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NUR 514 Benchmark-Electronic Health Record Implementation Paper SAMPLE

NUR 514 Benchmark – Electronic Health Record Implementation Paper Essay

NUR 514 Benchmark-Electronic Health Record Implementation Paper SAMPLE

Health informatics comprise one of the most effective ways to enhance quality care and patient outcomes. Patients receive better medical care if health care providers have access to complete and accurate information. Many studies demonstrate that electronic health records (EHRs) can enhance the ability to diagnose diseases and reduce and prevent medical errors that leads to optimal patient outcomes (Hansen et al., 2019). Implementing an electronic health records system in a health care facility is one of the critical aspects of attaining quality care and increasing patient satisfaction. The benefits of EHRs as a form of health informatics are broad. On this basis, the paper explores the role of nurse practitioners in different situations in implementing an EHR system in their facilities.

Tracking Opportunities based on the Database

An effective electronic health record system provides the basis for an organization to develop a functional health information system to enhance efficiencies. However, an EHR enables nurse practitioners to track healthcare settings opportunities through an array of information available in such systems. Health data comprises patient information, demographic data, administrative data, health status, medical history, current medical interventions and management, and information on outcomes (Health IT.gov, 2017). A detailed database will comprise current and potentially sensitive information concerning individual patients and families or group populations. Health providers frequently enter clinical and laboratory data into the system as an electronic record for patient care.

The information sources in the database may differ. For instance, data comes from hospital discharge abstracts, self-completed patent respondents’ questionnaires, submissions of insurance claims, employees’ files, and computerized pharmacy records. Personally identified data contained pieces of information or facts that refer to an individual, which allows for identification. Information can also come from the electronic medical records (EMRs) of patients (Aldosari, 2017). EMRs contain medical information, while EHRs contain data related to the health of an individual. Therefore, opportunities arise from nurses and providers’ ability to use data from EHRs to make effective decisions using frameworks like the Clinical Decision Support (CDS). CDS opportunities include improved quality and health care outcomes through avoiding errors and adverse effects, reduced costs and enhanced efficiency, and patient satisfaction. Again, data from the EHRs system allow practitioners to use Computerized physician order entry (CPOE), which entails automation of the medication ordering process. The use of CPOE improves patient safety and efficiency in care when incorporated with CDSs and EHRs.

Role of Informatics in Capturing Data

Health information technology allows facilities to collect data monitoring the effects of a new EHR to enhance performance. Health informatics manages health information and utilizes information technology tools to organize health records to improve health outcomes. Informatics nurses must manage, interpret, and communicate health information with the primary purpose of improving care quality. Informatics has improved care through better documentation, improved care coordination, and minimization of medical errors (Yen et al., 2017). Caring for patients begins with collecting data on the patient’s medical history, clinical symptoms, history of allergies, and the current list of medications. Nurses collect this data and document it in the electronic database. Nurses and other health professionals can retrieve and record information in the system in real-time to reduce medication errors by effectively integrating alerts for medical reactions and allergies. The implication is that informatics nurses have a critical role in capturing data included in the electronic health record system for patients in their facilities.

Systems and Staff Members Involved in Designing and Implementation Process and Team

The selection and design of an EHRs system rely mainly on the organizational needs, However, while corporate needs should influence the system selection, the organization and its management must develop an effective implementation strategic plan consisting of many experts and professionals from different areas and departments within the entity. The system should demonstrate the ease of interaction between other users, especially patients and care providers, and should not impede communication between the critical stakeholders.

The multidisciplinary approach in initiating the EHR system indicates the need for stakeholders to understand the new framework, ensuring consistency based on protection and security, structure work processes, and preparing group consideration (McCororie, 2019). Practical training on EHR usage allows practitioners to adjust to the new model that benefits patients, nurses, doctors, and other healthcare providers. The implication is that the organization must have an effective team that understands or designs an implementation process based on an information strategy that emphasizes information governance.

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The organization should create an execution group or team from different departments, design the product or system, identify equipment needs, share information, and enhance pre-dispatch processes. Successful implementation will entail having an effective team and having insight and expertise in their respective areas. As a new project in the organization, the EHR system should have a leader, project manager, and top users, mainly nurses, and patients. The lead physicist connects health care professionals and other staff using the system. The project manager is in charge of the entire project and ensures that all deliverables are attained (Bjarnadottir et al., 2017). Nurses, top users of the new system, and IT experts in the organization, and administrative staff and physicians will provide essential inputs in designing and implementing the system. Collaboration is a crucial aspect of the successful implementation of the new system, and all these individuals are critical to the plan.

Professional, Ethical & Regulatory Standards in Designing and Implementation of the System

It is essential to consider different ethical, professional, and regulatory requirements and standards in designing and implementing the EHRs system. Professional standards entail requirements set by professional associations that guide decisions of nurse practitioners in different settings. The American Nurses Association emphasizes the need for safety and positive patient outcomes in deploying information technologies in health care (Balestra, 2017). The association asserts that informatics nurses should ensure data accuracy and proficiency when collecting, storing, scrutinizing, and reporting information. Ethical principles are also essential and consist of different areas related to privacy, confidentiality, and security. Health care providers must design, execute, and evaluate the EHR system’s use within their health care settings.

The integration of regulatory requirements by existing federal legislation like the Health Information Technology and Clinical Health Act (HITECH and Health Insurance Portability and Accountability Act (HIPAA) is a critical aspect of compliance. Health care organizations must protect patient’s health data and personal information. Privacy, security, confidentiality requirements should also be considered to attain practical and effective use of electronic health information. The HITECH regulations emphasize the need to comply with HIPAA standards and increase the legal responsibility for entities that fail to comply with set requirements on data use and security.

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Order Sets as part of the New Record

Health care entities are deploying evidence-based practices to improve quality care. The use of clinical order sets based on evidence-based guidelines within the EHR system reduces errors and enhances patient outcomes. Consequently, to attain useful and current order sets, the team should incorporate these components into their design. Therefore, to achieve success in this model, get a buy-in from the main stakeholders, and satisfaction from providers, the team needs to have a lead physician’s formal governance structure (Balestra, 2017). Imperatively, clinical order sets should have the best practices and organizational standards that entail identifying and selecting data content sources, reviewing content, and maintaining and updating these resources. The team should establish a process to identify and replace content that can impact patient safety or care quality if the content is not current.

Communicating Changes

Managing change requires the deployment of principles, techniques, and prescriptions that allow people to accept the transition and improve overall implementation. Kotter’s change model is sufficient, and the team must use it to generate leadership and momentum for change. Health care providers may possess different responses to change processes in the organization, as some may accept, while others may require time. Therefore, it is essential to communicate these changes by laying out how the team will roll out the EHR system. The unit can use Kotter’s 8-Step Model to communicate the changes based on the steps that include creating an urgency for transformation, forming a powerful coalition, and developing a vision for the changes. The team should then communicate the vision, remove any hurdles, and create short-term wins while building on the changes (McCororie et al., 2019). Finally, they should incorporate the change as part of their organizational culture. The team can communicate the changes using different layers of communication channels that include banners, posters, and creating flyers and emails to individual practitioners.

Evaluation of the EHR Implementation from a Staff, Setting, and Patient Perspective

Before the implementation of the project, a set of parameters of what constitutes success should be created. Kotter’s 8-Step Model for change can offer guidelines for milestones at each step of the implementation. Short achievement and developing milestones are some of the goals established in the initial plan before implementation. For instance, the team can set milestones and goals like assessing the stakeholders’ readiness to transition and plan on how to launch the EHRs system based on the assessment and attainment of meaningful utilization. Secondly, keen preparation at the start is critical to the successful implementation of the EHR, but having realistic anticipations and a manageable time frame is essential (Laukka et al., 2020). Once the performance is complete, continual tracking is critical in assessing how internal users deploy the new system. The monitoring is essential as it will ensure the successful implementation of the EHR system.

Leadership Skills and Theories to Facilitate Collaboration with Inter-Professional Team

The implementation of the EHRs system is intricate and presents significant challenges. Therefore, practical leadership skills are essential for successful implementation. Leadership skills will enhance the Lead physician and team’s ability to attain buy-in from users and other stakeholders. The requisite skills include excellent communication attributes, critical thinking, problem-solving skills and techniques, and project management skills.

Communication skills are essential because the team and management must engage employees and other stakeholders like patients on the system’s benefits. Importantly, successful designing and implementing the EHRs system requires staff participation from diverse expertise, perspectives, and experiences. Therefore, communication skills are a critical aspect of the overall project’s success (McCororie et al., 2019). The team and its leadership require effective project management and technical skills to ease the understanding and deliverable of the expected outcomes.

Transformative and contingency leadership theories will be appropriate in designing and implementing the EHRs system in the facility. Transformational leadership will ensure that stakeholders collaborate to attain a common goal. Leaders have to motivate, stimulate, and inspire all providers to embrace the innovative way of interacting with customers. The situational leadership model means that leaders will make decisions based on the circumstances and enhance all stakeholders’ effective participation. These theories implore leaders to nurture their subordinates and provide directions based on the situation.

Conclusion

Implementing the EHR system is a critical aspect of improving care quality and getting different opportunities for providers, primarily through the deployment of CDSs and CEOs. Therefore, healthcare organizations’ leaders should implement EHR systems to enhance efficiency, quality care, and other benefits from health information technologies. An integrative approach is essential in implementing an EHR system where all stakeholders are incorporated into the plan. Most importantly, leaders implementing EHR should deploy effective leadership styles and possess relevant skills to attain such projects’ goals.

The current health practice has evolved in multiple dimensions, including better clinical systems, increased access, and more emphasis on patient-centered care. As these developments occur, technology has been instrumental in evolving critical patient care dimensions. As a result, nursing informaticists and other healthcare practitioners should embrace innovation and guide their organizations in tracking care improvement opportunities and intervening appropriately. For innovation to succeed, healthcare facilities should have the appropriate culture and resources to support and facilitate change (Sharplin et al., 2019). Advanced practice nurses should also play their role as change leaders effectively. The purpose of this paper is to discuss an opportunity for care improvement and the necessary considerations for implementing a new electronic health record (EHR) system.

An Opportunity for Tracking Care Improvement and Database Information

When visiting healthcare facilities, patients always look forward to a comprehensive analysis of their conditions. However, such care can only be achieved if the facilities have efficient and up-to-date EHR systems and other tools for clinical decision support. Effective EHR systems improve care efficiency and reduce inconveniences occasioned by medical errors (Kehsta & Odeh, 2021). A suitable opportunity for tracking care improvement is a system’s task completion rate. In everyday practice, systems’ inefficiencies hamper care outcomes by causing treatment delays or failing to facilitate quick information sharing between providers. An upgrade of the system’s operating system can produce better results in such instances. The other option is implementing a new EHR system to capture patient data easily, enable quick analysis, and ensure that practitioners can share crucial data in real time.

A database contains essential health information to guide practitioners in decision-making. In clinical settings, a database should allow clinicians to store information in a way that can be accessed and managed easily. Appropriate data updates should also be done conveniently. Key information in the database should be primarily about patients. Such information includes patients’ demographics, problems, and current medications (CMS.gov, 2023). The other crucial information relevant to clinicians and patients includes progress notes and time spent during the care process. Further analysis of the time spent during the care process can indicate whether the new EHR system requires improvements.

Role of Informatics in Data Capturing and Project Management Strategies

Informatics is at the center of healthcare evolution and plays an instrumental role in promoting data-driven care. According to Estiri et al. (2018), informatics allows clinicians to capture information rapidly to facilitate quick decision-making. Through informatics, patient information can also be captured in multiple formats, although organizations must have highly interoperable systems to use such data effectively. The implication is that the clinical setting embracing informatics would benefit from quick information capturing, further improving collation, analysis, storage, and retrieval.

Implementing system changes typifies engaging in a project designed to improve patient outcomes. Essential project management strategies and methodologies include teamwork, planning, design, and implementation. Teamwork is crucial in improving quality in clinical practice since it allows people to share perspectives and address a common issue creatively. Regarding system changes, Aguirre et al. (2019) underlined that EHR implementation could be challenging hence the need for effective planning to minimize errors. The planning phase is broad since it entails assessing the selection criteria of teams and intended system performance, including interoperability and confidentiality. Concerning design, maximum consideration of the infrastructure is crucial to ensure clinicians are provided with a robust system and tools to transform practice (Estiri et al., 2018). Implementation denotes putting the system into use. In the current context, it should be implemented after successful piloting and when users can use it comfortably and effectively.

Systems, Staff Members, and the Role of the Advanced Registered Nurse

System implementation should be a collaborative task. Such an approach is crucial since diverse leaders and healthcare teams have different skills and competencies, which are essential in informed decision-making. In clinical practice, shared perspectives improve decision-making since information can be analyzed and critiqued (Roodbeen et al., 2021). Systems necessary in the design and implementation process include communication and health information technology (IT) systems. Communication systems are crucial for enabling healthy interaction between team members, while IT systems are valuable for data collection, analysis, and other related functions. Staff members include the organization’s management, IT department members, system analysts and designers, nurse leaders, and nurses as the end users. Involving nurses as the end users is vital since they will be interacting with the system regularly. Hence, they should understand its basic features, functionality, and how to use it for optimal patient care.

Successful organizations should be open to change and support innovation. Consequently, they should promote evidence-based practice (EBP) and support quality improvement initiatives. As Sharplin et al. (2019) suggested, EBP thrives in a culture ready for change and in organizations that support and reward innovation. In this setting, advanced registered nurses are mandated to identify opportunities for quality improvement and propose interventions for enhancing outcomes. For instance, advanced practice nurses design education programs to reduce infections and improve health literacy. This implies that they are pivotal in practice transformation and ensuring progressive improvement in healthcare processes and outcomes.

Strategies for Implementing the New EHR Proposal

The new EHR system is expected to improve clinical outcomes and have new features, including design, themes, and layout. As a result, communication about the proposed changes is essential to ensure its targeted users are mentally ready for it. Readiness for change reduces possible resistance hence quick implementation (Sharplin et al., 2019). When everyone is ready, a transition to the new system can occur. Here, clinicians would start using the new EHR system to perform tasks quicker than the previous system. A crucial component of the transitioning process is user education to ensure nurses and other users can use the system competently and confidently. Teamwork should also be encouraged before everyone is conversant with the new system. Change leaders should also monitor nurses’ experience with the new system and intervene in areas where user challenges are witnessed. Doing so would allow leaders to design post-implementation support for the sustainable use of the new EHR system.

Professional, Ethical, and Regulatory Standards

EHRs are the foundation of health information exchange. They facilitate the exchange of protected health information (PHI) hence the need for compliance with the established standards. Professional standards that must be incorporated into the system’s design and implementation include user-centeredness and interoperability. User-centeredness can be achieved by an institutive design that is user-friendly to encourage healthcare professionals to use a system (Micheal et al., 2021). Interoperability entails a system’s capacity to share information among different users. It should also be a priority area since interoperable systems should be convenient and safe to use.

The most crucial ethical standards to consider are security, privacy, and confidentiality. The system should be secure from internal and external attacks that can hamper its efficiency. Effective system security is achieved by implementing appropriate safety measures. A secure EHR system is also able to protect patients’ private information (Kehsta & Odeh, 2021). Confidentiality is achieved by ensuring identifiable health information is inaccessible to unauthorized users. Regarding regulatory standards, the EHR system should adhere to the principles of meaningful use. In this case, all the design considerations should enable healthcare professionals to use the system to improve care outcomes such as quality and safety. For instance, quick information sharing would improve care quality and patient satisfaction due to timely care.

Success Evaluation

EHR system implementation can be tedious and time-consuming. Evaluating outcomes would help to determine whether the desired goals were achieved. From a staff perspective, the EHR system should improve communication and teamwork between clinicians. Effective communication and sustained teamwork are the foundation of interprofessional collaboration (Schot et al., 2020). Other outcome measures include improved efficiency (task completion speed) and patient care characterized by minimal errors and treatment delays. The setting would benefit from teamwork and efficiency to increase its productivity, leading to higher revenue. Efficient systems also enhance job satisfaction, reducing fatigue and other potential causes of staff burnout. From a patient perspective, the system’s success could be evaluated by increased satisfaction, reduced treatment delays, and better patient-provider interaction. The implication is that patient experience would improve, and failure to achieve these goals would necessitate further practice improvements.

Leadership Skills and Theories for Collaboration and Evidence-Based, Patient-Centered Care

An interprofessional team comprises members with diverse skills and roles. Keeping such a team motivated and glued to accomplishing its role is a critical success factor. Leadership skills crucial in facilitating collaboration with the interprofessional team include open communication, dialogue, and respect. It is crucial for all team members to be respected, irrespective of their ranks and roles. Open communication and dialogue encourage sharing information and ensure all perspectives are incorporated in decision-making (Albert et al., 2020). The transformational leadership theory would facilitate collaboration with the team and provide evidence-based, patient-centered care. According to Collins et al. (2020), transformational leadership focuses on empowering and motivating the team by utilizing a leader’s influential attributes and behaviors. In a transformative approach, the leader carries the team’s vision and inspires the team to work together for a shared purpose. A similar approach would be required in the EHR system implementation due to the diverse nature of team members.

Conclusion

Healthcare organizations require efficient systems for the continuous delivery of high patient outcomes. As a result, appropriate system changes should be encouraged to ensure clinical settings benefit from technology and informatics as they strive to optimize patient outcomes. When designing and implementing a new EHR system, nurses and other change leaders should be guided by professional, ethical, and regulatory standards. Adherence to these standards would ensure the system complies with the foundation principles of standard practice. Since system design and implementation require teamwork, transformational leadership should be highly recommended. A transformational approach encourages shared decision-making as the team work together to achieve a shared vision.

 

 

References

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