NURS FPX 8012 Assessment 5 Quality Improvement Project Plan

NURS FPX 8012 Assessment 5 Quality Improvement Project Plan

Name

Capella University

NURS-FPX 8012 Nursing Technology and Health Care Information Systems

Prof. Name

Date

Introduction

Problem

The primary objective of Allen Medical Clinic is to provide high-quality patient care; however, an inadequate and inefficient electronic health record (EHR) system hampers the effectiveness of this care. The subpar EHR framework negatively impacts clinical workflow, largely due to insufficient staff training. Additionally, the ineffective EHR system fails to secure patient information within digital databases, compromising confidentiality and breaching privacy regulations.

Stakeholders play a crucial role in enhancing the clinic’s performance. The ineffective EHR system affects various departments, including IT, executive leadership, clinical staff, and finance. Data breaches lead to diminished patient satisfaction, reducing patient volumes and adversely affecting the organization’s financial status. Furthermore, such inefficiencies contribute to burnout among clinical and administrative staff, further deteriorating organizational performance. Poorly managed EHR systems can have significant repercussions, prompting stakeholders to collaboratively address the identified risks (Kaihlanen et al., 2020).

The EHR system can lead to clinical errors, including medication mistakes, incorrect diagnoses, and flawed treatment plans, resulting in decreased health outcomes. For instance, Jump data assigned Allen Clinic a “C” grade in this regard (Jump Clinic Security Grade, 2019). Moreover, breaches of patient health information due to poorly designed EHR systems can result in serious repercussions for the healthcare organization, including potential legal actions. Furthermore, inadequately maintained EHR systems may frequently experience downtime, causing delays in patient care that lead to negative patient outcomes, as reported by federal healthcare comparisons. Allen Clinic received a three-star patient review rating compared to two other local hospitals, Sartori Memorial Hospital (SMH) and MercyOne Waterloo Medical Center (MWMC) (Federal Healthcare, 2023). This situation has also contributed to increased burdens on healthcare professionals and rising healthcare costs due to the lower quality of care provided to patients.

Proposed Arrangement

The vision for Allen Clinic is to enhance patient health outcomes and achieve financial success. The proposed solution involves implementing advanced technology, specifically an upgraded EHR system, to enhance the interoperability of the healthcare setting. Staff will receive educational training on the use of the EHR to ensure effective implementation. Moreover, financial resources will be necessary to integrate the latest software, including Computerized Physician Order Entry (CPOE) and Patient Identification systems (Beauvais et al., 2020). Anticipating the necessary material and financial resources is crucial for executing the proposed solution in the healthcare setting. An EHR system is designed to collect, store, retrieve, and analyze patient data in healthcare environments. Healthcare professionals must utilize EHRs effectively to enhance patient care standards and safety (Gariépy-Saper et al., 2021). EHRs serve as an informatics solution, relying on a combination of networking, software, and hardware technologies to develop and integrate electronic health records.

EHRs aim to improve the quality and safety of patient care by providing authorized healthcare providers with complete patient health information. They also facilitate data analysis to enhance population health and support care coordination among various providers and patients (Vos et al., 2020). The adoption and effective use of EHRs enhance interoperability, data security, and privacy within healthcare settings.

Measuring and Monitoring Three Key Indicators

Patient Satisfaction: A critical measure of how effectively healthcare organizations deliver services, reflecting patient satisfaction levels. Healthcare staff employ patient satisfaction survey tools, such as the Consumer Assessment of Healthcare Providers and Systems (CAHPS), to monitor patient satisfaction (Xenakis et al., 2020). The organization gathers feedback from patients regarding provider behavior, the timeliness of care, and the cleanliness of the environment.

Hospital Readmission Rates: The readmission rate serves as a significant metric for evaluating patient care within healthcare organizations. The Readmission Reduction Dashboard created by the Agency for Healthcare Research and Quality monitors readmissions (Wong et al., 2020). Healthcare professionals identify high-risk patients and provide optimal care to prevent readmissions using this tool.

Mortality Rates: The mortality rate is a critical data point measuring an organization’s performance in healthcare services. The death rates associated with specific illnesses, such as pneumonia, heart disease, and kidney disease, inform the quality of hospital care. Utilizing a mortality dashboard allows for identifying risk factors and opportunities for care improvement, categorizing mortality data by unit, healthcare provider, or patient population (Greco et al., 2021).

EHR Implementation Issues and Challenges

The capability of various software programs to exchange data and enhance interoperability poses challenges as different departments within the healthcare organization use distinct standards. Data security and confidentiality are paramount, necessitating collaboration among stakeholders to ensure patient data remains protected during transfers (Li et al., 2021). Achieving this requires proper communication channels among departments. Additionally, the use of telehealth can facilitate the secure dissemination of information among healthcare providers. Financial resources will be necessary to implement innovative informatics in the healthcare organization (Shaw et al., 2020).

The implementation of informatics technology may raise ethical concerns if data privacy is compromised due to cyberattacks. A breach of patient privacy allows patients to file lawsuits against the provider and the organization (Seh et al., 2020). To mitigate this issue, the healthcare setting can implement two-factor authentication to protect patient health information. Only authorized users can access patient data through a specific PIN or password (Xiang et al., 2021). Additionally, the nursing code of ethics will be communicated to staff, ensuring they safeguard patient data by adhering to HIPAA regulations.

A skilled workforce is essential for operating the EHR system effectively to achieve better patient outcomes. Accurate and up-to-date patient information is crucial for making clinical decisions. Integrating clinical decision support systems (CDSS) into the organization will be beneficial for achieving positive outcomes. It enhances the organization’s workflow while aiding healthcare professionals in safeguarding patient information under HIPAA guidelines (Muhiyaddin et al., 2020). Therefore, integrating CDSS and EHR requires human resources, posing challenges in implementing informatics. Staff training and practical workshops will enhance their effectiveness in utilizing the EHR system and improve healthcare professionals’ clinical problem-solving skills, thereby improving patient health outcomes.

Role of Leaders in Change Strategy

Leaders guide teams in implementing change strategies within organizations to yield positive results. They define a vision for all stakeholders and empower them to work towards a common goal (Frechette, 2019). The change management strategy is comprehensive, encompassing risk identification and pursuing a strategy to achieve favorable outcomes.

Leaders communicate with stakeholders and devise an effective plan considering existing resources. They can utilize the Lewin Change Model to enhance performance in the healthcare sector. This model comprises three stages: unfreeze, change, and refreeze (Rwafa-Ponela et al., 2020). Throughout these stages, leaders address the need for change and assist the organization in adopting new processes to achieve positive results (Gemeda et al., 2020). For instance, the current staff’s readiness for change indicates the organization’s preparedness for the change strategy. Moreover, leaders recognize the organization’s resources, such as existing workforce knowledge of organizational policies and procedures, which facilitates participation in the change process and reduces the need for new hiring, thereby alleviating financial strain. Focusing on the need for change, leaders also address barriers that impede the change process, such as limited resources, minimal support, and lack of communication among stakeholders. Leaders can overcome these challenges by enhancing communication and collaboration across various departments (Harrison et al., 2021).

Communication Plan

A professional communication plan is essential for effective change management. It enables leaders to pursue change efficiently. The components of the communication plan are as follows:

• Stakeholder Identification: Identifying stakeholders to pursue change is essential. Stakeholders include clinical staff, IT personnel, executive leaders, and finance and administrative staff (Franco-Trigo et al., 2020).

• Defining Key Messages: Clear and concise messages must be developed that explain the rationale for the change and the specific benefits it will bring. These messages ensure that communications among stakeholders align with the overall goals of the change initiative.

• Direct Communication Channels: The communication plan determines the best methods of communication for each project stakeholder. Various channels, such as emails, media platforms, webinars, and brochures, can be utilized.

• Communication Materials: Leaders should establish a set of communication methods to convey critical messages to each stakeholder group, including FAQs, training sessions, video content, and promotional materials (Zdunek et al., 2020).

• Training Key Communicators: Leaders and other key communicators should be trained to effectively convey core messages to their teams, equipping them with the necessary tools for communication and preparing them to address questions or concerns.

• Establishing Timelines: Leaders must set a timeline for all communication efforts, detailing when each stakeholder will receive essential information. The schedule should also outline meetings and distribution of communication materials.

• Assessing Effectiveness: Finally, monitoring and evaluating communication plans are essential for assessing the effectiveness of the initiative over time. This involves ensuring that messages are communicated effectively to stakeholders and the primary audience during the change management process. Evaluation can also involve soliciting feedback from stakeholders and making necessary adjustments (Kang et al., 2020).

This communication plan will assist leaders in effectively managing change initiatives. It ensures that all stakeholders are informed and engaged throughout the process, reducing resistance to change while fostering investment and enhancing the likelihood of successful change management.

Information regarding EHR implementation highlights the benefits of this informatics solution within healthcare organizations. It enhances interoperability among different departments, improving patient satisfaction and financial success (Light et al., 2020). Additionally, the cost-benefit analysis related to the proposed change aids leadership in budget planning, encompassing expenses for software acquisition, training materials, and staff development. This analysis also informs leaders about stakeholder contributions to the change management process, essential for achieving successful organizational transformation.

Workflow Analysis

Existing Workflow Mapping in Healthcare Setting

The previous

workflow mapping in the healthcare setting provides an overview of how processes operate within Allen Clinic. The workflow includes various steps involving staff and systems that contribute to delivering patient care.

The workflow begins with patient registration, where clinical staff collects patient information, including demographics, insurance, and medical history. This information is entered into the EHR system, establishing a comprehensive patient profile. Subsequently, healthcare providers assess the patient, documenting symptoms and clinical findings in the EHR. Orders for diagnostic tests and treatment plans are created, communicated to relevant departments through the EHR, and the results are recorded in the system. After treatment, follow-up appointments and referrals are managed through the EHR, enabling streamlined communication between departments.

Current System Workflow in Allen Clinic:

1. Patient Registration: Staff collects patient information and inputs it into the EHR system.
2. Patient Assessment: Providers document clinical findings in the EHR.
3. Order Management: Orders for tests and treatments are communicated through the EHR.
4. Results Management: Test results are recorded in the EHR.
5. Follow-up and Referrals: Appointments and referrals are managed through the EHR.

Proposed Changes to Workflow

The proposed changes to the workflow aim to enhance patient care delivery. Incorporating advanced technology and a robust EHR system will ensure seamless communication between departments. The proposed workflow will integrate electronic order management systems, including Computerized Physician Order Entry (CPOE), enhancing accuracy and efficiency.

Proposed Workflow Changes:

1. Patient Registration: Enhanced EHR for streamlined data entry and management.
2. Patient Assessment: Integrated clinical decision support tools to improve diagnostics and treatment plans.
3. Order Management: Implementation of CPOE for electronic ordering of tests and treatments.
4. Results Management: Automatic notifications of results to providers, improving response times.
5. Follow-up and Referrals: Streamlined scheduling and referral processes through the upgraded EHR.

These changes will improve efficiency, reduce errors, and enhance patient care delivery at Allen Clinic.

Conclusion

In summary, addressing the EHR system’s inefficiencies is crucial for Allen Medical Clinic to improve patient care quality and overall performance. By implementing advanced technology, investing in staff training, and fostering effective communication among stakeholders, the organization can enhance interoperability, patient satisfaction, and financial success. Leaders play a pivotal role in guiding the change process, while a well-structured communication plan ensures that stakeholders remain engaged throughout the transition. The proposed workflow changes aim to streamline operations and improve patient outcomes, ultimately benefiting both patients and the organization as a whole.

References

Avendano, J. P., Gallagher, D. O., Hawes, J. D., Boyle, J., Glasser, L., Aryee, J., & Katt, B. M. (2022). Interfacing with the electronic health record (EHR): A comparative review of modes of documentation. Cureus, 14(6). https://doi.org/10.7759/cureus.26330

Beauvais, B., Kruse, C., Fulton, L., Shanmugam, R., Ramamonjiarivelo, Z., & Brooks, M. (2020). Electronic health record vendors: An evaluation of the association with hospital financial and quality performance (Preprint). Journal of Medical Internet Research, 23(4). https://doi.org/10.2196/23961

Basil, N. N., Ambe, S., Ekhator, C., & Fonkem, E. (2022). Health records database and inherent security concerns: A review of the literature. Cureus, 14(10). https://doi.org/10.7759/cureus.30168

Dunn Lopez, K., Chin, C.-L., Leitão Azevedo, R. F., Kaushik, V., Roy, B., Schuh, W., Banks, K., Sousa, V., & Morrow, D. (2021). Electronic health record usability and workload changes over time for provider and nursing staff following transition to new EHR. Applied Ergonomics, 93, 103359. https://doi.org/10.1016/j.apergo.2021.103359

Fortman, E., Hettinger, A. Z., Howe, J. L., Fong, A., Pruitt, Z., Miller, K., & Ratwani, R. M. (2020). Varying rates of patient identity verification when using computerized provider order entry. Journal of the American Medical Informatics Association, 27(6), 924–928. https://doi.org/10.1093/jamia/ocaa047

NURS FPX 8012 Assessment 5 Quality Improvement Project Plan

Franco-Trigo, L., Fernández-Llimós, F., Martínez-Martínez, F., Benrimoj, S. I., & Sabater-Hernández, D. (2020). Stakeholder analysis in health innovation planning processes: A systematic scoping review. Health Policy, 124(10). https://doi.org/10.1016/j.healthpol.2020.06.012

Frechette, J. (2019). Shared vision in nursing. The Health Care Manager, 38(2), 156–165. https://doi.org/10.1097/hcm.0000000000000259

Gemeda, H. K., & Lee, J. (2020). Leadership styles, work engagement and outcomes among information and communications technology professionals: A cross-national study. Heliyon, 6(4). NCBI. https://doi.org/10.1016/j.heliyon.2020.e03699

Gariépy-Saper, K., & Decarie, N. (2021). Privacy of electronic health records: A review of the literature. Journal of the Canadian Health Libraries Association / Journal de l’Association Des Bibliothèques de La Santé Du Canada, 42(1). https://doi.org/10.29173/jchla29496

Greco, K. J., Rao, N., Urman, R. D., & Brovman, E. Y. (2021). A dashboard for tracking mortality after cardiac surgery using a national administrative database. Cardiology Research, 12(2), 86–90. https://doi.org/10.14740/cr1220

Han, Y., Zhang, Y., & Vermund, S. H. (2022). Blockchain Technology for Electronic Health Records. International Journal of Environmental Research and Public Health, 19(23), 15577. https://doi.org/10.3390/ijerph192315577

NURS FPX 8012 Assessment 5 Quality Improvement Project Plan

Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where do models for change management, improvement and implementation meet? A systematic review of the applications of change management models in healthcare. Journal of Healthcare Leadership, Volume 13(13), 85–108. NCBI. https://doi.org/10.2147/jhl.s289176

Kaihlanen, A.-M., Gluschkoff, K., Hyppönen, H., Kaipio, J., Puttonen, S., Vehko, T., Saranto, K., Karhe, L., & Heponiemi, T. (2020). The associations of electronic health record usability and user age with stress and cognitive failures among finnish registered nurses: Cross-sectional study. JMIR Medical Informatics, 8(11), e23623. https://doi.org/10.2196/23623

Kang, S. K., Doshi, A. M., Recht, M. P., Lover, A. C., Kim, D. C., & Moore, W. (2020). Process improvement for communication and follow-up of incidental lung nodules. Journal of the American College of Radiology, 17(2), 224–230. https://doi.org/10.1016/j.jacr.2019.11.023

Leapfrog Hospital Safety Grade. (2022). Allen hospital – IA – Hospital Safety Grade. Hospitalsafetygrade.org. https://www.hospitalsafetygrade.org/h/allen-hospital?findBy=hospital&hospital=Allen+Hospital&rPos=0&rSort=grade

Li, E., Clarke, J., Neves, A. L., Ashrafian, H., & Darzi, A. (2021). Electronic health records, interoperability and patient safety in health systems of high-income countries: A systematic review protocol. BMJ Open, 11(7), e044941. https://doi.org/10.1136/bmjopen-2020-044941

Lite, S., Gordon, W. J., & Stern, A. D. (2020). Association of the meaningful use electronic health record incentive program with health information technology venture capital funding. Journal of the American Medical Association Network Open, 3(3), e201402. https://doi.org/10.1001/jamanetworkopen.2020.1402

NURS FPX 8012 Assessment 5 Quality Improvement Project Plan

Medicare. (2023). Medicare.gov. Www.medicare.gov. https://www.medicare.gov/care-compare/compare?providerType=Hospital&providerIds=160110

Muhiyaddin, R., Abd-Alrazaq, A. A., Househ, M., Alam, T., & Shah, Z. (2020). The impact of clinical decision support systems (CDSS) on physicians: A scoping review. Studies in Health Technology and Informatics, 272, 470–473. https://doi.org/10.3233/SHTI200597

Rwafa-Ponela, T., Eyles, J., Christofides, N., & Goudge, J. (2020). Implementing without guidelines, learning at the coalface: A case study of health promoters in an era of community health workers in South Africa. Health Research Policy and Systems, 18, 46. https://doi.org/10.1186/s12961-020-00561-5

Seh, A. H., Zarour, M., Alenezi, M., Sarkar, A. K., Agrawal, A., Kumar, R., & Khan, R. A. (2020). Healthcare data breaches: Insights and implications. Healthcare, 8(2), 133. NCBI. https://doi.org/10.3390/healthcare8020133

Shaw, R., Stroo, M., Fiander, C., & McMillan, K. (2020). Selecting mobile health technologies for electronic health record integration: Case study. Journal of Medical Internet Research, 22(10), e23314. https://doi.org/10.2196/23314

Vos, J. F. J., Boonstra, A., Kooistra, A., Seelen, M., & van Offenbeek, M. (2020). The influence of electronic health record use on collaboration among medical specialties. BMC Health Services Research, 20(1). https://doi.org/10.1186/s12913-020-05542-6

NURS FPX 8012 Assessment 5 Quality Improvement Project Plan

Wong, T., Brovman, E. Y., Rao, N., Tsai, M. H., & Urman, R. D. (2020). A dashboard prototype for tracking the impact of diabetes on hospital readmissions using a national administrative database. Journal of Clinical Medicine Research, 12(1), 18–25. https://doi.org/10.14740/jocmr4029

Xenakis, L., Quigley, D. D., Qureshi, N., AlMasarweh, L., Pham, C., & Hays, R. D. (2020). Some aspects of patient experience assessed by practices undergoing patient-centered medical home transformation are measured by CAHPS, others are not. Quality Management in Health Care, 29(4), 179–187. https://doi.org/10.1097/qmh.0000000000000263

Xiang, D., & Cai, W. (2021). Privacy protection and secondary use of health data: Strategies and methods. BioMed Research International, 2021, 1–11. https://doi.org/10.1155/2021/6967166

Zdunek, K., Schröder-Bäck, P., Alexander, D., Vlasblom, E., Kocken, P., Rigby, M., & Blair, M. (2020). Tailored communication methods as key to implementation of evidence-based solutions in primary child health care. European Journal of Public Health, 31(1), 92–99. https://doi.org/10.1093/eurpub/ckaa23