NUR 514 Benchmark – Electronic Health Record Implementation
NUR 514 Benchmark – Electronic Health Record Implementation
The implementation of the EHRs system is complex and fraught with difficulties. As a result, practical leadership skills are required for successful implementation. Leadership abilities will help the Lead physician and team gain support from users and other stakeholders. Excellent communication abilities, critical thinking, problem-solving skills and techniques, and project management abilities are required.
Communication skills are required because the team and management must educate employees and other stakeholders, such as patients, on the benefits of the system. Importantly, successful design and implementation of the EHRs system necessitates the participation of staff with diverse expertise, perspectives, and experiences. As a result, communication skills are critical to the overall success of the project (McCororie et al., 2019). To facilitate understanding and delivery of the expected outcomes, the team and its leadership require effective project management and technical skills.
Transformative and contingency will be useful in designing and implementing the facility’s EHRs system. Transformational leadership ensures that stakeholders work together to achieve a common goal. Leaders must motivate, stimulate, and inspire all providers to embrace an innovative approach to customer interaction. According to the situational leadership model, leaders will make decisions based on the circumstances and increase the effective participation of all stakeholders. These theories encourage leaders to nurture their subordinates and provide situational guidance.
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.
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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 , 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:
- 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?
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? - . 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, 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?
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Tracking Opportunities based on the Database
In order to improve efficiencies, an effective electronic health record system serves as the foundation for an organization to build a functional health information system. In contrast, an EHR enables nurse practitioners to track healthcare setting opportunities by utilizing the wealth of information available in such systems. Health data includes patient information, demographic data, administrative data, health status, medical history, current medical interventions and management, and outcome information (Health IT.gov, 2017). A comprehensive database will include up-to-date and potentially sensitive information about individual patients, families, or groups of people. 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. Hospital discharge abstracts, self-completed patent respondent questionnaires, insurance claim submissions, employee files, and computerized pharmacy records are some of the data sources. Personally identifiable data contained information or facts that could be used to identify an individual. EMRs (electronic medical records) of patients can also provide information (Aldosari, 2017). EMRs contain medical information, whereas EHRs contain health-related data. As a result of nurses’ and providers’ ability to use EHR data to make effective decisions using frameworks such as the Clinical Decision Support Framework, opportunities arise (CDS). CDS opportunities include increased patient satisfaction, lower costs and efficiency, and improved quality and health care outcomes by avoiding errors and adverse effects. Again, EHR system data allows practitioners to use Computerized physician order entry (CPOE), which automates medication ordering. When used in conjunction with CDSs and EHRs, CPOE improves patient safety and care efficiency.
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.
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.
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.
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.
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:
- 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 Techniques to Support Nursing Intervention Research
Description:
Read “Application of Project Management Tools and Techniques to Support Nursing Intervention Research,” by Rew, Cauvin, Cengiz, Pretorius, and Johnson, from Nursing Outlook (2020).
How Data Can Save Lives: Informatics for Health 2017
Description:
Read “How Data Can Save Lives: Informatics for Health 2017,” by Cookson, from BMC Series Blog (2017), located on the BioMed Central website.
Electronic Health Record (EHR) System Testing Plan
Description:
Read “Electronic Health Record (EHR) System Testing Plan,” located on the HealthIT.gov website.
EHR Testing: Specifics and Best Practices
Description:
Read “EHR Testing: Specifics and Best Practices,” by Mikhailau (2019), located on the Health IT Outcomes website.
Health IT Standards
Description:
Read “Health IT Standards,” located on the HealthIT.gov website.
Perspectives of Healthcare Practitioners: An Exploration of Interprofessional Communication Using Electronic Medical Records
Tasks
