Discussions
1.
Electronic Health Records
Electronic health records (EHRs) are at the center stage of the effort to improve health care quality and control costs. In addition to allowing medical practitioners to access and record clinical documentation at much faster rates, EHRs are also positively influencing care delivery and nurse-patient interaction. Yet despite the potential benefits of EHRs, their implementation can be a formidable task that has broad-reaching implications for an entire health care organization.
In this Discussion, you appraise strategies for obtaining the benefits and overcoming the challenges of implementing and using electronic health records.
To prepare
Review the implementation of EHRs in an organization. Reflect on the various approaches used.
If applicable, consider your own experiences with implementing EHRs. What were some positive aspects of the implementation? What suggestions would you make to improve the process?
Reflect on the reactions of others during the implementation process. Were concerns handled effectively?
If you have not had any experiences with an EHR implementation, talk to someone who has and get his or her feedback on the experience.
Search and indicate examples of effective and poor implementation of EHRs.
RESOURCES
Required Readings
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 15, “The Electronic Health Record and Clinical Informatics”
This chapter describes the crucial parts of an electronic health record system and explores the benefits of implementing one.
Bates, D. W. (2010). Getting in step: Electronic health records and their role in care coordination. Journal of General Internal Medicine, 25(3), 174–176.
The author of this editorial critically analyzes current applications of electronic health records (EHRs) and their impact on cost, quality, and safety of health care delivery. The author describes a study on the use of vendor-developed EHRs in clinical practice settings, the results of which pinpointed the benefits and drawbacks of EHRs.
Cresswell, K., & Sheikh, A. (2009). The NHS Care Record Service: Recommendations from the literature on successful implementation and adoption. Informatics in Primary Care, 17(3), 153–160.
This article defines the United Kingdom’s National Health Service’s Care Record Service (NHS CRS) as a standard electronic health record system. The article describes the challenges associated with implementing this new information technology and provides recommendations for overcoming those challenges.
Fickenscher, K., & Bakerman, M. (2011). Change management in health care IT. Physician Executive, 37(2), 64–67.
This article offers strategies for health care leaders to successfully implement change programs in their organizations, especially with regard to the new standards for electronic health records (EHRs). The article provide.
Transforming Nursing and Healthcare through TechnologyDiscussion.docxturveycharlyn
Transforming Nursing and Healthcare through Technology
Discussions
1. Electronic Health Records
Electronic health records (EHRs) are at the center stage of the effort to improve health care quality and control costs. In addition to allowing medical practitioners to access and record clinical documentation at much faster rates, EHRs are also positively influencing care delivery and nurse-patient interaction. Yet despite the potential benefits of EHRs, their implementation can be a formidable task that has broad-reaching implications for an entire health care organization.
In this Discussion, you appraise strategies for obtaining the benefits and overcoming the challenges of implementing and using electronic health records.
To prepare
Review the implementation of EHRs in an organization. Reflect on the various approaches used.
If applicable, consider your own experiences with implementing EHRs. What were some positive aspects of the implementation? What suggestions would you make to improve the process?
Reflect on the reactions of others during the implementation process. Were concerns handled effectively?
If you have not had any experiences with an EHR implementation, talk to someone who has and get his or her feedback on the experience.
Search and indicate examples of effective and poor implementation of EHRs.
RESOURCES
Required Readings
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 15, “The Electronic Health Record and Clinical Informatics”
This chapter describes the crucial parts of an electronic health record system and explores the benefits of implementing one.
Bates, D. W. (2010). Getting in step: Electronic health records and their role in care coordination. Journal of General Internal Medicine, 25(3), 174–176.
The author of this editorial critically analyzes current applications of electronic health records (EHRs) and their impact on cost, quality, and safety of health care delivery. The author describes a study on the use of vendor-developed EHRs in clinical practice settings, the results of which pinpointed the benefits and drawbacks of EHRs.
Cresswell, K., & Sheikh, A. (2009). The NHS Care Record Service: Recommendations from the literature on successful implementation and adoption. Informatics in Primary Care, 17(3), 153–160.
This article defines the United Kingdom’s National Health Service’s Care Record Service (NHS CRS) as a standard electronic health record system. The article describes the challenges associated with implementing this new information technology and provides recommendations for overcoming those challenges.
Fickenscher, K., & Bakerman, M. (2011). Change management in health care IT. Physician Executive, 37(2), 64–67.
This article offers strategies for health care leaders to successfully implement change programs in their organizations, especially with regard to the new standards for electronic health ...
Assignment Application Adoption of New Technology SystemsAs a nu.docxMatthewTennant613
Assignment: Application: Adoption of New Technology Systems
As a nurse, you can have a great impact on the success or failure of the adoption of EHRs. It is important for nurses to understand their role as change agents and the ways they can influence others when addressing the challenges of changing to a drastically different way of doing things.
Everett Rogers, a pioneer in the field of the diffusion of innovations, identified five qualities that determine individual attitudes towards adopting new technology (2003). He theorized that individuals are concerned with:
Relative advantage: The individual adopting the new innovation must see how it will be an improvement over the old way of doing things.
Compatibility with existing values and practices: The adopter must understand how the new innovation aligns with current practices.
Simplicity: The adopter must believe he or she can easily master the new technology; the more difficult learning the new system appears, the greater the resistance that will occur.
Trialability: The adopter should have the opportunity to “play around’ with the new technology and explore its capabilities.
Observable results: The adopter must have evidence that the proposed innovation has been successful in other situations.
Note:
You are not required to purchase Rogers’ book or pursue further information regarding his list of five qualities. The information provided here is sufficient to complete this Assignment. The full reference for Rogers’ work is provided below the due date on this page.
For this Assignment, you assume the role of a nurse facilitator in a small hospital in upstate New York. You have been part of a team preparing for the implementation of a new electronic health records system. Decisions as to the program that will be used have been finalized, and you are now tasked with preparing the nurses for the new system. There has been an undercurrent of resistance expressed by nurses, and you must respond to their concerns. You have a meeting scheduled with the nurses 1 week prior to the training on the new EHR system. Consider how you can use the five qualities outlined by Rogers (2003) to assist in preparing the nurses for the upcoming implementation.
To prepare
Review the Learning Resources this week about successful implementations of EHRs.
Consider how you would present the new EHR system to the nurses to win their approval.
Reflect on the five qualities outlined by Rogers. How would addressing each of those areas improve the likelihood of success?
By Day 7 of Week 6
Write a 3- to 5-page paper which includes the following:
Using Rogers’ (2003) theory as a foundation, outline how you would approach the meeting with the nurses. Be specific as to the types of information or activities you could provide to address each area and include how you would respond to resistance.
Analyze the role of nurses as change agents in facilitating the adoption of new technology.
McGonigle, D., & Mastrian, K. G. (2015). .
A Nurse’s Role in the Systems Development Life CycleWhile the proc.docxJospehStull43
A Nurse’s Role in the Systems Development Life Cycle
While the process of developing and implementing a health information technology system may seem overwhelming at first, the systems development life cycle (SDLC) provides organizations with a framework to deliver efficient and effective information systems. Though the SDLC is a common overarching structure for implementing information systems, it is not a one-size-fits-all process. In fact, there are a multitude of approaches that can be used to guide the systems development life cycle. The SDLC approach that is most appropriate for a particular organization will be highly contextual and subject to organization-specific differences.
This week prompts you to analyze the process of selecting an appropriate health information technology and then evaluate techniques that positively impact the steps of the systems development life cycle in an EHR implementation. You also determine what barriers might occur at each stage and how these could be overcome.
Learning Objectives
Students will:
Analyze how a nurse can contribute to each stage of the systems development life cycle
Photo Credit: Jose Luis Pelaez Inc]/[Brand X Pictures]/Getty ImagesCredit
Learning Resources
Note:
To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
McGonigle, D., & Mastrian, K. G. (2015).
Nursing informatics and the foundation of knowledge
(3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 10, “Systems Development Life Cycle: Nursing Informatics and Organizational Decision Making”
This chapter explains the systems development life cycle and explores various methods of applying it. The chapter also examines the importance of interoperability in implementing HITECH.
Chapter 11, “Administrative Information Systems”
This chapter provides an overview of agency-based health information systems. The text also details how administrators can use core business systems in their practice.
Boswell, R. A. (2011). A physician group’s movement toward electronic health records: A case study using the transtheoretical model for organizational change.
Consulting Psychology Journal: Practice and Research, 63
(2), 138–148.
Retrieved from the Walden Library databases.
The authors of this article present a case study on an EHR implementation in a multispecialty physician group. The case study attempts to determine actions that promote successful EHR implementation and the pros and cons of implementation.
Hsiao, J., Chang, H., & Chen, R. (2011).A study of factors affecting acceptance of hospital information systems: A nursing perspective.
Journal of Nursing Research, 19
(2), 150–160.
Retrieved from the Walden Library databases.
The focus of this article is to determine what factors are most important in predicting the acceptance of new health information technology. The results of the study indicated .
This article introduces health care managers to the theories and philosophies of John Kotter and William Bridges, 2 leaders in the evolving field of change management. For Kotter, change has both an emotional and situational component, and methods for managing each are expressed in his 8-step model (developing urgency, building a guiding team, creating a vision, communicating for buy-in, enabling action, creating short-term wins, don't let up, and making it stick). Bridges deals with change at a more granular, individual level, suggesting that change within a health care organization means that individuals must transition from one identity to a new identity when they are involved in a process of change. According to Bridges, transitions occur in 3 steps: endings, the neutral zone, and beginnings. The major steps and important concepts within the models of each are addressed, and examples are provided to demonstrate how health care managers can actualize the models within their health care organizations.
Transforming Nursing and Healthcare through TechnologyDiscussion.docxturveycharlyn
Transforming Nursing and Healthcare through Technology
Discussions
1. Electronic Health Records
Electronic health records (EHRs) are at the center stage of the effort to improve health care quality and control costs. In addition to allowing medical practitioners to access and record clinical documentation at much faster rates, EHRs are also positively influencing care delivery and nurse-patient interaction. Yet despite the potential benefits of EHRs, their implementation can be a formidable task that has broad-reaching implications for an entire health care organization.
In this Discussion, you appraise strategies for obtaining the benefits and overcoming the challenges of implementing and using electronic health records.
To prepare
Review the implementation of EHRs in an organization. Reflect on the various approaches used.
If applicable, consider your own experiences with implementing EHRs. What were some positive aspects of the implementation? What suggestions would you make to improve the process?
Reflect on the reactions of others during the implementation process. Were concerns handled effectively?
If you have not had any experiences with an EHR implementation, talk to someone who has and get his or her feedback on the experience.
Search and indicate examples of effective and poor implementation of EHRs.
RESOURCES
Required Readings
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 15, “The Electronic Health Record and Clinical Informatics”
This chapter describes the crucial parts of an electronic health record system and explores the benefits of implementing one.
Bates, D. W. (2010). Getting in step: Electronic health records and their role in care coordination. Journal of General Internal Medicine, 25(3), 174–176.
The author of this editorial critically analyzes current applications of electronic health records (EHRs) and their impact on cost, quality, and safety of health care delivery. The author describes a study on the use of vendor-developed EHRs in clinical practice settings, the results of which pinpointed the benefits and drawbacks of EHRs.
Cresswell, K., & Sheikh, A. (2009). The NHS Care Record Service: Recommendations from the literature on successful implementation and adoption. Informatics in Primary Care, 17(3), 153–160.
This article defines the United Kingdom’s National Health Service’s Care Record Service (NHS CRS) as a standard electronic health record system. The article describes the challenges associated with implementing this new information technology and provides recommendations for overcoming those challenges.
Fickenscher, K., & Bakerman, M. (2011). Change management in health care IT. Physician Executive, 37(2), 64–67.
This article offers strategies for health care leaders to successfully implement change programs in their organizations, especially with regard to the new standards for electronic health ...
Assignment Application Adoption of New Technology SystemsAs a nu.docxMatthewTennant613
Assignment: Application: Adoption of New Technology Systems
As a nurse, you can have a great impact on the success or failure of the adoption of EHRs. It is important for nurses to understand their role as change agents and the ways they can influence others when addressing the challenges of changing to a drastically different way of doing things.
Everett Rogers, a pioneer in the field of the diffusion of innovations, identified five qualities that determine individual attitudes towards adopting new technology (2003). He theorized that individuals are concerned with:
Relative advantage: The individual adopting the new innovation must see how it will be an improvement over the old way of doing things.
Compatibility with existing values and practices: The adopter must understand how the new innovation aligns with current practices.
Simplicity: The adopter must believe he or she can easily master the new technology; the more difficult learning the new system appears, the greater the resistance that will occur.
Trialability: The adopter should have the opportunity to “play around’ with the new technology and explore its capabilities.
Observable results: The adopter must have evidence that the proposed innovation has been successful in other situations.
Note:
You are not required to purchase Rogers’ book or pursue further information regarding his list of five qualities. The information provided here is sufficient to complete this Assignment. The full reference for Rogers’ work is provided below the due date on this page.
For this Assignment, you assume the role of a nurse facilitator in a small hospital in upstate New York. You have been part of a team preparing for the implementation of a new electronic health records system. Decisions as to the program that will be used have been finalized, and you are now tasked with preparing the nurses for the new system. There has been an undercurrent of resistance expressed by nurses, and you must respond to their concerns. You have a meeting scheduled with the nurses 1 week prior to the training on the new EHR system. Consider how you can use the five qualities outlined by Rogers (2003) to assist in preparing the nurses for the upcoming implementation.
To prepare
Review the Learning Resources this week about successful implementations of EHRs.
Consider how you would present the new EHR system to the nurses to win their approval.
Reflect on the five qualities outlined by Rogers. How would addressing each of those areas improve the likelihood of success?
By Day 7 of Week 6
Write a 3- to 5-page paper which includes the following:
Using Rogers’ (2003) theory as a foundation, outline how you would approach the meeting with the nurses. Be specific as to the types of information or activities you could provide to address each area and include how you would respond to resistance.
Analyze the role of nurses as change agents in facilitating the adoption of new technology.
McGonigle, D., & Mastrian, K. G. (2015). .
A Nurse’s Role in the Systems Development Life CycleWhile the proc.docxJospehStull43
A Nurse’s Role in the Systems Development Life Cycle
While the process of developing and implementing a health information technology system may seem overwhelming at first, the systems development life cycle (SDLC) provides organizations with a framework to deliver efficient and effective information systems. Though the SDLC is a common overarching structure for implementing information systems, it is not a one-size-fits-all process. In fact, there are a multitude of approaches that can be used to guide the systems development life cycle. The SDLC approach that is most appropriate for a particular organization will be highly contextual and subject to organization-specific differences.
This week prompts you to analyze the process of selecting an appropriate health information technology and then evaluate techniques that positively impact the steps of the systems development life cycle in an EHR implementation. You also determine what barriers might occur at each stage and how these could be overcome.
Learning Objectives
Students will:
Analyze how a nurse can contribute to each stage of the systems development life cycle
Photo Credit: Jose Luis Pelaez Inc]/[Brand X Pictures]/Getty ImagesCredit
Learning Resources
Note:
To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
McGonigle, D., & Mastrian, K. G. (2015).
Nursing informatics and the foundation of knowledge
(3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 10, “Systems Development Life Cycle: Nursing Informatics and Organizational Decision Making”
This chapter explains the systems development life cycle and explores various methods of applying it. The chapter also examines the importance of interoperability in implementing HITECH.
Chapter 11, “Administrative Information Systems”
This chapter provides an overview of agency-based health information systems. The text also details how administrators can use core business systems in their practice.
Boswell, R. A. (2011). A physician group’s movement toward electronic health records: A case study using the transtheoretical model for organizational change.
Consulting Psychology Journal: Practice and Research, 63
(2), 138–148.
Retrieved from the Walden Library databases.
The authors of this article present a case study on an EHR implementation in a multispecialty physician group. The case study attempts to determine actions that promote successful EHR implementation and the pros and cons of implementation.
Hsiao, J., Chang, H., & Chen, R. (2011).A study of factors affecting acceptance of hospital information systems: A nursing perspective.
Journal of Nursing Research, 19
(2), 150–160.
Retrieved from the Walden Library databases.
The focus of this article is to determine what factors are most important in predicting the acceptance of new health information technology. The results of the study indicated .
This article introduces health care managers to the theories and philosophies of John Kotter and William Bridges, 2 leaders in the evolving field of change management. For Kotter, change has both an emotional and situational component, and methods for managing each are expressed in his 8-step model (developing urgency, building a guiding team, creating a vision, communicating for buy-in, enabling action, creating short-term wins, don't let up, and making it stick). Bridges deals with change at a more granular, individual level, suggesting that change within a health care organization means that individuals must transition from one identity to a new identity when they are involved in a process of change. According to Bridges, transitions occur in 3 steps: endings, the neutral zone, and beginnings. The major steps and important concepts within the models of each are addressed, and examples are provided to demonstrate how health care managers can actualize the models within their health care organizations.
Key Topics in Health Care Technology EvaluationThe amount of new i.docxsleeperfindley
Key Topics in Health Care Technology Evaluation
The amount of new information and data, and the number of available technologies are growing at an ever-accelerating rate. Did you know that during any given 24 hours, humanity generates enough new information to fill the Library of Congress 70 times (Smolan & Erwitt, 2012)? As a nurse informaticist, it is important to keep current on new developments in the field, but with the rapid pace of change, that effort can be overwhelming. It is easier to keep current with key trends if nurse informaticists focus on selected issues.
In this Discussion, you consider key topics in the field of health care technology. You then consider the different approaches you could take when designing an evaluation in these areas. For example, if you are interested in usability, your goal could be to determine if a system is user friendly from the viewpoint of a nurse. A different goal might be to determine if the location of the system facilitates ease of use from the viewpoint of physicians.
Note:
This Discussion serves as practice for the first part of your Evaluation Project. What you derive from your Discussion with colleagues will likely inform the work that you do in Part 1 of the Evaluation Project.
The Discussion focuses on the following major topics in the health care information field:
Implementing HIT Systems
Consumer health information
Computerized Physician Order Entry (CPOE)
Decision support systems
Electronic health records (EHR)
Tele-medicine and eHealth
Nursing documentation
Other Issues Related to the Use of HIT Systems
Interoperability
Unforeseen consequences
Usability
To prepare:
Select at least
two
topics from the
lists above
that are relevant to your current organization or that are of particular interest to you. Read the articles in this week’s Learning Resources that relate to these topics. Consider why these topics are of interest to you, what relevance they have to health care organizations, and how they impact your professional responsibilities. Choose one topic to be the focus of your Evaluation Project, and consider potential evaluation goals.
Determine the viewpoint from which you would approach the evaluation, and why.
By tomorrow, post a minimum of 550 words essay in APA format with a minimum of 3 references from the list of required resources below, that addresses the level one headings as numbered below:
1)
Post
the two topics you identified as most relevant to your organization or to you personally, and explain why you selected those topics.
2)
Identify the topic you selected for your Evaluation Project, and propose three potential evaluation goals for this topic.
3)
Identify the viewpoint you would use with each goal, and explain why.
Required Readings
Friedman, C. P., & Wyatt, J. C. (2010). Evaluation methods in biomedical informatics (2nd ed.). New York, NY: Springer Science+Business Media, Inc
.
Chapter 2, “Evaluation as a Field” (pp. 21–47)
This chapter defines.
Application Evaluation Project Part 1 Evaluation Plan FocusTec.docxalfredai53p
Application: Evaluation Project Part 1: Evaluation Plan Focus
Technology increases human effectiveness. Using a lever, you can move an object several times your size. In an airplane, you can move exponentially faster than on foot. Using the Internet, you can access information much more quickly than at a library. What possibilities like this exist in the nursing field? What health information technologies can amplify your impact as a nurse far more than ever before? In this Evaluation Project, you will have the opportunity to answer these questions.
Because of the great differences between HIT systems and different goals of an evaluation, there is no one-size-fits-all evaluation plan. Different technologies require different evaluation methods. Consequently, in this part of your Evaluation Project, you will conduct research on how system implementations similar to the one you select have been previously evaluated. After exploring similar system implementations, you will select one research goal and viewpoint to use in the evaluation.
Read the following three scenarios, and select the one that is of most interest to you:
Scenario 1:
Your hospital is implementing a new unified acute and ambulatory Electronic Health Record (EHR) system through which patient care documentation will occur. Interdisciplinary assessment forms (including nursing), clinical decision support, and medical notes will be documented in this system. The implementation of the system is anticipated to improve the hospital’s performance in a multitude of areas. In particular, it is hoped that the use of the EHR system will reduce the rate of patient safety events, improve the quality of care, deter sentinel events, reduce patient readmissions, and impact spending. The implementation of the EHR system is also intended to fulfill the “Meaningful Use” requirements stipulated in the Health Information Technology for Economic and Clinical Health (HITECH) Act. As the hospital’s lead nurse informaticist, you have been tasked with planning the evaluation of the EHR implementation.
Scenario 2:
As the lead nurse informaticist in your hospital, you have been given the task of planning an evaluation for a soon-to-be launched computerized provider order entry (CPOE) system. The CPOE system is designed to replace conventional methods of placing medication, laboratory, admission, referral, and radiology orders. CPOE systems enable health care providers to electronically specify orders, rather than rely on paper prescriptions, telephone calls, and faxes. The intended goal of a CPOE system is to improve safety by ensuring that orders are easily comprehensible through the use of evidence-based order sets. In addition, the CPOE system has the potential for improving workflow by avoiding duplicate orders and reducing the steps between those who place medical orders and their recipients.
Scenario 3:
You are the lead nurse informaticist in a large urban hospital that has recently implemented a new .
Discussion The Systems Development Life Cycle and the Nurse Infor.docxmickietanger
Discussion: The Systems Development Life Cycle and the Nurse Informaticist
The systems development life cycle (SDLC) is a model for planning and implementing change within an organization. It is important for many individuals to be represented in the process, especially the end users of the system or the employees who must live with the change. As informatics become more and more widespread throughout the health care field, collaboration between information technology (IT) professionals and health care practitioners is becoming increasingly important. The nurse informaticist is able to combine the perspective of the information technology side with the clinical nursing perspective.
While the titles and specific responsibilities of nurse informaticists vary across organizations and practice settings, the fundamental purpose of the role remains the same. Nurse informaticists synthesize their knowledge of how technology can improve health care with an understanding of clinical practice and workflow. This is why nurse informaticists can be instrumental in facilitating the SDLC for informatics in health care. For this Discussion, you examine the relationship between the nurse informaticist and the use of the SDLC.
To prepare:
Review the information in this week’s Learning Resources on the SDLC and the role of the nurse informaticist. Reflect on Chapter 1 of the Dennis, Wixom, and Roth course text and consider how the information about the systems analyst role translates into nursing and health care.
Consider a recent change in your organization related to the implementation of a new technology or system. How was this change handled? What was the general SDLC process? Who was involved, and what were the outcomes?
Identify whether your organization (or one with which you are familiar) has a formal title or position for the nurse informaticist. This position may be called by a different name, such as nurse informatics specialist or informatics analyst, so be sure to review the position description.
If your organization has a position for the nurse informaticist, what are the responsibilities of that position? If your organization does not have such a position, conduct research in the Walden Library and at credible online sources on the role of the nurse informaticist.
Reflect on the role of the nurse informaticist in the overall health care field. How is this position connected to the SDLC? Assess the benefits of having this specialized position within health care organizations and involving the nurse informaticist in the SDLC.
Post by tomorrow 8/30/16 550 words in APA format with a minimum of 3 references from the list provided under Required Readings. Apply the level 1 headings as numbered below:
1) A description of how the systems development life cycle is utilized in your organization (Hospital), or in one with which you are familiar, and assess its effectiveness.
2)
Assess the role of the nurse informaticist in your organization. If.
Assignment Application Adoption of New Technology SystemsAs a nu.docxrosemariebrayshaw
Assignment: Application: Adoption of New Technology Systems
As a nurse, you can have a great impact on the success or failure of the adoption of EHRs. It is important for nurses to understand their role as change agents and the ways they can influence others when addressing the challenges of changing to a drastically different way of doing things.
Everett Rogers, a pioneer in the field of the diffusion of innovations, identified five qualities that determine individual attitudes towards adopting new technology (2003). He theorized that individuals are concerned with:
Relative advantage: The individual adopting the new innovation must see how it will be an improvement over the old way of doing things.
Compatibility with existing values and practices: The adopter must understand how the new innovation aligns with current practices.
Simplicity: The adopter must believe he or she can easily master the new technology; the more difficult learning the new system appears, the greater the resistance that will occur.
Trialability: The adopter should have the opportunity to “play around’ with the new technology and explore its capabilities.
Observable results: The adopter must have evidence that the proposed innovation has been successful in other situations.
Note:
You are not required to purchase Rogers’ book or pursue further information regarding his list of five qualities. The information provided here is sufficient to complete this Assignment. The full reference for Rogers’ work is provided below the due date on this page.
For this Assignment, you assume the role of a nurse facilitator in a small hospital in upstate New York. You have been part of a team preparing for the implementation of a new electronic health records system. Decisions as to the program that will be used have been finalized, and you are now tasked with preparing the nurses for the new system. There has been an undercurrent of resistance expressed by nurses, and you must respond to their concerns. You have a meeting scheduled with the nurses 1 week prior to the training on the new EHR system. Consider how you can use the five qualities outlined by Rogers (2003) to assist in preparing the nurses for the upcoming implementation.
To prepare
Review the Learning Resources this week about successful implementations of EHRs.
Consider how you would present the new EHR system to the nurses to win their approval.
Reflect on the five qualities outlined by Rogers. How would addressing each of those areas improve the likelihood of success
RESOURCES
McGonigle, D., & Mastrian, K. G. (2015).
Nursing informatics and the foundation of knowledge
(3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 15, “The Electronic Health Record and Clinical Informatics”
This chapter describes the crucial parts of an electronic health record system and explores the benefits of implementing one.
Bates, D. W. (2010). Getting in step: Electronic health records and their role in care co.
WK1 Main Post Clark Adrienne In 1992, Nursing Informatics was.docxericbrooks84875
WK1 Main Post Clark Adrienne
In 1992, Nursing Informatics was recognized as a specialty by the American Nurse Association (ANA). Nursing continues to be one of the most demanding and critical fields in medicine. Being a nurse for over 22 years, it wasn’t until the last 16 years that I had the opportunity to excel in various nursing positions which involved data mining via electronic medical records or some part of nursing informatics process. Technology in health care is increasingly becoming an integral component of the U.S. health care delivery system. Nurses, through their role in the delivery of patient care, have a pivotal role in technology deployment, maintenance, and evolution. Although nurses are becoming involved in technology in health care, the specific roles are diverse, and more nurses are expressing an interest in nursing informatics according to Ericksen (2009). Of those many roles, nursing informatics has become one of those key roles. It became my goal to learn more about nursing informatics to improve the safety and efficiency of patient care via electronic medical records documentation.
Key Functional Areas and Relevance
According to the ANA, there are nine functional area of nursing informatics (2015). During my military career, I have gained experiences via the various functional roles of informatics nursing all except the “research and evaluation” according to ANA (2015). For example, I held many nursing leadership and management positions as a utilization/case/disease manager, clinical director of operations, health care integrator, and medical management director and inspection compliance officer. For the purpose of this discussion, the two key functional areas of informatics were found to be relevant to my interest and nursing career is leadership and compliance.
When I think of the roles and responsibilities of a nurse leader, who plays a significant role in advocating for nursing informatics “interpersonal collaboration” comes to mind in developing technology (ANA, 2015). Also, nurse informatics, leaders need to communicate clearly and concisely and to structure their ideas strategically in line with the organization’s mission and goals (ANA, 2015). Together with nurse frontline managers and clinical leaders, and nurse informatics leaders help set the organization’s direction and objectives. Also, these teams strive for consistent practices and accountability across an organization. Also,
In 2005, I was stationed overseas as a new Director of Quality. Upon my arrival, there was an influx of medication errors approximately 45 reported via The Patient Safety Reporting System (PSRS) all within year to include three sentinel events. There were a few nurses' names repeated via PSRS. The Chief Nurse (CN) was in the process to submit paperwork to have their license suspended. Also, the next step was to have them remove from the military if there was no progress within a year. In preparation for my new job, I atten.
Conduct a case study analysis The Electronic Medical Record EffLinaCovington707
Conduct a case study analysis
The Electronic Medical Record: Efficient Medical Care or Disaster in the Making?
Dale Buchbinder
You are the Chief Information Officer (CIO) of a large health care system. Medicare has mandated that all medical practices seeking Medicare compensation must begin using electronic medical records (EMR). Medicare has incentivized medical practices to place electronic medical records in their offices by giving financial bonuses to medical practices that achieve certain goals. These EMR systems are supposed to allow communication between practitioners and hospitals, so medical information can be rapidly transferred to provide more efficient medical care. The EMR will enable physicians to allow access to the records of their patients by other providers. Eventually these records are supposed to be easily accessed so any physician or hospital will have complete medical information on a patient.
The physician practices in your health care system have been mandated to use the Unified Medical Record System (UMRS). The UMRS was designed by a central committee; all hospital-owned physician practices have been mandated to use the system. As part of the incentives, Medicare will add dollars back to each practice when they meet goals for reaching meaningful use (MU). MU has been defined by the U.S. Department of Health and Human Services (n.d.) as “using certified electronic health record (EHR) technology to:
• Improve quality, safety, efficiency, and reduce health disparities
• Engage patients and family
• Improve care coordination, and population and public health
• Maintain privacy and security of patient health information.”
It is a step-by-step system requiring “electronic functions to support the care of a certain percentage of patients” (Jha, Burke, DesRoches, Joshi, Kralovec, Campbell, & Buntin, 2011, p. SP118).
One of the hospitals in your system has many primary care and specialty practices; however, the UMRS system was designed primarily for the primary care practices. The committee that developed UMRS did not take into account the needs of the specialty practices, which are significantly different from the primary care practices. This issue has been brought to the forefront by several medical specialists who have stated UMRS is not only cumbersome, but also extremely difficult to use. UMRS also does not give the specialist the information he needs. Specialists noted that after UMRS was implemented, it took them approximately 10 to 15 minutes longer to see each patient. Since an average day for a specialist consists of seeing between 20 and 25 patients, adding 10 to 15 minutes per patient adds 200 to 250 additional minutes, or 3 to 4 hours more each day. And, the physician cannot see the same number of patients each day. In reality, this represents a 30% decrease in productivity because of the amount of time it takes to use UMRS. Now the specialist office schedules constantly run significantly la ...
The Dual Nature of InformaticsInformatics can be used for impr.docxhe45mcurnow
The Dual Nature of Informatics
Informatics can be used for improving health outcomes not only for individual patients, but also for whole groups of patients with similar conditions. This is often referred to as the dual nature of informatics. Technologies, such as electronic health records (EHRs) and clinical decision support (CDS) systems, can provide insights and guidance for health care professionals at the point of care. In addition, data warehousing and mining allow health care organizations to use the vast amount of information stored in EHRs to make predictions and diagnoses for other patients with similar conditions.
In this Discussion, you examine the dual nature of informatics. First, you review a scenario and consider the patient information to be collected and recorded at the point of care. Then, you decide how this information could be aggregated for population health and future use.
Consider the following scenario:
Mrs. Jones has come into your office stating that she has been experiencing frequent dizzy spells. She also reports that she has been unable to eat anything substantial over the last few days due to extreme nausea. The last time Mrs. Jones was in your office, the physician had suggested she start walking around the block or bicycling around the neighborhood to get her activity level up. Mrs. Jones admits that she did very little of that after a “ flip-flop” feeling of her heart scared her. You know that her symptoms could be a result of many conditions. Following the prompts on your informatics system, you begin to gather more specific information about Mrs. Jones’ symptoms and health history.
To prepare:
Based on the scenario, what information would you want to immediately gather about Mrs. Jones?
With that in mind, compile a list of patient questions you would like an EHR documentation screen to have.
How might the information derived from these questions help you provide high-quality care to Mrs. Jones?
Once this information is collected, what alerts might be critical to the evaluation of Mrs. Jones?
Review this week’s media presentation,
Dual Nature of Informatics Systems
, and reflect on the movement towards more transparent data and meaningful use. How might the data entered about an individual patient help to build preventative care and treatment for whole populations?
Refer back to your list of patient questions. Of these questions, which would generate data that could be aggregated for use with a larger group of patients? (
Note:
When developing your questions, consider the whole patient.)
Post on Tuesday 06/06/2016 a minimum of 550 words in APA format with 4 references
1)
A description of the ideal EHR documentation screen that you would like to have at the point of care for all patients and why.
2)
Explain how information gathered at the point of care with an individual patient can be aggregated to help provide high quality care to a larger population of patients.
Required Resources
Readin.
Integrating PHRs into EHR Platforms When electronic health re.docxBHANU281672
Integrating PHRs into EHR Platforms
When electronic health records (EHRs) first entered the market, their primary focus was to collect and analyze patient information within health care settings. As technological capabilities grew, so did the interest in making these records available to patients. In addition, many health care professionals saw benefits in allowing the patient to enter his or her own health data into EHR platforms. Though many patients are already utilizing personal health records (PHRs) to manage and track their own health, some believe that an integrated system would provide a better, more comprehensive picture of a patient’s health history.
As a result, many EHR platforms are now equipped with a PHR tool. This PHR tool allows patients to enter health information as they would in a stand-alone PHR system. In addition, web-based portals within the EHR allow patients to access information entered by their physicians and health care providers.
Like many emerging trends and technologies, there is much discussion about the potential benefits and challenges of this type of integrated system. While many health care professionals are excited about the empowerment provided to patients, others express significant concerns about access, security, ethics, and other implications.
In this Discussion, you explore how integrating PHRs into EHR platforms could impact you and your patients.
To prepare:
Review the media
Patient-Centered Technologies
, and reflect upon Dr. Simpson’
s
statements about the ownership of patient data.
Review the article,“Dreams and Nightmares: Practice and Ethical Issues for Patients and Physicians Using Personal Health Records” found in this week’s Learning Resources. Consider how PHR capabilities can be integrated into EHR platforms.
Examine the “dreams” and the “nightmares” the authors associate with this type of integrated health record. Select one benefit or one challenge of integrating PHRs into EHR platforms. Then, consider its potential impact on health care providers and patients. Why is this considered to be a benefit or challenge for health care professionals and patients?
Post by tomorrow 07/05/2016 a minimum of 550 words in APA format and 3 references.
1) A brief description of your selected benefit or challenge and support your selection.
2) Explain the potential impact on health care professionals and patients.
Required Resources
Readings
Saba, V. K., & McCormick, K. A. (2015).
Essentials of nursing informatics
(6th ed.). New York, NY: McGraw-Hill.
Review Chapter 1, “Historical Perspectives of Nursing Informatics”
In this chapter, the authors explain the transition from paper-based records to electronic records. The chapter provides an overview of the historical events that contributed to the rise of electronic health records.
Chapter 25, “Care Delivery Across the Care Continuum: Hospital-Community-Home”
Chapter 25 analyzes the impact of home health on the heal ...
Assignment 2 Complementary Partners Imagine you are working wit.docxsalmonpybus
Assignment 2: Complementary Partners
Imagine you are working with a partner to plan and host a workshop on leadership. There will be 100 people attending. Within this assignment you will be creating a document that discusses the main components of leadership and corporate culture.
Write a three to five (3-5) page paper in which you:
1. Address a key leadership trait that can assist in managing conflict.
2. Discuss a tool or strategy a leader can adopt for improving communication within the organization.
3. Describe some methods for motivating employees and improving behaviors within the workplace.
4. Format your assignment according to the following formatting requirements:
a. This course requires use of APA format.
The specific course learning outcomes associated with this assignment are:
· Describe the primary functions of management (planning, organizing, leading, controlling) and the associated skills, tools, and theoretical approaches that can be used to accomplish these functions.
· Explain the principal theories of leadership and motivation, and describe the fundamental considerations in managing and motivating individual and group behavior.
· Describe actions to improve communications, manage conflict, develop strong organizational culture, and improve the ethical behavior in organizations.
· Use technology and information resources to research issues in management concepts.
· Write clearly and concisely about management concepts using proper writing mechanics.
Introduction to Information Technology—Role in Nursing and Healthcare
In this module, we begin with an introduction to information technology and the management of information. The readings in this module identify the many areas in healthcare in which information technology is used. The fundamental of healthcare delivery is an important start to our course. Information technology is used in such healthcare facilities as ambulatory care, acute care, and subacute care. The different methods and means each healthcare facility uses and manages information technology is outlined in our readings. Healthcare providers such as direct care providers, clinical allied professionals, and other organizations (i.e., American Medical Association, American Nurses Association) all use technology to guide delivery of care, information, and manage these deliveries for various reasons (McGonigle & Mastrian, 2015).
Introduction
As an information-intensive profession, nursing continues to use information technology in healthcare. Nurses use information in applying knowledge to problems, and acting with wisdom forming the basis of the professional of nursing. The availability of this information in caring for patients continues to grow for nurses and allows for increased accessibility, accuracy, and timeliness in caring for patients. The information age is here for nursing and the U.S. healthcare system (McGonigle & Mastrian, 2015). In this module, an introduction to information technology (IT), .
February 10, 2011 BDPA Charlotte Program meeting.
Presented by:
Karen D. Hill, RHIA
Recruitment/Placement Specialist
ONC HIT Grant
Health Sciences Division
Central Piedmont Community College
Health Information Technology Workforce Development Program
Central Piedmont Community College
We have spent a lot of time this semester talking about various as.docxmelbruce90096
We have spent a lot of time this semester talking about various aspects of the health care industry -- cost, access, utilization, strategy. Another important aspect that needs to be balanced with all these other concerns is QUALITY!
What does QUALITY mean in health care?
How do you go about defining quality in health care? Is there just one measure of quality, or more?!
Find one outside article that addresses health care quality. Tell us about the article and how they define quality.
Be sure to post your citations
Alicia AliendreCOLLAPSE
Top of Form
Parent Post
In the health care industry quality of care means everyone participating in ways to improve health care such as health care professionals, patients and their families, researchers, payers, planners and educators. These changes lead to better outcomes in health, a better system performance in care, as well as better professional development.
When you describe quality, it’s the process for making strategic choices in health systems for quality assurance in health care and decision making. Although there are many outcomes to improve quality of care, the main concern is accomplishing a goal that will be beneficial for the future.
Good quality means providing patients with appropriate services in a technically competent manner, with good communication, shared decision making, and cultural sensitivity. In practical terms, poor quality can mean too much care (e.g., providing unnecessary tests, medications, and procedures, with associated risks and side effects), too little care (e.g., not providing an indicated diagnostic test or a lifesaving surgical procedure), or the wrong care (e.g., prescribing medicines that should not be given together, using poor surgical technique).
Quality can be evaluated based on structure, process, and outcomes (Donabedian 1980). Structural quality evaluates health system characteristics, process quality assesses interactions between clinicians and patients, and outcomes offer evidence about changes in patients' health status. All three dimensions can provide valuable information for measuring quality, but the published quality-of-care literature reveals that there is more experience with measuring processes of care.
Marie Savino
To many health care consumers quality of health care can mean several different things, including wait times, doctors professionalism, the courtesy of the medical staff and use of updated medical technology, which can all effect how people judge the quality of health care they are receiving. These characteristics may be important to the patient but they do not add up to a quality health care system. Quality health care can be defined as levels of superiority which distinguish the health care provided based on accepted standards of quality. Several factors help measure quality of care:
* Safety- health care does not cause harm
* Effective- health care service is based on scientific and medical knowledge and is right for the.
Change ManagementAs health care organizations adopt more and m.docxTawnaDelatorrejs
Change Management
As health care organizations adopt more and more informatics solutions, they inevitably experience significant changes. Such changes are often met with hesitation, resistance, and even outright refusal. Nurse informaticists should be aware of these barriers and be prepared to employ change-management strategies to ensure stakeholder buy-in and end-user adoption.
In this Discussion, you explore the concept of change management and how it is relevant to the role of the nurse informaticist. You consider what steps can be taken during implementation of a project to contribute to more successful end-user adoption. In addition, you explore the competencies and skills a nurse informaticist should have when serving as a change agent within an organization.
To prepare
Review this week’s Learning Resources, including pages 481–483 (
See attached file
) in the Dennis course text, on change management. How is change management relevant to the role of the nurse informaticist?
Consider steps a nurse informaticist can take to promote more successful end-user adoption.
What change-management strategies are most useful for a nurse informaticist to be aware of when implementing a change within an organization? How can those strategies help to mitigate negative attitudes toward change?
Reflect on the competencies and skills required for nurse informaticists to be effective change agents. How can you best prepare yourself to manage change and address resistance?
With these thoughts in mind:
Post by tomorrow 10/25/16 a 550 words essay in APA format and 3 references that include the level one headings as numbered below:
1)
An analysis of how change management is relevant to the role of the nurse informaticist.
2) Explain at least two change-management strategies that can be used to promote end-user adoption, and justify their effectiveness in mitigating resistance.
3) Identify at least two skills or competencies necessary for nurse informaticists in serving as change agents, and describe how you plan to cultivate those skills or competencies.
Required Readings
Dennis, A., Wixom, B. H., & Roth, R. M. (2015).
Systems analysis and design
(6th ed.). Hoboken, NJ: Wiley.
Review Chapter 13, “Transition to the New System” (pp. 400–424)
Kulhanek, B. J. (2011). Creating effective electronic medical record change management processes.
Computers, Informatics, Nursing, 29
(8), 431–435.
Retrieved from the Walden Library databases.
Efficient implementation and use of electronic medical/health records requires organizationwide restructuring. This article addresses how management procedures, organizational initiatives, and communication needs require adjustment in order to suit the changing health care environment.
Lee, V., Ridzi, F., Lo, A. W., & Coskun, E. (2011). A healthcare case study of team learner style and change management.
Journal of Organizational Change Management, 24
(6), 830–852.
Retrieved from the Walden Library databases.
.
WORK BREAKDOWN STRUCTUREProject TitleDate Prepared 1.Proje.docxlefrancoishazlett
WORK BREAKDOWN STRUCTURE
Project Title: Date Prepared:
1. Project
1.1. Major Deliverable
1.1.1. Control Account
1.1.1.1. Work package
1.1.1.2. Work package
1.1.1.3. Work package
1.1.2. Work package
1.2. Control Account
1.2.1. Work package
1.2.2. Work package
1.3. Major Deliverable
1.3.1. Control account
1.3.2. Control account
1.3.2.1. Work package
1.3.2.2. Work package
Page 1 of 1
Running Head: EVALUATING PHYSICIANS AND NURSES PERSPECTIVE ON FACTORS CONTRIBUTING TO READMISSION OF OPHTHALMIC DISCHARGED PATIENTS AND POTENTIAL ONLINE FOLLOW-UP STRATEGIES TO REDUCE THEIR READMISSION IN A GOVERNMENT HOSPITAL OF RIYADH
[Type text] [Type text] [Type text]
EVALUATING PHYSICIANS AND NURSES PERSPECTIVE ON FACTORS CONTRIBUTING TO READMISSION OF OPHTHALMIC DISCHARGED PATIENTS AND POTENTIAL ONLINE FOLLOW-UP STRATEGIES TO REDUCE THEIR READMISSION IN A GOVERNMENT HOSPITAL OF RIYADH
Evaluating Physicians and Nurses Perspective on Factors Contributing to Readmission of Ophthalmic Discharged Patients and Potential Online Follow-Up Strategies to Reduce Their Readmission in a Government Hospital of Riyadh
CHAPTER I
Introduction
Annually, unplanned readmissions cost 15-20 billion dollars, and preventing such readmission will potentially improve the quality of life for patients and decrease the financial pain of health care systems, (Alper,2017). The existing precedence of many healthcare facilities is to reduce readmissions using post-discharge follow-up practices. The definitive objective of health care providers is to deliver high-quality health care services to patients using transitional care models. The methodologies encourage the use of appropriate outpatient follow-up appointments implemented through Medicare incentives to promote the reduction in hospital readmissions (Adib-Hajbaghery, Maghaminejad & Abbasi, 2013). Comment by Editor: Setting of margins required
Many of the researchers analyzing the outcome of follow-up on outpatients in reducing hospital readmissions majors on particular illnesses in a state; hence it is shallow. The review indicates that outpatient follow-ups decrease sickle cell anemia, pediatric asthma, and heart failure patient readmission (Hasan et al., 2010; Alper, 2017). However, there is an indication of mixed results obtained from examinations on hospitalized individuals. One study carried out by the Medicare Payment Advisory Commission demonstrated that there is no relationship between the timing of outpatient follow-up, and 30-day readmission rate in discharged patients from medical facilities (Ferrandino et al., 2017).
Statement of the Problem
According to Ferrandino et al. (2017), the readmission of roughly a half of the Medicaid receivers countrywide is within 30 days of discharge, and they fail to get a follow-up on outpatient before readmission. Equally, patients readmitted for chronic illnesses recorded a decrease in outpatient follow-up. It implies that the use of timely follow-ups to decrease the rates of readmi.
Work Breakdown Structure (WBS)Project Name Massive Solutions .docxlefrancoishazlett
Work Breakdown Structure (WBS)
Project Name: Massive
Solution
s International Data Center ExpansionDate: 1/19/19
Prepared by:
1.0 Current state analysis 1
1.1 Complete an inventory of all physical and virtual servers.
1.2 Complete an inventory of all software applications currently being provided, and critical index factor (CIF) for each.
1.2.1 Identify what an acceptable downtown would be for each application.
1.3 Determine the interdependencies between applications, servers, storage, and telecommunications.
1.4 Conduct a benchmarking of existing performance metrics of data center operations.
1.5 Determine viability of moving existing equipment or cost-benefit of procuring new equipment.
2.0 Planning and management 2
2.1 Identify potential costs.
2.2 Develop a budget.
2.3 Develop a process list of all anticipated move-related tasks.
2.4 Determine lessons learned from past moves.
2.5 Test move processes to identify problems or issues.
2.6 Obtain stakeholder approval to continue project.
3.0 Data center move strategy 3
3.1 Identify key personnel who will be involved with executing the move.
3.1.1 Determine if outsourcing of tasks is required.
3.2 Identify potential risks.
3.2.1 Develop risk mitigation processes.
3.3 Assign servers and applications to move bundles.
3.4 Prioritize the order in which bundles will be moved to the new data center.
4.0 Data center migration 4
4.1 Shift data center operations to a back-up site.
4.2 Verify operations are working properly.
4.3 Shut down current operations.
4.4 Procure/order new equipment required.
4.5 Uninstall existing equipment.
4.6 Prepare for shipment.
4.7 Track shipment.
4.8 Receive shipments at new data center.
4.8.1 New procurements
4.8.2 Existing equipment
4.9 Install equipment.
4.9.1 Test and verify.
4.10 Install software/applications.
4.10.1 Test and verify.
4.11 Migrate live data from backup site.
4.11.1 Test and verify.
5.0 Post-move verification
5.1 Ensure all installations are complete.
5.2 Conduct post-move benchmarks of performance, and compare with pre-
move benchmarks to determine delta (difference), if any.
5.3 Obtain stakeholder approval and accepatance.
.
More Related Content
Similar to Discussions1.Electronic Health RecordsElectronic healt.docx
Key Topics in Health Care Technology EvaluationThe amount of new i.docxsleeperfindley
Key Topics in Health Care Technology Evaluation
The amount of new information and data, and the number of available technologies are growing at an ever-accelerating rate. Did you know that during any given 24 hours, humanity generates enough new information to fill the Library of Congress 70 times (Smolan & Erwitt, 2012)? As a nurse informaticist, it is important to keep current on new developments in the field, but with the rapid pace of change, that effort can be overwhelming. It is easier to keep current with key trends if nurse informaticists focus on selected issues.
In this Discussion, you consider key topics in the field of health care technology. You then consider the different approaches you could take when designing an evaluation in these areas. For example, if you are interested in usability, your goal could be to determine if a system is user friendly from the viewpoint of a nurse. A different goal might be to determine if the location of the system facilitates ease of use from the viewpoint of physicians.
Note:
This Discussion serves as practice for the first part of your Evaluation Project. What you derive from your Discussion with colleagues will likely inform the work that you do in Part 1 of the Evaluation Project.
The Discussion focuses on the following major topics in the health care information field:
Implementing HIT Systems
Consumer health information
Computerized Physician Order Entry (CPOE)
Decision support systems
Electronic health records (EHR)
Tele-medicine and eHealth
Nursing documentation
Other Issues Related to the Use of HIT Systems
Interoperability
Unforeseen consequences
Usability
To prepare:
Select at least
two
topics from the
lists above
that are relevant to your current organization or that are of particular interest to you. Read the articles in this week’s Learning Resources that relate to these topics. Consider why these topics are of interest to you, what relevance they have to health care organizations, and how they impact your professional responsibilities. Choose one topic to be the focus of your Evaluation Project, and consider potential evaluation goals.
Determine the viewpoint from which you would approach the evaluation, and why.
By tomorrow, post a minimum of 550 words essay in APA format with a minimum of 3 references from the list of required resources below, that addresses the level one headings as numbered below:
1)
Post
the two topics you identified as most relevant to your organization or to you personally, and explain why you selected those topics.
2)
Identify the topic you selected for your Evaluation Project, and propose three potential evaluation goals for this topic.
3)
Identify the viewpoint you would use with each goal, and explain why.
Required Readings
Friedman, C. P., & Wyatt, J. C. (2010). Evaluation methods in biomedical informatics (2nd ed.). New York, NY: Springer Science+Business Media, Inc
.
Chapter 2, “Evaluation as a Field” (pp. 21–47)
This chapter defines.
Application Evaluation Project Part 1 Evaluation Plan FocusTec.docxalfredai53p
Application: Evaluation Project Part 1: Evaluation Plan Focus
Technology increases human effectiveness. Using a lever, you can move an object several times your size. In an airplane, you can move exponentially faster than on foot. Using the Internet, you can access information much more quickly than at a library. What possibilities like this exist in the nursing field? What health information technologies can amplify your impact as a nurse far more than ever before? In this Evaluation Project, you will have the opportunity to answer these questions.
Because of the great differences between HIT systems and different goals of an evaluation, there is no one-size-fits-all evaluation plan. Different technologies require different evaluation methods. Consequently, in this part of your Evaluation Project, you will conduct research on how system implementations similar to the one you select have been previously evaluated. After exploring similar system implementations, you will select one research goal and viewpoint to use in the evaluation.
Read the following three scenarios, and select the one that is of most interest to you:
Scenario 1:
Your hospital is implementing a new unified acute and ambulatory Electronic Health Record (EHR) system through which patient care documentation will occur. Interdisciplinary assessment forms (including nursing), clinical decision support, and medical notes will be documented in this system. The implementation of the system is anticipated to improve the hospital’s performance in a multitude of areas. In particular, it is hoped that the use of the EHR system will reduce the rate of patient safety events, improve the quality of care, deter sentinel events, reduce patient readmissions, and impact spending. The implementation of the EHR system is also intended to fulfill the “Meaningful Use” requirements stipulated in the Health Information Technology for Economic and Clinical Health (HITECH) Act. As the hospital’s lead nurse informaticist, you have been tasked with planning the evaluation of the EHR implementation.
Scenario 2:
As the lead nurse informaticist in your hospital, you have been given the task of planning an evaluation for a soon-to-be launched computerized provider order entry (CPOE) system. The CPOE system is designed to replace conventional methods of placing medication, laboratory, admission, referral, and radiology orders. CPOE systems enable health care providers to electronically specify orders, rather than rely on paper prescriptions, telephone calls, and faxes. The intended goal of a CPOE system is to improve safety by ensuring that orders are easily comprehensible through the use of evidence-based order sets. In addition, the CPOE system has the potential for improving workflow by avoiding duplicate orders and reducing the steps between those who place medical orders and their recipients.
Scenario 3:
You are the lead nurse informaticist in a large urban hospital that has recently implemented a new .
Discussion The Systems Development Life Cycle and the Nurse Infor.docxmickietanger
Discussion: The Systems Development Life Cycle and the Nurse Informaticist
The systems development life cycle (SDLC) is a model for planning and implementing change within an organization. It is important for many individuals to be represented in the process, especially the end users of the system or the employees who must live with the change. As informatics become more and more widespread throughout the health care field, collaboration between information technology (IT) professionals and health care practitioners is becoming increasingly important. The nurse informaticist is able to combine the perspective of the information technology side with the clinical nursing perspective.
While the titles and specific responsibilities of nurse informaticists vary across organizations and practice settings, the fundamental purpose of the role remains the same. Nurse informaticists synthesize their knowledge of how technology can improve health care with an understanding of clinical practice and workflow. This is why nurse informaticists can be instrumental in facilitating the SDLC for informatics in health care. For this Discussion, you examine the relationship between the nurse informaticist and the use of the SDLC.
To prepare:
Review the information in this week’s Learning Resources on the SDLC and the role of the nurse informaticist. Reflect on Chapter 1 of the Dennis, Wixom, and Roth course text and consider how the information about the systems analyst role translates into nursing and health care.
Consider a recent change in your organization related to the implementation of a new technology or system. How was this change handled? What was the general SDLC process? Who was involved, and what were the outcomes?
Identify whether your organization (or one with which you are familiar) has a formal title or position for the nurse informaticist. This position may be called by a different name, such as nurse informatics specialist or informatics analyst, so be sure to review the position description.
If your organization has a position for the nurse informaticist, what are the responsibilities of that position? If your organization does not have such a position, conduct research in the Walden Library and at credible online sources on the role of the nurse informaticist.
Reflect on the role of the nurse informaticist in the overall health care field. How is this position connected to the SDLC? Assess the benefits of having this specialized position within health care organizations and involving the nurse informaticist in the SDLC.
Post by tomorrow 8/30/16 550 words in APA format with a minimum of 3 references from the list provided under Required Readings. Apply the level 1 headings as numbered below:
1) A description of how the systems development life cycle is utilized in your organization (Hospital), or in one with which you are familiar, and assess its effectiveness.
2)
Assess the role of the nurse informaticist in your organization. If.
Assignment Application Adoption of New Technology SystemsAs a nu.docxrosemariebrayshaw
Assignment: Application: Adoption of New Technology Systems
As a nurse, you can have a great impact on the success or failure of the adoption of EHRs. It is important for nurses to understand their role as change agents and the ways they can influence others when addressing the challenges of changing to a drastically different way of doing things.
Everett Rogers, a pioneer in the field of the diffusion of innovations, identified five qualities that determine individual attitudes towards adopting new technology (2003). He theorized that individuals are concerned with:
Relative advantage: The individual adopting the new innovation must see how it will be an improvement over the old way of doing things.
Compatibility with existing values and practices: The adopter must understand how the new innovation aligns with current practices.
Simplicity: The adopter must believe he or she can easily master the new technology; the more difficult learning the new system appears, the greater the resistance that will occur.
Trialability: The adopter should have the opportunity to “play around’ with the new technology and explore its capabilities.
Observable results: The adopter must have evidence that the proposed innovation has been successful in other situations.
Note:
You are not required to purchase Rogers’ book or pursue further information regarding his list of five qualities. The information provided here is sufficient to complete this Assignment. The full reference for Rogers’ work is provided below the due date on this page.
For this Assignment, you assume the role of a nurse facilitator in a small hospital in upstate New York. You have been part of a team preparing for the implementation of a new electronic health records system. Decisions as to the program that will be used have been finalized, and you are now tasked with preparing the nurses for the new system. There has been an undercurrent of resistance expressed by nurses, and you must respond to their concerns. You have a meeting scheduled with the nurses 1 week prior to the training on the new EHR system. Consider how you can use the five qualities outlined by Rogers (2003) to assist in preparing the nurses for the upcoming implementation.
To prepare
Review the Learning Resources this week about successful implementations of EHRs.
Consider how you would present the new EHR system to the nurses to win their approval.
Reflect on the five qualities outlined by Rogers. How would addressing each of those areas improve the likelihood of success
RESOURCES
McGonigle, D., & Mastrian, K. G. (2015).
Nursing informatics and the foundation of knowledge
(3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 15, “The Electronic Health Record and Clinical Informatics”
This chapter describes the crucial parts of an electronic health record system and explores the benefits of implementing one.
Bates, D. W. (2010). Getting in step: Electronic health records and their role in care co.
WK1 Main Post Clark Adrienne In 1992, Nursing Informatics was.docxericbrooks84875
WK1 Main Post Clark Adrienne
In 1992, Nursing Informatics was recognized as a specialty by the American Nurse Association (ANA). Nursing continues to be one of the most demanding and critical fields in medicine. Being a nurse for over 22 years, it wasn’t until the last 16 years that I had the opportunity to excel in various nursing positions which involved data mining via electronic medical records or some part of nursing informatics process. Technology in health care is increasingly becoming an integral component of the U.S. health care delivery system. Nurses, through their role in the delivery of patient care, have a pivotal role in technology deployment, maintenance, and evolution. Although nurses are becoming involved in technology in health care, the specific roles are diverse, and more nurses are expressing an interest in nursing informatics according to Ericksen (2009). Of those many roles, nursing informatics has become one of those key roles. It became my goal to learn more about nursing informatics to improve the safety and efficiency of patient care via electronic medical records documentation.
Key Functional Areas and Relevance
According to the ANA, there are nine functional area of nursing informatics (2015). During my military career, I have gained experiences via the various functional roles of informatics nursing all except the “research and evaluation” according to ANA (2015). For example, I held many nursing leadership and management positions as a utilization/case/disease manager, clinical director of operations, health care integrator, and medical management director and inspection compliance officer. For the purpose of this discussion, the two key functional areas of informatics were found to be relevant to my interest and nursing career is leadership and compliance.
When I think of the roles and responsibilities of a nurse leader, who plays a significant role in advocating for nursing informatics “interpersonal collaboration” comes to mind in developing technology (ANA, 2015). Also, nurse informatics, leaders need to communicate clearly and concisely and to structure their ideas strategically in line with the organization’s mission and goals (ANA, 2015). Together with nurse frontline managers and clinical leaders, and nurse informatics leaders help set the organization’s direction and objectives. Also, these teams strive for consistent practices and accountability across an organization. Also,
In 2005, I was stationed overseas as a new Director of Quality. Upon my arrival, there was an influx of medication errors approximately 45 reported via The Patient Safety Reporting System (PSRS) all within year to include three sentinel events. There were a few nurses' names repeated via PSRS. The Chief Nurse (CN) was in the process to submit paperwork to have their license suspended. Also, the next step was to have them remove from the military if there was no progress within a year. In preparation for my new job, I atten.
Conduct a case study analysis The Electronic Medical Record EffLinaCovington707
Conduct a case study analysis
The Electronic Medical Record: Efficient Medical Care or Disaster in the Making?
Dale Buchbinder
You are the Chief Information Officer (CIO) of a large health care system. Medicare has mandated that all medical practices seeking Medicare compensation must begin using electronic medical records (EMR). Medicare has incentivized medical practices to place electronic medical records in their offices by giving financial bonuses to medical practices that achieve certain goals. These EMR systems are supposed to allow communication between practitioners and hospitals, so medical information can be rapidly transferred to provide more efficient medical care. The EMR will enable physicians to allow access to the records of their patients by other providers. Eventually these records are supposed to be easily accessed so any physician or hospital will have complete medical information on a patient.
The physician practices in your health care system have been mandated to use the Unified Medical Record System (UMRS). The UMRS was designed by a central committee; all hospital-owned physician practices have been mandated to use the system. As part of the incentives, Medicare will add dollars back to each practice when they meet goals for reaching meaningful use (MU). MU has been defined by the U.S. Department of Health and Human Services (n.d.) as “using certified electronic health record (EHR) technology to:
• Improve quality, safety, efficiency, and reduce health disparities
• Engage patients and family
• Improve care coordination, and population and public health
• Maintain privacy and security of patient health information.”
It is a step-by-step system requiring “electronic functions to support the care of a certain percentage of patients” (Jha, Burke, DesRoches, Joshi, Kralovec, Campbell, & Buntin, 2011, p. SP118).
One of the hospitals in your system has many primary care and specialty practices; however, the UMRS system was designed primarily for the primary care practices. The committee that developed UMRS did not take into account the needs of the specialty practices, which are significantly different from the primary care practices. This issue has been brought to the forefront by several medical specialists who have stated UMRS is not only cumbersome, but also extremely difficult to use. UMRS also does not give the specialist the information he needs. Specialists noted that after UMRS was implemented, it took them approximately 10 to 15 minutes longer to see each patient. Since an average day for a specialist consists of seeing between 20 and 25 patients, adding 10 to 15 minutes per patient adds 200 to 250 additional minutes, or 3 to 4 hours more each day. And, the physician cannot see the same number of patients each day. In reality, this represents a 30% decrease in productivity because of the amount of time it takes to use UMRS. Now the specialist office schedules constantly run significantly la ...
The Dual Nature of InformaticsInformatics can be used for impr.docxhe45mcurnow
The Dual Nature of Informatics
Informatics can be used for improving health outcomes not only for individual patients, but also for whole groups of patients with similar conditions. This is often referred to as the dual nature of informatics. Technologies, such as electronic health records (EHRs) and clinical decision support (CDS) systems, can provide insights and guidance for health care professionals at the point of care. In addition, data warehousing and mining allow health care organizations to use the vast amount of information stored in EHRs to make predictions and diagnoses for other patients with similar conditions.
In this Discussion, you examine the dual nature of informatics. First, you review a scenario and consider the patient information to be collected and recorded at the point of care. Then, you decide how this information could be aggregated for population health and future use.
Consider the following scenario:
Mrs. Jones has come into your office stating that she has been experiencing frequent dizzy spells. She also reports that she has been unable to eat anything substantial over the last few days due to extreme nausea. The last time Mrs. Jones was in your office, the physician had suggested she start walking around the block or bicycling around the neighborhood to get her activity level up. Mrs. Jones admits that she did very little of that after a “ flip-flop” feeling of her heart scared her. You know that her symptoms could be a result of many conditions. Following the prompts on your informatics system, you begin to gather more specific information about Mrs. Jones’ symptoms and health history.
To prepare:
Based on the scenario, what information would you want to immediately gather about Mrs. Jones?
With that in mind, compile a list of patient questions you would like an EHR documentation screen to have.
How might the information derived from these questions help you provide high-quality care to Mrs. Jones?
Once this information is collected, what alerts might be critical to the evaluation of Mrs. Jones?
Review this week’s media presentation,
Dual Nature of Informatics Systems
, and reflect on the movement towards more transparent data and meaningful use. How might the data entered about an individual patient help to build preventative care and treatment for whole populations?
Refer back to your list of patient questions. Of these questions, which would generate data that could be aggregated for use with a larger group of patients? (
Note:
When developing your questions, consider the whole patient.)
Post on Tuesday 06/06/2016 a minimum of 550 words in APA format with 4 references
1)
A description of the ideal EHR documentation screen that you would like to have at the point of care for all patients and why.
2)
Explain how information gathered at the point of care with an individual patient can be aggregated to help provide high quality care to a larger population of patients.
Required Resources
Readin.
Integrating PHRs into EHR Platforms When electronic health re.docxBHANU281672
Integrating PHRs into EHR Platforms
When electronic health records (EHRs) first entered the market, their primary focus was to collect and analyze patient information within health care settings. As technological capabilities grew, so did the interest in making these records available to patients. In addition, many health care professionals saw benefits in allowing the patient to enter his or her own health data into EHR platforms. Though many patients are already utilizing personal health records (PHRs) to manage and track their own health, some believe that an integrated system would provide a better, more comprehensive picture of a patient’s health history.
As a result, many EHR platforms are now equipped with a PHR tool. This PHR tool allows patients to enter health information as they would in a stand-alone PHR system. In addition, web-based portals within the EHR allow patients to access information entered by their physicians and health care providers.
Like many emerging trends and technologies, there is much discussion about the potential benefits and challenges of this type of integrated system. While many health care professionals are excited about the empowerment provided to patients, others express significant concerns about access, security, ethics, and other implications.
In this Discussion, you explore how integrating PHRs into EHR platforms could impact you and your patients.
To prepare:
Review the media
Patient-Centered Technologies
, and reflect upon Dr. Simpson’
s
statements about the ownership of patient data.
Review the article,“Dreams and Nightmares: Practice and Ethical Issues for Patients and Physicians Using Personal Health Records” found in this week’s Learning Resources. Consider how PHR capabilities can be integrated into EHR platforms.
Examine the “dreams” and the “nightmares” the authors associate with this type of integrated health record. Select one benefit or one challenge of integrating PHRs into EHR platforms. Then, consider its potential impact on health care providers and patients. Why is this considered to be a benefit or challenge for health care professionals and patients?
Post by tomorrow 07/05/2016 a minimum of 550 words in APA format and 3 references.
1) A brief description of your selected benefit or challenge and support your selection.
2) Explain the potential impact on health care professionals and patients.
Required Resources
Readings
Saba, V. K., & McCormick, K. A. (2015).
Essentials of nursing informatics
(6th ed.). New York, NY: McGraw-Hill.
Review Chapter 1, “Historical Perspectives of Nursing Informatics”
In this chapter, the authors explain the transition from paper-based records to electronic records. The chapter provides an overview of the historical events that contributed to the rise of electronic health records.
Chapter 25, “Care Delivery Across the Care Continuum: Hospital-Community-Home”
Chapter 25 analyzes the impact of home health on the heal ...
Assignment 2 Complementary Partners Imagine you are working wit.docxsalmonpybus
Assignment 2: Complementary Partners
Imagine you are working with a partner to plan and host a workshop on leadership. There will be 100 people attending. Within this assignment you will be creating a document that discusses the main components of leadership and corporate culture.
Write a three to five (3-5) page paper in which you:
1. Address a key leadership trait that can assist in managing conflict.
2. Discuss a tool or strategy a leader can adopt for improving communication within the organization.
3. Describe some methods for motivating employees and improving behaviors within the workplace.
4. Format your assignment according to the following formatting requirements:
a. This course requires use of APA format.
The specific course learning outcomes associated with this assignment are:
· Describe the primary functions of management (planning, organizing, leading, controlling) and the associated skills, tools, and theoretical approaches that can be used to accomplish these functions.
· Explain the principal theories of leadership and motivation, and describe the fundamental considerations in managing and motivating individual and group behavior.
· Describe actions to improve communications, manage conflict, develop strong organizational culture, and improve the ethical behavior in organizations.
· Use technology and information resources to research issues in management concepts.
· Write clearly and concisely about management concepts using proper writing mechanics.
Introduction to Information Technology—Role in Nursing and Healthcare
In this module, we begin with an introduction to information technology and the management of information. The readings in this module identify the many areas in healthcare in which information technology is used. The fundamental of healthcare delivery is an important start to our course. Information technology is used in such healthcare facilities as ambulatory care, acute care, and subacute care. The different methods and means each healthcare facility uses and manages information technology is outlined in our readings. Healthcare providers such as direct care providers, clinical allied professionals, and other organizations (i.e., American Medical Association, American Nurses Association) all use technology to guide delivery of care, information, and manage these deliveries for various reasons (McGonigle & Mastrian, 2015).
Introduction
As an information-intensive profession, nursing continues to use information technology in healthcare. Nurses use information in applying knowledge to problems, and acting with wisdom forming the basis of the professional of nursing. The availability of this information in caring for patients continues to grow for nurses and allows for increased accessibility, accuracy, and timeliness in caring for patients. The information age is here for nursing and the U.S. healthcare system (McGonigle & Mastrian, 2015). In this module, an introduction to information technology (IT), .
February 10, 2011 BDPA Charlotte Program meeting.
Presented by:
Karen D. Hill, RHIA
Recruitment/Placement Specialist
ONC HIT Grant
Health Sciences Division
Central Piedmont Community College
Health Information Technology Workforce Development Program
Central Piedmont Community College
We have spent a lot of time this semester talking about various as.docxmelbruce90096
We have spent a lot of time this semester talking about various aspects of the health care industry -- cost, access, utilization, strategy. Another important aspect that needs to be balanced with all these other concerns is QUALITY!
What does QUALITY mean in health care?
How do you go about defining quality in health care? Is there just one measure of quality, or more?!
Find one outside article that addresses health care quality. Tell us about the article and how they define quality.
Be sure to post your citations
Alicia AliendreCOLLAPSE
Top of Form
Parent Post
In the health care industry quality of care means everyone participating in ways to improve health care such as health care professionals, patients and their families, researchers, payers, planners and educators. These changes lead to better outcomes in health, a better system performance in care, as well as better professional development.
When you describe quality, it’s the process for making strategic choices in health systems for quality assurance in health care and decision making. Although there are many outcomes to improve quality of care, the main concern is accomplishing a goal that will be beneficial for the future.
Good quality means providing patients with appropriate services in a technically competent manner, with good communication, shared decision making, and cultural sensitivity. In practical terms, poor quality can mean too much care (e.g., providing unnecessary tests, medications, and procedures, with associated risks and side effects), too little care (e.g., not providing an indicated diagnostic test or a lifesaving surgical procedure), or the wrong care (e.g., prescribing medicines that should not be given together, using poor surgical technique).
Quality can be evaluated based on structure, process, and outcomes (Donabedian 1980). Structural quality evaluates health system characteristics, process quality assesses interactions between clinicians and patients, and outcomes offer evidence about changes in patients' health status. All three dimensions can provide valuable information for measuring quality, but the published quality-of-care literature reveals that there is more experience with measuring processes of care.
Marie Savino
To many health care consumers quality of health care can mean several different things, including wait times, doctors professionalism, the courtesy of the medical staff and use of updated medical technology, which can all effect how people judge the quality of health care they are receiving. These characteristics may be important to the patient but they do not add up to a quality health care system. Quality health care can be defined as levels of superiority which distinguish the health care provided based on accepted standards of quality. Several factors help measure quality of care:
* Safety- health care does not cause harm
* Effective- health care service is based on scientific and medical knowledge and is right for the.
Change ManagementAs health care organizations adopt more and m.docxTawnaDelatorrejs
Change Management
As health care organizations adopt more and more informatics solutions, they inevitably experience significant changes. Such changes are often met with hesitation, resistance, and even outright refusal. Nurse informaticists should be aware of these barriers and be prepared to employ change-management strategies to ensure stakeholder buy-in and end-user adoption.
In this Discussion, you explore the concept of change management and how it is relevant to the role of the nurse informaticist. You consider what steps can be taken during implementation of a project to contribute to more successful end-user adoption. In addition, you explore the competencies and skills a nurse informaticist should have when serving as a change agent within an organization.
To prepare
Review this week’s Learning Resources, including pages 481–483 (
See attached file
) in the Dennis course text, on change management. How is change management relevant to the role of the nurse informaticist?
Consider steps a nurse informaticist can take to promote more successful end-user adoption.
What change-management strategies are most useful for a nurse informaticist to be aware of when implementing a change within an organization? How can those strategies help to mitigate negative attitudes toward change?
Reflect on the competencies and skills required for nurse informaticists to be effective change agents. How can you best prepare yourself to manage change and address resistance?
With these thoughts in mind:
Post by tomorrow 10/25/16 a 550 words essay in APA format and 3 references that include the level one headings as numbered below:
1)
An analysis of how change management is relevant to the role of the nurse informaticist.
2) Explain at least two change-management strategies that can be used to promote end-user adoption, and justify their effectiveness in mitigating resistance.
3) Identify at least two skills or competencies necessary for nurse informaticists in serving as change agents, and describe how you plan to cultivate those skills or competencies.
Required Readings
Dennis, A., Wixom, B. H., & Roth, R. M. (2015).
Systems analysis and design
(6th ed.). Hoboken, NJ: Wiley.
Review Chapter 13, “Transition to the New System” (pp. 400–424)
Kulhanek, B. J. (2011). Creating effective electronic medical record change management processes.
Computers, Informatics, Nursing, 29
(8), 431–435.
Retrieved from the Walden Library databases.
Efficient implementation and use of electronic medical/health records requires organizationwide restructuring. This article addresses how management procedures, organizational initiatives, and communication needs require adjustment in order to suit the changing health care environment.
Lee, V., Ridzi, F., Lo, A. W., & Coskun, E. (2011). A healthcare case study of team learner style and change management.
Journal of Organizational Change Management, 24
(6), 830–852.
Retrieved from the Walden Library databases.
.
Similar to Discussions1.Electronic Health RecordsElectronic healt.docx (20)
WORK BREAKDOWN STRUCTUREProject TitleDate Prepared 1.Proje.docxlefrancoishazlett
WORK BREAKDOWN STRUCTURE
Project Title: Date Prepared:
1. Project
1.1. Major Deliverable
1.1.1. Control Account
1.1.1.1. Work package
1.1.1.2. Work package
1.1.1.3. Work package
1.1.2. Work package
1.2. Control Account
1.2.1. Work package
1.2.2. Work package
1.3. Major Deliverable
1.3.1. Control account
1.3.2. Control account
1.3.2.1. Work package
1.3.2.2. Work package
Page 1 of 1
Running Head: EVALUATING PHYSICIANS AND NURSES PERSPECTIVE ON FACTORS CONTRIBUTING TO READMISSION OF OPHTHALMIC DISCHARGED PATIENTS AND POTENTIAL ONLINE FOLLOW-UP STRATEGIES TO REDUCE THEIR READMISSION IN A GOVERNMENT HOSPITAL OF RIYADH
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EVALUATING PHYSICIANS AND NURSES PERSPECTIVE ON FACTORS CONTRIBUTING TO READMISSION OF OPHTHALMIC DISCHARGED PATIENTS AND POTENTIAL ONLINE FOLLOW-UP STRATEGIES TO REDUCE THEIR READMISSION IN A GOVERNMENT HOSPITAL OF RIYADH
Evaluating Physicians and Nurses Perspective on Factors Contributing to Readmission of Ophthalmic Discharged Patients and Potential Online Follow-Up Strategies to Reduce Their Readmission in a Government Hospital of Riyadh
CHAPTER I
Introduction
Annually, unplanned readmissions cost 15-20 billion dollars, and preventing such readmission will potentially improve the quality of life for patients and decrease the financial pain of health care systems, (Alper,2017). The existing precedence of many healthcare facilities is to reduce readmissions using post-discharge follow-up practices. The definitive objective of health care providers is to deliver high-quality health care services to patients using transitional care models. The methodologies encourage the use of appropriate outpatient follow-up appointments implemented through Medicare incentives to promote the reduction in hospital readmissions (Adib-Hajbaghery, Maghaminejad & Abbasi, 2013). Comment by Editor: Setting of margins required
Many of the researchers analyzing the outcome of follow-up on outpatients in reducing hospital readmissions majors on particular illnesses in a state; hence it is shallow. The review indicates that outpatient follow-ups decrease sickle cell anemia, pediatric asthma, and heart failure patient readmission (Hasan et al., 2010; Alper, 2017). However, there is an indication of mixed results obtained from examinations on hospitalized individuals. One study carried out by the Medicare Payment Advisory Commission demonstrated that there is no relationship between the timing of outpatient follow-up, and 30-day readmission rate in discharged patients from medical facilities (Ferrandino et al., 2017).
Statement of the Problem
According to Ferrandino et al. (2017), the readmission of roughly a half of the Medicaid receivers countrywide is within 30 days of discharge, and they fail to get a follow-up on outpatient before readmission. Equally, patients readmitted for chronic illnesses recorded a decrease in outpatient follow-up. It implies that the use of timely follow-ups to decrease the rates of readmi.
Work Breakdown Structure (WBS)Project Name Massive Solutions .docxlefrancoishazlett
Work Breakdown Structure (WBS)
Project Name: Massive
Solution
s International Data Center ExpansionDate: 1/19/19
Prepared by:
1.0 Current state analysis 1
1.1 Complete an inventory of all physical and virtual servers.
1.2 Complete an inventory of all software applications currently being provided, and critical index factor (CIF) for each.
1.2.1 Identify what an acceptable downtown would be for each application.
1.3 Determine the interdependencies between applications, servers, storage, and telecommunications.
1.4 Conduct a benchmarking of existing performance metrics of data center operations.
1.5 Determine viability of moving existing equipment or cost-benefit of procuring new equipment.
2.0 Planning and management 2
2.1 Identify potential costs.
2.2 Develop a budget.
2.3 Develop a process list of all anticipated move-related tasks.
2.4 Determine lessons learned from past moves.
2.5 Test move processes to identify problems or issues.
2.6 Obtain stakeholder approval to continue project.
3.0 Data center move strategy 3
3.1 Identify key personnel who will be involved with executing the move.
3.1.1 Determine if outsourcing of tasks is required.
3.2 Identify potential risks.
3.2.1 Develop risk mitigation processes.
3.3 Assign servers and applications to move bundles.
3.4 Prioritize the order in which bundles will be moved to the new data center.
4.0 Data center migration 4
4.1 Shift data center operations to a back-up site.
4.2 Verify operations are working properly.
4.3 Shut down current operations.
4.4 Procure/order new equipment required.
4.5 Uninstall existing equipment.
4.6 Prepare for shipment.
4.7 Track shipment.
4.8 Receive shipments at new data center.
4.8.1 New procurements
4.8.2 Existing equipment
4.9 Install equipment.
4.9.1 Test and verify.
4.10 Install software/applications.
4.10.1 Test and verify.
4.11 Migrate live data from backup site.
4.11.1 Test and verify.
5.0 Post-move verification
5.1 Ensure all installations are complete.
5.2 Conduct post-move benchmarks of performance, and compare with pre-
move benchmarks to determine delta (difference), if any.
5.3 Obtain stakeholder approval and accepatance.
.
work breakdown structureAssignment ContentCreate a Wor.docxlefrancoishazlett
work breakdown structure
Assignment Content
Create
a Work Breakdown Structure (WBS) and project schedule for the Learning Software Project.
Use
Microsoft® Project to list the components and breakdown of the project's WBS (i.e., project phases, grouping of tasks, resource assignments, etc.).
Develop
a Gantt chart with the following:
Project phase
Tasks
Resource names/titles
Duration
Start and finish dates
Predecessors
Milestones highlighted
Submit
your assignment.
.
Work as a team to complete a Lean Six Sigma implementation case. EV.docxlefrancoishazlett
Work as a team to complete a Lean Six Sigma implementation case. EVERYONE will interview two different person(s) who have experienced or associated with the Lean, Six Sigma, or Lean Six Sigma implementation project. The interviews can be via phone, f2f meeting, or video conference and focus on the following topics:
- The project’s objectives and outcomes (successful/failure), brief explaining methodology
- The roles of this person in the project
- Any forces and factors enabling the implementation process
- Any barriers or obstacles that limited or constrained the process
- Any techniques/tools and relevant metrics used by the organization
Section 1 – brief description of all interviews following the above topics
- Section 2 – drawing tables/figures finding similarities and differences of these interviews focusing on forces and factors enabling the implementation, as well as the barriers or obstacles that limited or constrained the process. Any other useful information on Lean Six Sigma implementation process should be presented.
A list of reference noting the interviews conducted (names of individuals and organizations can be masked), data utilized, and additional source materials cited or consulted.
QUESTIONS WHICH HAVE TO BE ASKED ARE LISTED IN BELOW ATTACHED PHOTO
.
Work Area Recovery Plan is a vital plan that establishes an adequate.docxlefrancoishazlett
Work Area Recovery Plan is a vital plan that establishes an adequate environment for people to work in the event of a disruptive incident. Discuss the challenges that organizations without proper Work Area Recovery Plan may face when disruptive events arise.
What are the benefits of performing Pandemic risk assessment in an organization?
.
WORK 1Mental Health DisorderNeurological developmental dis.docxlefrancoishazlett
WORK 1
Mental Health Disorder
Neurological developmental disorder
Introduction
1. Make a detailed summary where you define the disorders within the assigned category, their diagnostic criteria, specifiers and differential diagnoses.
2. What are neurodevelopmental disorders
3. Some causes of neurodevelopmental disorders
4. Classification of neurodevelopmental disorders
5. Intellectual disability
6. Communication disorders
7. Autism Spectrum Disorder (ASD)
8. Attention deficit hyperactivity disorder (ADHD)
9. Latest advances
10. Describe the prevalence, development and course
11. Risk factors
12. Cultural considerations
13. Present examples of situations / cases in relation to the assigned disorder
14. Present physical conditions associated with the disorder
15. Medications and clinical intervention models that have shown effectiveness
16. Look for articles or professional mental health journals (minimum 2 articles) that talk about these disorders and report relevant information for Clinical Social Work.
Important:
1. They must use the DSM V, textbooks, Virtual Library
2. The professional articles must be in this time frame 2015 to 2021.
3. They can use additional resources to support their presentation (videos, role play, cases to discuss)
4. APA format
WORK 2
Mental Health Disorders
Neurocognitive Disorder
Oral presentation content by topic:
Presentation 2
Introduction
1. MAJOR NEUROCOGNITIVE DISORDERS (DEMENTIA)
2. EPIDEMIOLOGY
3. ETHIOPATHOGENESIS
4. EVALUATION, DIAGNOSTIC CRITERIA AND CLASSIFICATION
5. COGNITIVE TESTS
6. TREATMENT
7. AFFECTIVE DISORDERS IN THE ELDERLY ADULT
-GENERAL PERSPECTIVES
-SPECIFIC ENTITIES
8. TREATMENT AND PROGNOSIS
9. SLEEP DISORDERS IN THE ELDERLY ADULT
10. THE FUNCTIONS OF SLEEP AND SPECIFIC ENTITIES
17. Latest advances
18. Describe the prevalence, development and course
19. Risk factors
20. Cultural considerations
21. Present examples of situations / cases in relation to the assigned disorder
22. Present physical conditions associated with the disorder
23. Medications and clinical intervention models that have shown effectiveness
24. Look for articles or professional mental health journals (minimum 2 articles) that talk about these disorders and report relevant information for Clinical Social Work.
Important:
1. They must use the DSM V, textbooks, Virtual Library
2. The professional articles must be in this time frame 2015 to 2021.
3. They can use additional resources to support their presentation (videos, role play, cases to discuss)
4. APA format
.
Wordsworths Tintern Abbey is reflection on nature. Pick one of .docxlefrancoishazlett
Wordsworth's
Tintern Abbey is
reflection on nature. Pick one of these poems, and discuss the role nature plays in human life according to its author. (Be sure to refer to specific evidence in the text.) Do you agree or disagree with their view? Why? write about 300 words.
.
Words400 Topic When it comes to politics, the role of a wome.docxlefrancoishazlett
Words:40
0
Topic:
When it comes to politics, the role of a women in a less developed country will change significantly as women are now allowed to vote and become members of the parliament.
Description:
Literature review:
This section
reviews
the literature on key topics and makes links to the chosen theme. Include definitions of key concepts, and analyse and compare the effects and importance of the various trends based upon the readings. The literature review requires the group to address key areas in relation to the topic and theme
(
Concentrate here
in the lit review
on the ideas authors discuss about the role of
political
representation
in overcoming inequality
. Maybe use a historical perspective. A lit review should focus on ideas/arguments of authors, not statistics
. What are Mitter & Rowbotham / Burchielli / Mehdizadeh / Braverman / Williams
’
ideas
about power & equality, roles & economic freedom? Even
the international labour rights movement
)
Attached are 5 journal articles that need to be used. And you need to get 5 other journal articles.
References: 10
.
Words 500 Review the distinction between leadership and managem.docxlefrancoishazlett
Words: 500
Review the distinction between leadership and management. Then think about this in regard to how senior leaders versus senior managers lead change in an organization (especially when it comes to technical change in an organization).
When implementing change in an organization, there are always cultural issues that are faced, such as not accepting change, determine how differently this would be handled thinking about the management versus leadership constructs?
When dealing with performing work, how is this implemented differently within the management versus leadership constructs?
At least one scholarly (peer-reviewed) resource should be used in the initial discussion thread. Use APA references and in-text citations.
.
Wordcount 3.000 words (+-10).Cover, Table of Contents, Refe.docxlefrancoishazlett
Wordcount: 3.000 words (+/-10%).
Cover, Table of Contents, References and Appendix are excluded of the total slide count.
Font: Arial, size 12.5.
Text alignment: Justified.
The in-text References and the Bibliography have to be in Harvard’s citation style.
.
Words can be intelligible, cultural and storied. It may mean differ.docxlefrancoishazlett
“Words can be intelligible, cultural and storied. It may mean different things to you and to others. It may have one, several to many meanings, depending on where and who you are."
Pick one word or one phrase you feel you can write about to show you understand this. (Around Communications)
According to Communications and Culture:
1. Define it.
2. Explain its significance and meaning to you and us in our society
3. connect/refer to the topics /concepts taught in the course textbook only.
No references needed. References ONLY textbook and real-world examples.
Textbook: Strom, Bill and Agodzo, Divine (2018). More Than Talk: A Covenantal Approach to Everyday
Communication
, 5th edition. Dubuque, IA: Kendall/Hunt Publishing Company.
.
Word Test Out Materialw00_cumexam_council.xlsxCity of Floma C.docxlefrancoishazlett
Word Test Out Material/w00_cumexam_council.xlsx
City of Floma Council MembersSalutationFirst NameLast NameMrs.JenniferDoyleMr.DavidDawsonMr.RobertMosleyDr.JeremyRoy
Word Test Out Material/w00_cumexam_data.docx
City of Floma
Fiscal Year 2018 Audit ReportExecutive Summary
Introduction
This audit report was prepared to satisfy the City of Floma Charter’s requirement to have an external, independent, and qualified auditor annually examine its operations. The stated goal of the audit is to provide the citizens of the city with assurance that the city’s resources are being managed in accordance with local, state, and federal regulations.
The information presented in this audit report was compiled from data found in public records, transaction and management databases used by municipal software applications, and personal interviews of city employees. The data was reviewed for consistency and compliance with Generally Accepted Accounting Principles for state and local governments. Analysis of the data was then conducted to determine where opportunities for improved efficiencies exist.
The result of the audit can be found below. It includes specific findings by city department, supporting tables, and general recommendations.City Departments
Public Safety (Police and Fire)
The analysis of the personnel expenditures of both public safety agencies found that overall costs can be reduced by hiring additional police officers and firefighters. Calculations to support this conclusion can be found in Table 1 below. The current spending on overtime warrants the net addition of two police officers and one firefighter in fiscal year 2019.
The population growth of the city is noted, and as such, additional hires should be anticipated in each of the following two years. The hires required to maintain proper personnel levels in the police force and fire department will be financially covered by the expected increase in city tax revenue commensurate with the population growth.
Utilities
The acquisition of smart electricity meters has continued at a steady pace throughout 2018. We observed delays in the installation and proper configuration of the smart meters, which causes unnecessary inconvenience for citizens. The city personnel tasked with the implementation of the smart meters has not received sufficient training to complete the project within the allotted time frame.
The utility department should organize additional training sessions for the two supervisors so that they may in turn train their employees. This training is to focus on efficient installation of the meters and connection of the meters to the central utility computer system. Until such training is completed, it is not advisable to continue installation of the new meters to avoid disruptions and costly rework.
Waste Management
The Waste Management Department has not made any plans to address the city’s landfill capacity. The landfill is expected to reach its designed capacity in Q2, 2020. Several.
Words 1500 - 1700You have recently hired a new assistant, Susan .docxlefrancoishazlett
Words 1500 - 1700
You have recently hired a new assistant, Susan Thompson, who previously worked in a financial accounting office preparing journal entries, which provide you with a recording of the day-to-day activities of the company and financial statements (income statement, statement of owners' equity balance sheet, and cash flow statement). Although your new assistant has experience with and fully understands financial accounting, she has no experience with managerial accounting.
Assignment
In a memo to your new assistant, Susan Thompson, explain to her the similarities and differences between financial and managerial accounting. Provide examples of managerial accounting reports that she could expect to see within EEC, and explain how management might use the information to make decisions. Keep in mind that the income statement, statement of owners’ equity balance sheet, and cash flow statement, although generated in financial accounting, are used to develop all of your managerial accounting reports. Examples of a few of those reports are the horizontal analyzes, vertical analyzes, and ratios.
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Woodside and McClam (2013) describe the three components of case.docxlefrancoishazlett
Woodside and McClam (2013) describe the three components of case management as case review, report writing and documentation, and client participation.
In your own words, describe each of these components. Why is each component important for case managers?
Which component do you think is most important? Justify your answer.
Woodside, M., & McClam, T. (2013).
Generalist case management: A method of human service delivery
(4th ed.). Belmont, CA: Cengage.
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Word limit is 650, must be in APA format, citations and references.docxlefrancoishazlett
Word limit is 650, must be in APA format, citations and references
Consider this hypothetical situation:
David Doe is a network administrator for the ABC Company. David is passed over for promotion three times. He is quite vocal in his dissatisfaction with this situation. In fact, he begins to express negative opinions about the organization in general. Eventually, David quits and begins his own consulting business. Six months after David’s departure, it is discovered that a good deal of the ABC Company’s research has suddenly been duplicated by a competitor. Executives at ABC suspect that David Doe has done some consulting work for this competitor and may have passed on sensitive data. However, in the interim since David left, his computer has been formatted and reassigned to another person. ABC has no evidence that David Doe did anything wrong.
What steps might have been taken to detect David’s alleged industrial espionage?
What steps might have been taken to prevent his perpetrating such an offense?
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Word limit is 200 word . High quality is most important. Needs to be.docxlefrancoishazlett
Word limit is 200 word . High quality is most important. Needs to be in APA format and you need to use and cite 2 sources in APA format.
Select a technology that is of interest to you (for example, sewing machines, tanks, computers, TV, etc.); write a paper about its historic and current impact on the economy, the environment, relationships, education, and morals.
Need it in an hour...
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Woodrow Wilson, from The New Freedom (1913)Eugene V. Debs, The O.docxlefrancoishazlett
Woodrow Wilson, from The New Freedom (1913)
Eugene V. Debs, "The Outlook for Socialism in the United States" (1900)
Herbert Croly, Progressive Democracy (1914)
Theodore Roosevelt, from The New Nationalism (1910)
Compare these views on America and its desired future. Rate these authors by the radicalism expressed in these documents. What common themes do they share? Where are they significantly different? Which vision is the closest to the way America developed over the next several decades?
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Word count; 150 wordsCompare and discuss the two basic categor.docxlefrancoishazlett
Word count; 150 words
Compare and discuss the two basic categories of health policies. Give an example of federal or state legislation that reflect each category
Discuss the impact of federal and state legislation on health related issues.
Word count; 150 words
Discuss the impact of health policies on health services in terms of the money, human resources, and technology used to produce these services. Your answer should include a discussion on each of the three areas?Word count; 150
Who are the demanders and suppliers in health policies? Describe what motivates each in a political marketplace.Word count; 150 words
Your Opinion and Observations
When you are ready, respond to the prompts below.
Is influence in Public Policy environments a matter of power and focus? Why or why not
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Discuss the necessity of rulemaking and the role that interest groups play in it. Discuss the necessity of analysis in the rulemaking process in healthcare Assess general tools and frameworks used in policy analysis within healthcare. Word count; 150 words
Discuss the role of policy analysis in policy modification. Include a description of a federal agency that supports policymaking through policy analysis. Word count; 150 words
Research a current health policy of your choice and discuss why you find it relevant to you personally and the population. You may also discuss any changes you would make to the policy. Please provide justification for the change. Word count; 150 words
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Current policy allows employees 2 fifteen minute breaks (one in the morning and one in the afternoon) and a 30 minute lunch period. Your company also recognizes Easter, Hanukkah, and Christmas as holidays.
What should you do, given current practices and policy that will not precipitate problems with the remaining staff? Word count; 150 words
What have you learned that clarifies the positions and tools used by the various stakeholder groups to impact health care reform legislation? Word count; 150 words
What have you learned that clarifies the process of policymaking on health related topics? Is there anything that you would change? Word count; 150 words
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Word count The report should be between 600 to 800 words (excludi.docxlefrancoishazlett
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The report should be between 600 to 800 words (excluding the bibliography) with the following title:
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Ensure that you provide clear titles for separate sections within the report.
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Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
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Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
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Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
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The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
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Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
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This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Model Attribute Check Company Auto PropertyCeline George
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Discussions1.Electronic Health RecordsElectronic healt.docx
1. Discussions
1.
Electronic Health Records
Electronic health records (EHRs) are at the center stage of the
effort to improve health care quality and control costs. In
addition to allowing medical practitioners to access and record
clinical documentation at much faster rates, EHRs are also
positively influencing care delivery and nurse-patient
interaction. Yet despite the potential benefits of EHRs, their
implementation can be a formidable task that has broad-
reaching implications for an entire health care organization.
In this Discussion, you appraise strategies for obtaining the
benefits and overcoming the challenges of implementing and
using electronic health records.
To prepare
Review the implementation of EHRs in an organization. Reflect
on the various approaches used.
If applicable, consider your own experiences with implementing
EHRs. What were some positive aspects of the implementation?
What suggestions would you make to improve the process?
Reflect on the reactions of others during the implementation
process. Were concerns handled effectively?
If you have not had any experiences with an EHR
implementation, talk to someone who has and get his or her
feedback on the experience.
2. Search and indicate examples of effective and poor
implementation of EHRs.
RESOURCES
Required Readings
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics
and the foundation of knowledge (3rd ed.). Burlington, MA:
Jones and Bartlett Learning.
Chapter 15, “The Electronic Health Record and Clinical
Informatics”
This chapter describes the crucial parts of an electronic health
record system and explores the benefits of implementing one.
Bates, D. W. (2010). Getting in step: Electronic health records
and their role in care coordination. Journal of General Internal
Medicine, 25(3), 174–176.
The author of this editorial critically analyzes current
applications of electronic health records (EHRs) and their
impact on cost, quality, and safety of health care delivery. The
author describes a study on the use of vendor-developed EHRs
in clinical practice settings, the results of which pinpointed the
benefits and drawbacks of EHRs.
Cresswell, K., & Sheikh, A. (2009). The NHS Care Record
Service: Recommendations from the literature on successful
implementation and adoption. Informatics in Primary Care,
17(3), 153–160.
This article defines the United Kingdom’s National Health
Service’s Care Record Service (NHS CRS) as a standard
3. electronic health record system. The article describes the
challenges associated with implementing this new information
technology and provides recommendations for overcoming those
challenges.
Fickenscher, K., & Bakerman, M. (2011). Change management
in health care IT. Physician Executive, 37(2), 64–67.
This article offers strategies for health care leaders to
successfully implement change programs in their organizations,
especially with regard to the new standards for electronic health
records (EHRs). The article provides insights on change
management, the reasons people resist change, and the ways to
establish a culture that is more open to change initiatives.
Gruber, N., Darragh, J., Puccia, P. H., Kadric, D. S., & Bruce,
S. (2010). Embracing change to improve performance. Long-
Term Living: For the Continuing Care Professional, 59(1), 28–
31.
This text describes the implementation of a new electronic
health record system at a 105-bed hospital related-facility. The
authors highlight five key elements that were deemed necessary
for a successful EHR implementation.
Hyrkäs, K., & Harvey, K. (2010). Leading innovation and
change. Journal of Nursing Management, 18(1), 1–3.
According to the authors, the health care field is in need of
more effective leaders who understand innovation, who
appreciate diversity and change, and who can foster and
implement innovation and creativity. The authors describe how
nurse leaders can be instrumental in embracing and
disseminating innovation throughout the health care system and
provide scaffolding for subsequent articles in this issue of the
journal.
4. Mooney, B. L., & Boyle, A. M. (2011). 10 steps to successful
EHR implementation. Medical Economics, 88(9), S4–6, S8–S11.
The authors of this article describe the incentives and
requirements for electronic health records (EHRs) outlined in
the Health Information Technology for Economic and Clinical
Health (HITECH) Act. The authors then provide 10 steps for
health care leaders and organizations to follow when
implementing EHRs.
Murphy, J. (2011). Leading from the future: Leadership makes a
difference during electronic health record implementation.
Frontiers of Health Services Management, 28(1), 25–30.
In this article, the author examines the causes behind the
increasing complication of EHR implementations. In addition,
the author explores the role of leadership in guiding successful
EHR implementations.
Required Media
Laureate Education (Producer). (2012b). Electronic health
records. Baltimore, MD: Author.
In this video, Katie Skelton, Richard Rodriguez, Carina Perez,
Shannon Mori, and Carmen Ferrell describe how their hospital
implemented an electronic health record. They also outline the
general considerations, benefits, and support measures related
to electronic health records.
2.
Successful Implementation of Electronic Health Information
Technology
5. Since the inception of the HITECH Act, health organizations
have faced increased pressure to update their health information
technology (HIT) resources. As discussed last week, many
believe that the increased use of electronic health records and
the quick and efficient communication afforded by HIT can lead
to improved quality of patient care. Yet there are significant
costs associated with implementing such systems. What can
organizations do to ensure that the correct system is selected
and that the system will be appropriate for those required to use
it? Who should be involved in those decisions?
This week introduces the systems development life cycle and
discusses how it can guide an organization through the
complexities of adopting a new HIT system.
In this Discussion, you are asked to consider the role of nurses
in the SDLC process.
To prepare:
Review the steps of the systems development life cycle.
Think about your own organization, or one with which you are
familiar, and the steps the organization goes through when
purchasing and implementing a new HIT system.
Consider what a nurse could contribute to decisions made at
each stage when planning for new health information
technology. What might be the consequences of not involving
nurses?
Reflect on your own experiences with your organization
selecting and implementing new technology. As an end user, do
you feel you had any input in the selection or and planning of
the new HIT system?
6. RESOURCES
Required Readings
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics
and the foundation of knowledge (3rd ed.). Burlington, MA:
Jones and Bartlett Learning.
Chapter 10, “Systems Development Life Cycle: Nursing
Informatics and Organizational Decision Making”
This chapter explains the systems development life cycle and
explores various methods of applying it. The chapter also
examines the importance of interoperability in implementing
HITECH.
Chapter 11, “Administrative Information Systems”
This chapter provides an overview of agency-based health
information systems. The text also details how administrators
can use core business systems in their practice.
Boswell, R. A. (2011). A physician group’s movement toward
electronic health records: A case study using the
transtheoretical model for organizational change. Consulting
Psychology Journal: Practice and Research, 63(2), 138–148.
The authors of this article present a case study on an EHR
implementation in a multispecialty physician group. The case
study attempts to determine actions that promote successful
EHR implementation and the pros and cons of implementation.
Hsiao, J., Chang, H., & Chen, R. (2011).A study of factors
affecting acceptance of hospital information systems: A nursing
perspective. Journal of Nursing Research, 19(2), 150–160.
7. The focus of this article is to determine what factors are most
important in predicting the acceptance of new health
information technology. The results of the study indicated that
self-efficacy, top management support, and the quality of
information retrieved are the most important determinants of the
willingness of nurses to adopt and use a new technology.
Kelley, T. F., Brandon, D. H., & Docherty, S. L. (2011).
Electronic nursing documentation as a strategy to improve
quality of patient care. Journal of Nursing Scholarship, 43(2),
154–162.
This article summarizes a literature review of the relationship
between electronic health records (EHRs) and quality of patient
care. The article identifies deficiencies in existing research
regarding the daily interactions of nurses, patients, and
electronic documentation, and it provides a comparison between
electronic and paper-based documentation and its effect on
quality of care.
Nurse leaders discuss the nurse’s role in driving technology
decisions. (2010). Virginia Nurses Today, 18(1), 8–9.
This article summarizes a roundtable held with a number of
nursing executives to discuss the role nurses should take in the
selection and adoption of new technologies for health care. The
executives concluded that the nurses’ goals should be to select
technology that will further their ability to provide safe, quality
care to their patients.
Page, D. (2011). Turning nurses into health IT superusers.
Hospitals & Health Networks, 85(4), 27–28.
This article highlights the importance of involving nurses with
all phases of the decision and implementation process
surrounding new health information technology. The author
8. stresses the importance of communication in the process as well
as defining success.
Swab, J., & Ciotti, V. (2010). What to consider when
purchasing an EHR system. hfm(Healthcare Financial
Management), 64(5), 38–41.
In this article, recommendations are given for purchasing health
information technology. These include selecting the appropriate
vendor, carefully considering the cost of both new equipment
and personnel, and involving clinicians in decisions.
Required Media
Laureate Education (Producer). (2012g). Systems development
life cycle. Baltimore, MD: Author.
The systems development life cycle (SLDC) provides a
framework for all of the steps necessary to implementing a new
technology or process within an organization. This video
explains the SDLC and how it is used in the health care field.
Optional Resources
Agency for Healthcare Research and Quality. (2005). A toolkit
for redesign in health care. Retrieved from
http://www.ahrq.gov/legacy/qual/toolkit/index.html
This website supplies strategies for reconfiguring and
transforming a hospital’s care processes. The text breaks down
the redesign process into a series of steps.
3.
Understanding Workflow Design
9. As you explored last week, the implementation of a new
technology can dramatically affect the workflow of an
organization. Newly implemented technologies can initially
limit the productivity of users as they adjust to their new tools.
Such implementations tend to be so significant that they often
require workflows to be redesigned in order to achieve
improvements in safety and patient outcomes. However, before
workflows can be redesigned, they must first be analyzed. This
analysis includes each step in completing a certain process.
Some systems duplicate efforts or contain unnecessary steps
that waste time and money and could even jeopardize patient
health care. By reviewing and modifying the workflow, you
enable greater productivity. This drive to implement new
technologies has elevated the demand for nurses who can
perform workflow analysis.
In this Discussion, you explore resources that have been
designed to help guide you through the process of workflow
assessment.
To prepare:
· Take a few minutes and peruse the information found in the
article “Workflow Assessment for Health IT Toolkit”.
o As you check out the information located on the different
tabs, identify key concepts that you could use to improve a
workflow in your own organization and consider how you could
use them.
o Go the Research tab and identify and read one article that is
of interest to you and relates to your specialty area.
RESOURCES
Required Readings
10. McGonigle, D., & Mastrian, K. G. (2015).
Nursing informatics and the foundation of knowledge
(3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 14, “Nursing Informatics: Improving Workflow and
Meaningful Use”
This chapter reviews the reasons for conducting workflow
analysis and design. The author explains specific workflow
analysis and redesign techniques.
Huser, V., Rasmussen, L. V., Oberg, R., & Starren, J. B. (2011).
Implementation of workflow engine technology to deliver basic
clinical decision support functionality.
BMC Medical Research Methodology, 11
(1), 43–61.
Retrieved from the Walden Library databases.
In this article, the authors describe an implementation of
workflow engine technology to support clinical decision
making. The article describes some of the pitfalls of
implementation, along with successful and future elements.
Koppel, R., & Kreda, D. A. (2010). Healthcare IT usability and
suitability for clinical needs: Challenges of design, workflow,
and contractual relations.
Studies in Health Technology and Informatics, 157
, 7–14.
Retrieved from the Walden Library databases.
11. This article points to many health information technology
designs and workflow decisions that limit their value and usage.
The authors also examine the structure of the conceptual
relationships between HIT vendors and the clinical facilities
that purchase HIT.
U.S. Department of Health & Human Services. (n.d.b).
Workflow assessment for health IT toolkit
. Retrieved, June 18, 2012, from
http://healthit.ahrq.gov/portal/server.pt/community/health_it_to
ols_and_resources/919/workflow_assessment_for_health_it_tool
kit/27865
This article supplies a toolkit on the planning, design,
implementation, and use of health information technology. The
sections of the website provide a definition of workflow,
examples of workflow tools, related anecdotes, and research.
Document: Sample Workflow of Answering a Telephone in an
Office (Word document)
Required Media
Laureate Education (Producer). (2012f).
System design and workflow
. Baltimore, MD: Author.
This video provides an overview of how workflow modeling can
be used in a health care setting to target areas for revising
current practices and procedures. The video also shows how
technology and informatics can be used to improve workflow
efficiency and increase the quality of care.
4.
12. Using Health Information Technology as a Source of Evidence-
Based Practice
Before the digital revolution, health information technology
supplied very limited support for evidence-based practice. If
nurses wanted to be informed about cutting-edge research, their
best bet was to either subscribe to leading journals or make
periodic trips to the library. With the establishment of research
databases, however, nurses became empowered to learn about
and facilitate interdisciplinary and translational research.
Databases are just one example of how health information
technology supports evidence-based practice.
To prepare:
· Read the following scenario from the text (McGonigle &
Mastrian, 2015, p. 445):
Twelve-hour shifts are problematic for patient and nurse safety,
and yet hospitals continue to keep the 12-hour shift schedule. In
2004, the Institute of Medicine (Board on Health Care Services
& Institute of Medicine, 2004) published a report that referred
to studies as early as 1988 that discussed the negative effects of
rotating shifts on intervention accuracy. Workers with 12-hour
shifts realized more fatigue than workers on 8-hour shifts. In
another study done in Turkey by Ilhan, Durukan, Aras,
Turkcuoglu, and Aygun (2006), factors relating to increased
risk for injury were age of 24 or less, less than 4 years of
nursing experience, working in the surgical intensive care units,
and working for more than 8 hours.
· Consider how the resources identified in the scenario above
could influence an organization’s practice.
· Select an issue in your practice that is of concern to you.
Using health information technology, locate at least three
13. evidence-based practice resources that address your concern and
that could possibly inform further action.
RESOURCES
Required Readings
McGonigle, D., & Mastrian, K. G. (2015).
Nursing informatics and the foundation of knowledge
(3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 23, “Research: Data Collection, Processing, and
Analytics”
The authors of this chapter relate nursing research to the
foundation of knowledge model. The chapter assesses
informatics tools for collecting data, storing information, and
processing and analyzing data.
Chapter 25, “Translational Research: Generating Evidence
for Practice”
In this chapter, the authors differentiate evidence-based practice
and translation research. They also describe models used to
introduce research findings intro practice.
Hynes, D. M., Weddle, T., Smith, N., Whittier, E., Atkins, D.,
& Francis, J. (2010). Use of health information technology to
advance evidence-based care: Lessons from the VA QUERI
program.
Journal of General Internal Medicine, 25
14. (Suppl. 1), S44–S49.
This article presents a study that evaluated the role of health
information technology (HIT) in the Department of Veteran
Affairs’ Quality Enhancement Research Initiative. The authors
convey their findings on how HIT provided data and
information to aid implementation research, and how
implementation research helped further HIT development.
Additionally, the text details methods of overcoming common
HIT barriers to implementation research.
Jamal, A., McKenzie, K., & Clark, M. (2009). The impact of
health information technology on the quality of medical and
health care: A systematic review.
Health Information Management Journal, 38
(3), 26–37.
This text details a study that reviews the published evidence
concerning the impact of health information technology (HIT)
on the quality of health care. The study investigated the use of
HIT in medical care and allied health and preventive services.
The authors primarily focus on the impact of electronic health
records, computerized provider order-entry, and decision
support systems.
Umscheid, C. A., Williams, K., & Brennan, P. (2010). Hospital-
based comparative effectiveness centers: Translating research
into practice to improve the quality, safety and value of patient
care.
JGIM: Journal of General Internal Medicine, 25
(12), 1,352–1,355.
This article revolves around the usage of the hospital-based
comparative effectiveness (CE) center model. The authors
highlight the model’s benefits and the increasing usage of CE
evidence. The article also reviews solutions to overcoming
15. many of the challenges to operating hospital-based CE centers.
Optional Resources
Chlan, L., Tracy, M. F., & Grossbach, I. (2011). Pulmonary
care. Achieving quality patient-ventilator management:
Advancing evidence-based nursing care.
Critical Care Nurse, 31
(6), 46–50.
5.
HITECH Legislation
In order for organizations to receive the incentives offered
through the HITECH legislation, they must be able to
demonstrate that they are using the technology in meaningful
ways. The following criteria for meaningful use must be evident
to qualify for EHR incentives (U.S. Department of Health &
Human Services, 2012). The technology must:
· Improve quality, safety, and efficiency, and reduce health
disparities
· Engage patients and families
· Improve care coordination
· Improve population and public health
· Ensure adequate privacy and security protections for personal
health information
For this Discussion, you consider the impact of the meaningful
use criteria of the HITECH legislation on the adoption of health
information technology.
16. To prepare:
· Review the Learning Resources on the HITECH legislation
and its primary goals.
· Reflect on the positive and negative impact this legislation has
had on your organization or one with which you are familiar.
· Consider the incentives to encourage the use of EHRs. Focus
on the definition of meaningful use and how it is measured.
· Reflect on how the incentives and meaningful use impact the
quality of patient care.
· Find an article dealing with one of the criteria to qualify for
meaningful use and how it has been successfully met.
RESOURCES
Required Readings
McGonigle, D., & Mastrian, K. G. (2015).
Nursing informatics and the foundation of knowledge
(3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 9, “Legislative Aspects of Nursing Informatics:
HITECH and HIPAA”
This chapter explores two pieces of legislation that
dramatically impact nursing informatics: the Health
Information Technology for Economic and Clinical Health
Act of 2009 and the Health Insurance Portability and
17. Accountability Act of 1996.
Arlotto, P. (2010). 7 strategies for improving HITECH
readiness.
hfm(Healthcare Financial Management)
,
64
(11), 90–96.
This article reviews seven strategies to help prepare for the
implementation of the Health Information Technology for
Economic and Clinical Health Act (HITECH). The central point
of the article focuses on demonstrating meaningful use of
electronic health records.
Begum, R., Smith Ryan, M., Winther, C. H., Wang, J. J.,
Bardach, N. S., Parsons, A. H., & … Adams Dudley, R. (2013).
Small Practices’ Experience With EHR, Quality Measurement,
and Incentives.
American Journal Of Managed Care, 19e
SP12–8.
This article presents a study of clinician’s attitudes toward the
use of financial incentives for the implementation of electronic
health records in small practices.
Brown, B. (2010). The final rules for meaningful use of EHRs.
Journal of Health Care Compliance, 12
(5), 49–50.
In this article, the author poses four questions pertaining to the
EHR system in the United States. In particular, the article
examines Medicare and Medicaid incentive payments and the
ways the meaningful use of certified EHRs will be verified.
18. Classen, D. C., & Bates, D. W. (2011). Finding the meaning in
meaningful use.
New England Journal of Medicine, 365
(9), 855–858.
This article details the challenges of meeting the meaningful use
standards in order to receive the benefits legislated under the
HITECH Act. The authors specify the requisites for achieving
benefits with EHRs, the relationship between meaningful use
and commercial EHRs, and the tools needed to evaluate EHRs
after implementation.
Kempfert, A. E., & Reed, B. D. (2011). Health care reform in
the United States: HITECH Act and HIPAA privacy, security,
and enforcement Issues.
FDCC Quarterly, 61
(3), 240–273.
The authors of this article examine HITECH, in addition to the
impact of the privacy rules under the Health Insurance
Portability and Accountability Act (HIPAA). The article details
the potential negative repercussions of failing to comply with
HIPAA and HITECH.
Murphy, J. (2010b). Nursing informatics. The journey to
meaningful use of electronic health records.
Nursing Economic$, 28
(4), 283–286.
This article reviews HITECH and the background leading up to
its passage. The author also details the financial incentives
intended to assist health care providers in purchasing and
implementing HIT and EHR systems.
Optional Resources
19. U.S. Department of Health & Human Services. (2011).
Health IT home
. Retrieved from http://www.healthit.gov/
U.S. Department of Health & Human Services. (2012).
Regulations and guidance
. Retrieved from http://www.healthit.gov/policy-researchers-
implementers/health-it-rules-regulations