should implement EHR systems to enhance efficiency, quality care, and other benefits from health information technologies. An integrative approach is essential in implementing an EHR system where all stakeholders are incorporated into the plan. Most importantly, leaders implementing EHR should deploy effective leadership styles and possess relevant skills to attain such projects’ goals.

NUR 514 Benchmark – Electronic Health Record Implementation References

Aldosari, B. (2017). Causes of EHR projects stalling or failing: A study of EHR projects in Saudi

Arabia. Computers in biology and medicine, 91, 372-381. DOI: 10.1016/j.compbiomed.2017.10.032

Balestra, L. M. (2017). Electronic Health Records: Patient Care and Ethical and Legal

Implications for Nurse Practitioners. The Journal for Nurse Practitioners. Vol 13(2), 105-111. https://doi.org/10.1016/j.nurpra.2016.09.010

Bjarnadottir, R. I., Herzig, C. T., Travers, J. L., Castle, N. G., & Stone, P. W. (2017).

Implementation of electronic health records in US nursing homes. Computers, informatics, nursing: CIN, 35(8), 417. Computer Information in Nursing, 35(8):417-424. DOI: 10.1097/CIN.0000000000000344

Hansen, M. B., Nørup, I., Elmholdt, K. T., Kidholm, K., Nøhr, C., & Schmidt, T. (2019,

November). Managing Change of EHR Systems. In SHI 2019. Proceedings of the 17th Scandinavian Conference on Health Informatics, November 12-13, 2019, Oslo, Norway (No. 161, pp. 104-107). Linköping University Electronic Press. https://ep.liu.se/ecp/161/018/ecp19161018.pdf

Health IT.gov (2017). Improved Patient Care Using EHRs. Retrieved from

https://www.healthit.gov/topic/health-it-basics/improved-patient-care-using-ehrs

Laukka, E., Huhtakangas, M., Heponiemi, T. & Kanste, O. (2020). Review: Identifying the Roles

of Healthcare Leaders in HIT Implementation: A Scoping Review of the Quantitative and Qualitative Evidence. International Journal of Environment Research and Public Health, 17(2865). doi:10.3390/ijerph17082865

McCrory, C., Benn, J., Johnson, O. A. & Scantlebury, A. (2019). Staff expectations for the

implementation of an electronic health record system: a qualitative study using normalization process theory. BMC Medical Informatics and Decision Making, 19 (222). https://doi.org/10.1186/s12911-019-0952-3

Yen, P. Y., McAlearney, A. S., Sieck, C. J., Hefner, J. L., & Huerta, T. R. (2017). Health

information technology (HIT) adaptation: refocusing on the journey to successful HIT implementation. JMIR medical informatics, 5(3), e28. DOI: 10.2196/misinform.7476

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

2.3: Develop leadership skills to collaborate on interprofessional teams in the provision of evidence-based, patient-centered care.

5.2: Apply professional, ethical, and regulatory standards of practice in the provision of safe, effective health care.

Topic 8 DQ 1

Description:

Open and clear communication is critical for the effective functioning of the interprofessional team and the delivery of safe patient care. Discuss the way communication technologies can enhance coordination of care by interprofessional teams. Be sure to discuss a specific communication technology in your response.

Effective communication across disciplines is imperative to the care of patients. In case management for example having an up-to-date chart because we rely heavily on the information that is presented in the chart. Are they going home on oxygen? What are their current needs, what was their walking room air, were they using this prior to admission, where do they live. It seems simple enough but if there is no room air the DME company cannot justify the need and in order to get reimbursed for services. In times like this having AI, computer on wheels, cell phones, secure chat or Vocera helps to cut the gap on what is documented, what is occurring with the nurse’s caseload and the needs of the team. Having communication technologies are tools that help to get the information that is needed quickly. In my current facility Vocera is often used between the interdisciplinary team as well as a mode to call outside lines if needed. Vocera is a technology that also needs to be improved, for instance the only mode to hear is on speaker mode where PHI may be overheard. Wooden & Blair (2019) report that technology is an effective tool to enhance communication between teams and results indicate that with the use these tools there is decreased length of stays, improved patient outcomes and improved nursing care.

NUR 514 Benchmark – Electronic Health Record Implementation References:

Wooden, K &Blair, K (June 15, 2019). The use of technology in multidisciplinary communication to improve patient-centered care coordination: A systemic review. The Use of Technology in Multidisciplinary Communication to Improve Patient-Centered Care Coordination: A Systemic Review – Oncology Nurse Advisor

The latest communication technologies have enhanced coordination of care by interprofessional teams in tremendous ways. Secure mobile applications are some of the most effective that I have experienced recently. My hospital implemented an application called Voalte using iphones for all patient-facing staff while on duty. The iphone connects through a secure network in the hospital, requires a login and password, is locked out from being used in any other fashion, and will not work outside the hospital. This app eliminates the need to keep track of unit numbers and offers convenient ways to communicate on-the-go. There is a desktop version available as well as a secure application that can be used on a personal device for physicians and supervisory staff that need to be contacted off-site. Once signed in, the employee can select a unit and role, as well as an indicator of “busy” or “available”. This icon helps other staff identify who may be the contact person for such roles as charge nurse, unit manager, or on-call physician. It also eliminates the need to contact the answering service and delays for paging. Staff nurses are assigned to patient rooms by the unit secretary during their shift. This information connects through middleware software to the EHR creating a direct connection to the nurse assigned to a specific patient. Clear and direct communication for such things as critical labs, family questions, report, and many other important matters go immediately to the assigned nurse. Because these devices are secure, text messages with wound pictures or an EKG during a chest pain event can be sent to the covering provider for a quick assessment. Overall, this application has decreased delays and allowed for better communication amongst the healthcare team.

Reference:

Hillrom. (n.d.). Voalte healthcare mobile messenger app. https://www.hillrom.com/en/products/care-comms-mobile/

Topic 8 DQ 2

Description:

Virtual care and telehealth technologies have the capability to greatly expand access to quality health care. Discuss some benefits and drawbacks of virtual care/telehealth, particularly related to the collaboration and coordination of care and the role of the advanced registered nurse.

Topic 8: Interprofessionalism and Interrelationships in Informatics and Information Systems

Description

Objectives:

1. Analyze the role of the advanced registered nurse in promoting evidence-based practice and leading quality and performance improvement initiatives.
   2. Analyze quality standards and performance measures related to the use of informatics for continuous quality improvement in practice settings.
   3. Discuss project management strategies and methodologies for implementing health care informatics initiatives that improve quality within clinical practice.
   Study Materials

Nursing Informatics and the Foundation of Knowledge

Description:

Read Chapters 16 and 20 in Nursing Informatics and the Foundation of Knowledge.

Health IT

Description:

Explore the HealthIT.gov website.

Artificial Intelligence Research: The Utility and Design of a Relational Database System

Description:

Read “Artificial Intelligence Research: The Utility and Design of a Relational Database System,” by Diling, from
Advances in Radiation Oncology (2020).

Application of Project Management Tools and