This document discusses maintaining improvements to health care workflow processes and contingency planning for electronic health record (EHR) system downtime. It outlines developing a business continuity plan (BCP) to ensure patient care can continue if the EHR system fails. The BCP should identify essential functions, critical processes, and alternate work locations. It should also establish a BCP team to oversee plan development and test the downtime plan through exercises to prepare for real incidents involving EHR outages. Maintaining improved processes involves continuously monitoring performance and identifying further areas for enhancement.
The presentations given at the Learning Layers and CAMERA workshop in Plymouth on the 23rd July. Gives an overview of the Learning Layers research project, which is exploring how technology can support informal learning in small and medium-sized enterprises. Introduces the 4 Learning Layers tools being developed to support learning in healthcare - GP practices.
Participants will learn about the importance of a Continuity of Operations Plan (COOP) in sustaining their organization’s work after a disaster. First steps for starting a COOP will be outlined. Free and easy to use COOP design resources will be shared.
Presentation given by Belinda Boulton and Tracy
Hughes, Oxford University
Hospitals NHS Trust. Reading 'Improving access to seven day services' event on 11th March 2015
Health Care: Cost Reductions through Data Insights - The Data Analysis GroupJames Karis
An overview of the cost reduction opportunities for a Health Care provider. These opportunities can be identified, quantified and optimised through data-driven insights. The slide pack also provides a strategic overview of how one would set up such a project within a large organisation, whilst mitigating patient-care concerns.
The webinar will cover why we should document the BCMS plan and how it can be done.
Main points covered:
· Why do we need to document
· What is included in the documentation
· How is the documentation used
Presenter:
Barbro Thöyrä, MBA., holds certificates in ISO 22301 Master and Lead Auditor, ICT Disaster Recovery Manager, ISO 28000 Provisional Implementer, PECB Certified Outsourcing Manager and DRI Risk Management. She is an approved PECB and DRI trainer and BCI Instructor.
She has several years of experience as an IT manager, product manager and subject matter expert in BCMS. She has worked as a senior consultant, project management, IT architect, wrote manuals and developed services within BCMS and CRM. Furthermore, she is a trainer in IT and BCMS and carried out several international BCMS and IT projects as an expert and project manager.
Link of the webinar published on YouTube: https://youtu.be/q3Jr9k-tbic
The presentations given at the Learning Layers and CAMERA workshop in Plymouth on the 23rd July. Gives an overview of the Learning Layers research project, which is exploring how technology can support informal learning in small and medium-sized enterprises. Introduces the 4 Learning Layers tools being developed to support learning in healthcare - GP practices.
Participants will learn about the importance of a Continuity of Operations Plan (COOP) in sustaining their organization’s work after a disaster. First steps for starting a COOP will be outlined. Free and easy to use COOP design resources will be shared.
Presentation given by Belinda Boulton and Tracy
Hughes, Oxford University
Hospitals NHS Trust. Reading 'Improving access to seven day services' event on 11th March 2015
Health Care: Cost Reductions through Data Insights - The Data Analysis GroupJames Karis
An overview of the cost reduction opportunities for a Health Care provider. These opportunities can be identified, quantified and optimised through data-driven insights. The slide pack also provides a strategic overview of how one would set up such a project within a large organisation, whilst mitigating patient-care concerns.
The webinar will cover why we should document the BCMS plan and how it can be done.
Main points covered:
· Why do we need to document
· What is included in the documentation
· How is the documentation used
Presenter:
Barbro Thöyrä, MBA., holds certificates in ISO 22301 Master and Lead Auditor, ICT Disaster Recovery Manager, ISO 28000 Provisional Implementer, PECB Certified Outsourcing Manager and DRI Risk Management. She is an approved PECB and DRI trainer and BCI Instructor.
She has several years of experience as an IT manager, product manager and subject matter expert in BCMS. She has worked as a senior consultant, project management, IT architect, wrote manuals and developed services within BCMS and CRM. Furthermore, she is a trainer in IT and BCMS and carried out several international BCMS and IT projects as an expert and project manager.
Link of the webinar published on YouTube: https://youtu.be/q3Jr9k-tbic
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
1. Health Care Workflow Process
Improvement
Maintaining and Enhancing
Improvements
Lecture b
This material (Comp 10 Unit 11) was developed by Duke University, funded by the Department of Health and
Human Services, Office of the National Coordinator for Health Information Technology under Award
Number IU24OC000024. This material was updated by Normandale Community College, funded under
Award Number 90WT0003.
This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International
License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/
2. Maintaining and Enhancing
Improvements
Learning Objectives
• Work with practice staff to develop a set of
plans to keep the practice running (to the
extent necessary and practical) if the EHR
system fails
• Work with practice staff to evaluate the
new processes as implemented and
identify problems and changes that are
needed
2
4. What is Affected When an EHR is
Down?
• Receipt of lab results via electronic
interface,
• Clinical decision support,
• Routing of prescription refills
• Electronic storage of entered clinical
documentation,
• Appointment call reminders, and
• Transmitting health information
4
5. BCP for EHR Downtime
• Business continuity planning for EHR
downtime is the systematic inventory of
EHR-facilitated processes and
contingency planning for each.
• Real-time clinical care
• Care follow-up activities
• Getting data into the EHR
5
6. Business Continuity
• Business Continuity Plan
• BCP Team
• BCP Objectives
• BCP Goals
• Essential Functions
• Critical Processes
• Exercises for Success
6
7. BCP Team
Source: Wikimedia, 2012
• Assemble Core Team
to oversee BCP
development
• Identify BCP
Points-of-Contact
for organizational units
• Define the overarching
BCP program
• Develop a BCP
timeline
7
8. BCP Plan Objectives
• Ensure continuous performance of an organization’s
mission-essential functions in an emergency
• Ensure safety of employees
• Protect essential equipment, records, and other assets
• Reduce disruptions to operations
• Minimize damage and losses
• Achieve an orderly recovery from emergency operations
• Identify alternate locations and ensure operational and
managerial requirements are met before an emergency
occurs.
8
9. Key BCP Plan Goals
• Essential organizational functions, vital systems,
data and information identified and prioritized
• Critical elements are capable of being recovered
quickly to resume operations
• People know who is in charge
• Back-up personnel are trained
• Alternate work locations are predefined
• Checklists are predefined to guide the
organization in responding to an emergency
9
10. Critical Processes
• Processes or services that must be
recovered within 24 hours after a
disruption to ensure resumption of the
essential function
• Includes all resources necessary to carry
out the critical process:
– Personnel
– Data or vital records
– Systems and equipment
10
11. Essential Functions
• Functions that must be performed to achieve the
organization’s mission
• Essential Functions include:
– Communications
– Vital Records, Systems and Equipment
– Key Personnel
– Alternate Work Sites
– Testing, Training & Exercises
– Personnel
– Data or vital records
– Systems and equipment 11
12. Exercising the Downtime Plan
• Exercises are events that allow participants to
apply their skills and knowledge to improve
operational readiness
• Goal of exercises is to prepare for a real incident
involving EHR Downtime Plan activation
• Three types of exercises:
– Tabletop
– Functional
– Full-scale
12
13. Maintaining and Enhancing
Improvements
Summary
• Monitoring processes to maintain
performance gains
• Continuing to improve process
performance
• Contingency planning for EHR downtime
– providing patient care when the EHR is down
– maintaining availability of health information to
providers and patients in major emergencies
13
14. Maintaining and Enhancing
Improvements
References – Lecture b
References
No references were used in this lecture.
Images
Slide 4: Ikeda, Masaki. 2008. Lightening at Saitama [Creative Commons]. Retrieved from
http://commons.wikimedia.org/wiki/File:Thunder_at_Saitama.jpg
Slide 4: Pedneault, Sylvain . 2006. A fire in Massueville [Creative Commons]. Retrieved from
http://en.wikipedia.org/wiki/File:FirePhotography.jpg
Slide 4: Tegtmeier, Steve. Union City Oklahoma [Creative Commons]. Retrieved from
http://commons.wikimedia.org/
Slide 8: FEMA Community Relations Team (CR) in a meeting in Georgia. [Public domain] Retrieved
from http://commons.wikimedia.org/
14
15. Maintaining and Enhancing
Improvements
Lecture b
This material was developed by Duke
University, funded by the Department of
Health and Human Services, Office of the
National Coordinator for Health Information
Technology under Award Number
IU24OC000024. This material was updated
by Normandale Community College, funded
under Award Number 90WT0003.
15
Editor's Notes
Welcome to Health Care Workflow Process Improvement, Maintaining and Enhancing Improvements. This is lecture b.
Objectives for lecture are to:
Work with practice staff to develop a set of plans to keep the practice running (to the extent necessary and practical) if the EHR system fails, and
Work with practice staff to evaluate the new processes as implemented and identify problems and changes that are needed.
Business continuity or disaster planning may seem like an odd topic to pair with maintaining and improving processes. But all three topics are about designing and maintaining a process that delivers the best possible care. That care and health information is especially needed in times of disaster, e.g., pandemic or natural disaster, when it may be the hardest to keep a practice running, and that care and health information is still needed, even if the practice itself is having difficulty, e.g., a computer system crash, local power outage, or unexpected extended absence of one or more key providers, etc. When you think about it, business continuity planning is about maintaining core processes under emergency or adverse conditions, or in the absence of normal operating resources.
The Business Dictionary defines the Business Continuity Plan as a: “Set of documents, instructions, and procedures which enable a business to respond to accidents, disasters, emergencies, and/or threats without any stoppage or hindrance in its key operations.”
It provides guidance for times when the organization experiences loss of use of its facility, loss of its vital equipment and systems, and/or loss of key personnel. While practices should consider Business Continuity and Emergency Planning in the broader sense, here, we are concerned with planning necessary to provide quality care when the EHR system is down.
What is affected when an EHR goes down? In short, everything that the EHR automates. As described in Unit 6 – Process Redesign leveraging EHRs automates clinic processes, for example, receipt of lab results via an electronic interface, notifications when patients are due for screening tests and other clinical decision support, routing of prescription refills for physician approval, electronic storage of entered clinical documentation, calls to patients to remind them of upcoming appointments, and transmitting health information to another provider with a referral. Any parts of clinic processes that rely on the EHR for partial or total automation will not function for the time the EHR is down.
Business continuity planning for EHR downtime is the systematic inventory of EHR-facilitated processes and contingency planning for each. By contingency planning, we mean figuring out exactly how the process will work in the absence of the EHR, including both real-time patient care, after the fact follow-up, and getting the documentation reflecting the encounter into the EHR. Some EHR facilitated processes will be easy, e.g., receipt of prescription refill requests – a possible scenario is that the sending system will detect a receipt failure and route via agreed back-up mechanism (maybe fax) instead. Following this scenario the practice, having planned ahead will know to expect and respond to the faxes until the system is back up. Further, the sending system will know not to send electronically what was faxed and responded to by the practice and WILL resend electronically once the system is up what was faxed and NOT responded to by the practice. This is an example of an EHR system downtime contingency plan for one EHR facilitated process. The EHR Downtime plan consists of a similar plan for EVERY EHR facilitated process. Many of the processes may require paper data collection forms or worksheets, e.g., data collection sheets to use in encounters that, as best as possible, help clinicians identify things that would be alerted by the EHR, possibly using patient prompts such as, I see that you are over 40, “when was your last mammogram?”
In the next few slides, we’ll discuss contents of a BCP and a framework for how a practice might go about creating one.
Business continuity planning is the task of identifying, developing, acquiring, documenting, and testing that will ensure the continuity of the organization’s key operations in the event of an accident, disaster and/or threat. It involves reducing possibility of the occurrence of adverse events and ensuring continued operation in the aftermath of a disaster. In other words, it is the effort to assure that the capability exists to continue essential functions across a wide range of potential emergencies.
Business continuity planning consists of:
Developing the Business Continuity Plan,
Forming a BCP Team to write the plan and in some cases to be activated in case of an emergency,
Identifying the BCP Objectives,
Defining the BCP Goals,
Identifying Essential Functions and Critical Processes that must be restored for the organization to resume operations after the event, and
Developing Exercises and a timetable for testing the plan to ensure that all perform as expected in the case where the BCP needs to be activated.
Hopefully, every practice that you work with will have a BCP and the EHR downtime plan can become a component of that larger plan. If not, you may be introducing practice leadership and staff to the concept of business continuity planning.
An initial step is to assemble a Core Team to oversee BCP development, identify Points-of-Contact for organizational units, define the overarching BCP program, and develop a BCP timeline for implementation. Often this same team is expanded to direct the implementation and continued testing of the plan.
The overarching objective of a business continuity plan, as in the specific case of an EHR downtime plan, is to plan for an event BEFORE it occurs so that when it does, everyone knows what to do and has everything they need for safe and effective operation.
Typical objectives of BCP plans include:
Ensuring continuous performance of an organization’s essential functions in an emergency, and in health care – patient safety
Protecting essential equipment, records, and other assets,
Reducing disruptions to operations,
Minimizing damage and losses, - including loss of health information
Achieving an orderly recovery from emergency operations, and
Identifying alternate locations and ensuring operational and managerial requirements are met before an emergency occurs.
Key goals will likely include:
Essential organizational functions, vital systems, data and information identified and prioritized,
Critical elements are capable of being recovered quickly to resume operations, - i.e., processes are defined and established and staff are trained on them. Job aids such as worksheets are readily available so that staff can switch to the “downtime process” on a moments notice.
People know who is in charge,
Back-up personnel are trained,
Alternate work locations are predefined, and
Checklists are predefined to guide the organization in responding to an emergency.
Critical processes are usually defined as those processes or services that must be recovered within 24 hours after a disruption to ensure resumption of the essential function.
They include all resources necessary to carry out the critical process:
Personnel,
Data or vital records, and
Systems and equipment.
Essential functions are functions that MUST be performed to achieve the organization’s mission. Some examples of essential functions to address include:
Communications,
Vital Records, Systems and Equipment,
Key Personnel,
Alternate Work Sites, and
Testing, Training & Exercises.
In a practice, in the face of a natural disaster, providing patient care may not be essential. However, maintaining availability of patient’s health information so that it is available to other providers probably is. Thus, EHR downtime plans should account for how information will be accessible to practice providers who may need to provide it to other providers, accessible to patients themselves, or accessible to other providers. Having data storage and hosting redundancy or a hosted patient portal with similar features would help accomplish this, as would participating in a health information exchange.
Without proper testing, the downtime plan may fail you when you need it the most. Exercises, like fire drills, are events that allow participants to apply their skills and knowledge to improve operational readiness. The goal of the exercises is to prepare for a real incident involving an EHR downtime plan activation.
There are three types of exercises,
Tabletop exercise involves practice staff and leadership talking through a downtime event from start to finish – who, what, when where how does everything get done
Functional exercise is a walk through where a process is tested
Full-scale exercise is a simulated event, e.g., on a Saturday, where there are pretend patients (family members for example), and clinic staff and leadership start with the EHR, then pretend it goes down and they resume operations according to the downtime plan like it were real.
Exercises are usually followed by after action reviews such as those done in the military where everyone involved talks through what happened, what went well and what went poorly – notes are taken so that the downtime plan is improved. Another method is called a Time Out Of Time, or TOOT, where during the functional or full scale exercise, at regular intervals someone calls “time” and everyone takes one or two minutes and jots down notes about what is working well and what is not working well so that the information is captured as it is happening; this information is then discussed in the after action review.
This concludes Maintaining and Enhancing Improvements.
In this lecture we covered:
Maintaining the performance gains achieved with the redesigned process, i.e., Process Control
Continuing to improve the redesigned process and other practice processes, Continuous Quality Improvement (CQI), and
Keeping the practice operational, or perhaps, in extreme emergencies, just keeping people’s health records available for emergency services, in the event of natural disasters, pandemic, but primarily focused on EHR downtime planning.
