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Advanced Practice Nurse Implementing a new EHR

Advanced Practice Nurse Implementing a new EHR

Sample Answer 

Advanced Practice Nurse Implementing a new EHR

EHRs are a critical component of patient-centered care. However, for them to be effective, they need to be efficient and safe so that patient records are kept safe and accurate. Adverse events resulting from poor communication and improper recording of patient data can have dire consequences. To that end, the current project will aim to improve patient safety and enhance efficiency, transparency, and compliance to government regulations.

The EHR system in this project will include a longitudinal collection of information on persons pertaining to an individual’s health; immediate access to patient information by persons authorized to do so; provision of decision support and knowledge that enhance efficiency, safety, and quality of patient care; and support of health care delivery efficient processes. Communication and medical information between the patient and healthcare professionals is important as this can and should prevent adverse events (Barrett, 2018). Therefore, uniform records of these events in the EHR are important in monitoring progress as well as ensuring that all parties responsible are aware of the possibility of a safety hazard. The system will also collect and link language, ethnicity, and race data to quality measures. These data will be used in the assessment of hospital-provided services quality and, when shared with other parties, for the facilitation of quality analysis across different settings.

Information is necessary for patient care, and informatics promotes patient-centered care though it can still serve as a barrier. According to Ohno (2018), informatics will promote care by providing a mechanism for patients to provide clinicians with necessary information about self-including their wellbeing and functioning. Additionally, clinicians will utilize informatics in integrating the information they access from patients with the data sources and medical knowledge to improve patient care. Informatics will also allow patients to share their information with family and friends. Lastly, informatics will allow for the care team to share and update critical information on patients. The way to harness informatics’ potential is to promote patient-centered care by using technology to direct the physician and patients to information of high quality and to share the said information.

The EHRs team, also referred to as the steering committee, will need to possess some qualities, and these include a range of knowledge and skills, a consistent positive perception toward the process of implementation, the ability and willingness to spend sufficient time in the process; and the different perspectives on the way the EHR will be utilized.

The EHRs implementation team will include Billing Staff Lead, EHR Builder, EHR Implementation Manager, EHR Team Lead, Information Technology Lead, Laboratory Staff Lead, Meaningful Use Lead, Medical Assistant Lead, Nurse Lead, Physician Champion, Registration Staff Lead, Scheduler Lead, Super-User/Training Lead, and Workflow Redesign Lead. The team members may need to take up more than one role, which will give them the experience of working in different capacities. The EHR will include information from systems such as administrative, and clinical data, radiology, immunizations, past medical history, progress notes, and personal demographic information.

The EHR has to allow for the execution of tasks while supporting patient care. In addition, the system will have to facilitate care processes that are more complex, dealing with several pharmacies and physicians related to one patient. The EHR will need to support sharing of data and management processes’ access rights for patient-related medical data so that the healthcare staff can use it if they are entitled to do so. Additionally, the system will provide an efficient means for the physicians and the team in the therapeutic and diagnostics of patients.

HIPAA and the Recovery Act on health information assert that patients have a right to access information on their medical records (Kiel, Ciamacco, & Steines, 2016). This means that the patient information should seamlessly move from one caregiver to another and should be readily usable and readable. These records should be sent securely to protect patient confidential information and uphold non-maleficence and beneficence.

Certification of the EHR will help the organization remain in compliance with patient-centered service delivery. Under the Meaningful Use program, the certified system will be in compliance in terms of security, reliability, and functionality. The Recovery Act is linked to the objectives of Meaningful Use, and hence, the healthcare facility in certifying the EHR will be in compliable to the regulations set by the Act. For example, one of the objectives set by the HHS is for healthcare practitioners to maintain medication lists. The system must show that a user can record patient medication, retrieve and modify the same, and store medication histories (Slight et al., 2015).

According to Li et al. (2019), an order set is used to standardize and expedite the ordering process for a specific clinical situation. Order sets that are standardized and up-to-date promote clinical support decisions at the point of care. Thus, the order sets will follow four steps in management and which the staff will be informed on when implementing the same. The first step is to establish a functioning governing structure and body to manage order sets that will be tied to the organization’s key objectives. The second will be planning and tracking the order sets’ maintenance workflow. Thirdly, a style guide will be developed and applied and which will focus on ease of use and consistency. The last step will be the implementation of methods that will streamline and encourage the involvement of clinicians and all staff. The project leader and team members will weigh on the common conditions, reflect on the challenges of organizational quality, and have reportable measures. This way, the team and its leader can decide which order sets call for review or development and then eliminate any duplicative and unnecessary order sets that can remove the team from the tasks at hand. Overall, content quality and access will be key drivers in effective and continued order sets’ use, as team members will be encouraged to implement quality information in an easily accessible way.

Communication is key to the success of any project, and this project will be no exception. The first level of communication will be through the weekly morning meetings, where the idea of new changes will be introduced to the team. A brief explanation of what the project is all about and what it aims to achieve will be discussed, and the team will be given an outline of what lies ahead. The next level will be choosing change agents that will drive the change and who will be the point men/women of communication between the team members and the leader. The third level will be using the intranet, where an update on the progress of the project will be given. The fourth level of communication is having a dedicated chatroom that will focus solely on issues to do with the project. A WhatsApp group will also be initiated that all team members will be part of and where they can communicate with each other at any time of the day or night (seeing that staff work in shifts), which will restrict communication to the EHR project.

To ensure that the EHR implementation is a success, staff will need to give feedback. Any staff member who still faces some challenges in navigating the system will be allowed to attend refresher training. Refresher training sessions will be held every two weeks after the close of the project and will continue to do so for four sessions. Also, staff will be requested to fill in a questionnaire detailing their experience with the new system. The questionnaire will have a Likert scale that will make it easier for staff to give their feedback. The last section of the questionnaire will allow for staff to give any additional information they may feel is necessary. The organization’s intranet will also have a chat room that is dedicated to discussing matters related to the EHR implementation, where team members can exchange any new information or ask queries. Based on the trends on the chat, the project leader will assess the success and assimilation rate of the new process in the department.

Transformational leadership is where a leader engages with their followers to pursue common goals. Transformational leaders engage with their followers to achieve these goals and hence, are dependent on each other. On the other hand, evidence-based management refers to the process of management where the leaders and followers search for, appraise, and apply empirical evidence from the research in management within the practice.  In this case, managers also need to be ready to have their actions and decisions recorded in a systematic manner and even evaluated in a way that will enable further addition to the evidence for effective practices in management.

Additionally, the leader should create a trust for the purpose of patient safety. Trust will link the team to the organization and the course that the team pursues. In other words, trust will make workers more willing to exert more effort without expecting immediate reward and also increase the length of time that leaders can rely on their workers to have the organization’s interests at heart. When team members trust their leaders, there are bound to be positive patient outcomes such as lower re-hospitalizations, fewer medication errors, and fewer fall rates within the hospital residence, among others. Lastly, when leaders actively engage in change process management, patient safety is protected because the leader’s oversight and guidance ensure that proper protocol is followed when caring for patients.

References

Barrett, A. K. (2018). Electronic health record (EHR) organizational change: explaining resistance through profession, organizational experience, and EHR communication quality. Health communication33(4), 496-506.

Kiel, J. M., Ciamacco, F. A., & Steines, B. T. (2016). Privacy and data security: HIPAA and HITECH. In Healthcare information management systems (pp. 437-449). Springer, Cham.

Li, R. C., Wang, J. K., Sharp, C., & Chen, J. H. (2019). When order sets do not align with clinician workflow: assessing practice patterns in the electronic health record. BMJ quality & safety28(12), 987-996.

Ohno-Machado, L. (2018). The role of informatics in promoting patient safety.

Slight, S. P., Berner, E. S., Galanter, W., Huff, S., Lambert, B. L., Lannon, C., … & Bates, D. W. (2015). Meaningful use of electronic health records: experiences from the field and future opportunities. JMIR medical informatics3(3), e30.

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Question 


Advanced Practice Nurse Implementing a new EHR

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

In a paper of 1,250-1,500 words, address the following questions related to the advanced registered nurse’s role during this type of scenario:

1. What key information would be needed in the database that would allow you to track opportunities for care improvement?
2. What role does informatics play in the ability to capture this data?
3. Which systems and staff members would need to be involved in the design and implementation process and team?
4. What professional, ethical, and regulatory standards must be incorporated into the design and implementation of the system?
5. How would the EHR team ensure that all order sets are part of the new record?
6. How would you communicate the changes, including any kind of transition plan?
7. What measures and steps would you take to evaluate the success of the EHR implementation from a staff, setting, and patient perspective?
8. What leadership skills and theories would facilitate collaboration with the interprofessional team and provide evidence-based, patient-centered care?

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

Advanced Practice Nurse Implementing a new EHR

Advanced Practice Nurse Implementing a new EHR

Prepare this assignment according to the guidelines found in the APA Style Guide,

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