NURS 8210 Discussion HIT Projects and Decision Makers

HIT Projects and Decision Makers

In a good functioning organization, many systems, including health information technologies (HIT), require constant maintenance, revision, and evaluation. So, depending on what phase a HIT system is, it might require analysis, re/design, implementation, or a replacement with a new system. This process is made easier because of the system development life cycle (SDLC). In addition, getting key stakeholders and decision-makers involved when planning a new HIT project can help avoid some risks or failures. In this Discussion, we describe an example of a HIT project implemented at our organizations and evaluate the impact of key decision-makers on implementing HIT Projects.

Description an Example of a HIT Project Implemented

Hospitals and healthcare facilities face patient falls, with about 2 to 3% of hospitalized patients fall each year. Unobserved falls require hospitals to rule out and/or diagnose and treat injuries by conducting imaging studies, performing costly procedures, which are not reimbursed by the Centers for Medicare and Medicaid (CMS) (Kramer et al., 2020). The civilian hospital where I work is not excluded from these fall events. As a result, the Director of my nursing unit identified video monitoring systems as means to reduce falls at another hospital. At first, the Director brought the idea during staff meetings, including all the stakeholders. She asked if anyone knew about this monitoring system, and we discussed its benefits and drawbacks. Next, she proposed the project for approval to the Chief nurse officer (CNO) along with all the fall statistics and costs to the hospital as support to her case during budgeting. Finally, the project was approved, and a systems analyst came to analyze and implement the system. This HIT project followed the four major stages of the systems development life cycle (SDLC): planning, design, implementation, and maintenance and evaluation stages (Laureate Education, 2011).

Evaluating the Impact of key Decision Makers on Implementing HIT Projects

During the process of this HIT project, key decision-makers and key stakeholders were part of the planning. Stakeholders had their questions and concerns answers, and the analyst provided solutions to anticipated incidences. Before complete implementation, they used one hospital unit as a pilot project to test the viability and effectiveness of the monitoring camera with a technician constantly watching the screen and alerting the staff in case of any attempt to fall and a runner available to intervene. This project was a great one, and the evaluation showed that it eliminated/reduced falls at the hospital for several months. But with time, the hospital did not maintain the system as it was designed. They did not have enough staff to be the runners, and the fall rate increased again. So, the leaders did a great job involving the key decision-makers and stakeholders, but the organization failed to maintain the usage of the system as designed.

Reference

Kramer, J. B., Sabalka, L., Rush, B., Jones, K., & Nolte, T. (2020). Automated depth video monitoring for fall reduction: A case study. 2020 IEEE/CVF Conference on Computer Vision and Pattern Recognition Workshops (CVPRW), Computer Vision and Pattern Recognition Workshops (CVPRW),2020 IEEE/CVF Conference On, 1188–1196. https://doi-org.ezp.waldenulibrary.org/10.1109/CVPRW50498.2020.00155

Laureate Education, Inc. (Executive Producer). (2011). Transforming nursing and healthcare through technology: Systems analysis. Author.

A nurse leader sought to implement greater security in the children’s wing of the hospital by installing a new alarm and monitoring system. Due to budget constraints, the CNO rejected the proposal, stating that current security methods were sufficient. Shortly after this failed proposal, an individual did in fact breach the children’s wing security and abducted a young child. Thankfully, the child was found and returned to her parents; and the CNO quickly found the money to install the new security system.

Not all HIT projects have such high-profile stakes. The main takeaway from this example is the importance of getting key stakeholders and decision makers on board when planning a new HIT project.

To prepare:

Bring to mind a HIT project implemented in your organization. Which leaders identified the project? Which stakeholders and decision makers helped moved the project forward?
Consider methods that were used to garner the support of stakeholders and decision makers to move the project forward.

By Day 3 post a cohesive response that addresses the following:

Describe an example of a HIT project implemented at your organization and analyze how that project was identified and moved forward.
Evaluate the impact of key decision makers on moving the HIT project forward.

Read a selection of your colleagues’ postings

By Day 6 respond to at least two of your colleagues in one or more of the following ways:

Ask a probing question, substantiated with additional background information, evidence, or research.
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional research.
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues. NURS 8210 Discussion HIT Projects and Decision Makers

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.

Click on the Reply button below to post your response.

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In order to have more affordable and quality healthcare, disruptive innovations need to take place. It involves using technologies to become more efficient (Townsend, 2013). For healthcare systems to implement new health information technology (HIT) the use of the systems development life cycle is used. The system development life cycle includes five stages, planning, design, implementation, maintenance, and evaluation (Laureate Education, 2011).

The healthcare system had five regional cancer centers all using the same electronic health record (EHR). The system had been implemented in 2005, and had undergone two upgrades to the system. The maintenance phase in the system development life cycle includes be aware of the new business needs, and refining the system to meet those needs (Dennis, Wixom, & Roth, 2012). The physicians were proficient in CPOE and all orders were entered electronically. The cancer center had an outpatient clinic, surgery, infusion center, and inpatient settings all using the EHR. Patients moved between levels of care frequently between levels of care, and the need became apparent that electronic reconciliation of medications needed to be implemented. In the Institute of Medicine’s Report, To Err is Human, recommendations were made for organizations to use CPOE, bar code medication administration and medication reconciliation to increase patient safety and reduce medication errors (To Err Is Human: Building a Safer Health System, 2000). The healthcare system had also implemented bar coded medication administration, but had never moved on to medication reconciliation using the EHR. The project was identified by the physicians within the cancer center. Patient due to their changes of condition were moving from the outpatient to inpatient units. The manual reconciliation for a patient at discharge from inpatient status was taking a physician at least two hours and mistakes were being made due to the manual process. I was director of clinical informatics for the hospital, and the chief hospitalist brought it to my attention. Together we coordinated a meeting with the chief hospitalists and informatics directors at the other four hospitals to gain consensus. The group created an enhancement request to take to the governance committee for information systems. The request was initially denied due to other projects currently prioritized.

In this situation, the physician and nursing leaders brought the new business need to the information systems (IS) department were willing to support the HIT project, but the IS department felt there was a shortage of resources to implement the medication reconciliation project (Szydlowski & Smith, 2009). To make change in an environment it is necessary to have support of by stakeholders who can influence the project outcome. It can be done through formal influence such at the executive team, and by informal influence of key stakeholders who may have influence conferred by their peers (Coplan & Masuda, 2011). The physicians supported their chief hospitalist and as a part of the medical leadership committee voted for the implementation of medication reconciliation. The chief hospitalist, the chief medical officer, and the chief surgeon aligned with the directors of clinical informatics to address the executive team at each hospital. Statistics had been gathered to show the waste of physician hours to manually reconcile the medications and the potential safety errors. The chief operating officer at each hospital sits on the IS governance board. Each hospital executive team agreed and voted that the medication reconciliation module needed to be the top priority for the organization, and trumped other projects. There was a meeting of the IS governance committee the next month, and the medication reconciliation was prioritized to be the next implementation. It then took six months to go through the system development life cycle to get to the go-love of the HIT.

Before implementing new HIT, the need for the new technology must be recognized. HIT that is in the maintenance phase should be evaluated to see if there are new business needs and is it meeting those needs (Laureate Education, 2011). The hospitalist recognized they were not using the HIT efficiently, when the patients were moving to different levels of care. And in this instance, it was the influence and perseverance of the key stakeholders, the physicians, that impacted the implementation of the medication reconciliation module.

References

Coplan, S., & Masuda, D. (2011). Change mangement Project management for healthcare information technology (pp. 193-237). New York, NY: McGrawHill Companies.

Dennis, A., Wixom, B. H., & Roth, R. M. (2012). Transition to the new system Systems Analysis & Design (5th ed., pp. 471-501). Hoboken, NJ: John Wiley& Sons, Inc.

Laureate Education, I. (Producer). (2011). Transforming nursing and healthcare through technology: Systems analysis.

Szydlowski, S., & Smith, C. (2009). Perspectives From Nurse Leaders and Chief Information Officers on Health Information Technology Implementation.Hospital Topics, 87(1), 3-9. doi:10.3200/HTPS.87.1.3-9

To Err Is Human: Building a Safer Health System. (2000). Washington, DC: The National Academies Press.

Townsend, J. C. (2013). Disruptive innovation: A prescription for better healthcare. Forbes, 5. Retrieved from Forbes website: http://www.forbes.com/

Content

Name: NURS_8210_Week4_Discussion_Rubric

	Excellent	Good	Fair	Poor
RESPONSIVENESS TO DISCUSSION QUESTION Discussion post minimum requirements: *The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.	Points Range: 8 (26.67%) – 8 (26.67%) Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.	Points Range: 7 (23.33%) – 7 (23.33%) Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.	Points Range: 6 (20%) – 6 (20%) Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.	Points Range: 0 (0%) – 5 (16.67%) Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.
CONTENT KNOWLEDGE	Points Range: 8 (26.67%) – 8 (26.67%) Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.	Points Range: 7 (23.33%) – 7 (23.33%) Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.	Points Range: 6 (20%) – 6 (20%) Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course	Points Range: 0 (0%) – 5 (16.67%) Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.
CONTRIBUTION TO THE DISCUSSION	Points Range: 8 (26.67%) – 8 (26.67%) Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.	Points Range: 7 (23.33%) – 7 (23.33%) Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature	Points Range: 6 (20%) – 6 (20%) Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.	Points Range: 0 (0%) – 5 (16.67%) Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas
QUALITY OF WRITING	Points Range: 6 (20%) – 6 (20%) Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.	Points Range: 5 (16.67%) – 5 (16.67%) Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.	Points Range: 4 (13.33%) – 4 (13.33%) Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.	Points Range: 0 (0%) – 3 (10%) Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.
Total Points: 30

Excellent

Good

Fair

Poor

RESPONSIVENESS TO DISCUSSION QUESTION

Discussion post minimum requirements:

*The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.

Points Range: 8 (26.67%) – 8 (26.67%)

Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.

Points Range: 7 (23.33%) – 7 (23.33%)

Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.

Points Range: 6 (20%) – 6 (20%)

Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.

Points Range: 0 (0%) – 5 (16.67%)

Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.

CONTENT KNOWLEDGE

Points Range: 8 (26.67%) – 8 (26.67%)

Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.

Points Range: 7 (23.33%) – 7 (23.33%)

Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.

Points Range: 6 (20%) – 6 (20%)

Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course

Points Range: 0 (0%) – 5 (16.67%)

Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.

CONTRIBUTION TO THE DISCUSSION

Points Range: 8 (26.67%) – 8 (26.67%)

Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.

Points Range: 7 (23.33%) – 7 (23.33%)

Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature

Points Range: 6 (20%) – 6 (20%)

Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.

Points Range: 0 (0%) – 5 (16.67%)

Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas

QUALITY OF WRITING

Points Range: 6 (20%) – 6 (20%)

Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.

Points Range: 5 (16.67%) – 5 (16.67%)

Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.

Points Range: 4 (13.33%) – 4 (13.33%)

Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.

Points Range: 0 (0%) – 3 (10%)

Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.

Total Points: 30