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NUR 514 The adoption of electronic health records Essay

NUR 514 The adoption of electronic health records Essay

NUR 514 The adoption of electronic health records Essay

The adoption of electronic health records has shaped significantly the provision of healthcare in the modern world. Electronic health records have made it possible for health organizations to obtain, organize, analyze and present data for the healthcare providers’ use in decision-making. The costs of healthcare have also declined significantly with the use of electronic health records. The reduction is attributed to the enhanced efficiency in the decision-making process and the provision of healthcare. There is also the enhanced provision of safe, high quality care that meets the actual and perceived needs of the diverse populations. Therefore, this research paper examines the roles of the registered nurse in various scenarios related to the use of electronic health records.

Christian values are essential to embody in all aspects of life. While GCU utilizes these values as a foundational component for educational standards, these should also be standard for how students are influenced in their academic performance as well. Academic dishonesty, which is the opposite of academic integrity, plagues all academic levels. There are several reasons why I think students are tempted into dishonesty including pressure for success, lack of understanding about what constitutes plagiarism, and not fully understanding the entire process of academia. Integrity is the intrinsic belief to do the right thing even when no one is watching and is an essential value of the Christian doctrine. When students believe and practice integrity, they will be able to apply this outside of the classroom and to other aspects of life. If students are engaging in academic dishonesty, this may be suggestive of a lack of integrity outside of the classroom as well. Lack of integrity is one example of the brokenness seen in society today. It shows a desire for success regardless of the means to get there or if there was any actual self-growth in the achievement of success. Having an educational infrastructure based on Christian values will not only foster academic success but will support students to apply these values beyond the classroom and become a part of their daily lives.

Database to Track Opportunities for Care Improvement Information

Health information systems should not only provide enhanced efficiencies in data use but also tracking for opportunities in healthcare too. Different kinds of information are needed to allow for tracking of healthcare opportunities. One of them is information on patient satisfaction. The systems should allow organizations to obtain data related to the level of patient satisfaction with care. The patients should also provide their feedback on areas of improvement that would result in better services to those in need (Sarkar, 2015). Such information is important since the organization learns more about the ways in which excellent services can be offered to meet the diverse needs of the patients.

The other information that is needed in the database is information on appointment processes. The organization needs to be available for the populations in need at all times. It is therefore important that information on the duration that it takes from the time of requesting an appointment to the actual appointment is obtained. Information on effectiveness of the reminders of appointment and missed or cancelled appointment should also be kept in the database. The above information is needed to evaluate the responsiveness of the organization to its consumers (Graña, Toro, & Howlett, 2015). The company can optimize such information by ensuring that patients receive excellent services from booking appointments, actual appointments, reminders, and finding out about the reasons for missed or cancelled appointments.

The other type of information that is needed in the database for tracking opportunities in healthcare is information on the quality of treatment offered to those in need. The nature of care given to the patients should be safe, effective, and quality. It should optimize on patient outcomes such as faster recovery, safety, cost-effectiveness, and minimize adverse events. Therefore, information such as those related to prescription, referral tracking, and result tracking can be used to improve the quality of treatment.

Role of Informatics in Capturing the Above Data

Health informatics plays an important role in capturing the above data that is used for tracking opportunities in healthcare. It promotes the provision of patient-centered care. It also provides a mechanism in which patients and healthcare providers exchange vital information for improving healthcare outcomes. The information can be shared with other healthcare providers for the purposes of collaborative provision of healthcare. Through it, shared decision-making is promoted since patients have more control over the planning of their healthcare needs. Informatics also provides opportunities for error minimization in the use of the collected data. For instance, standards of information used are developed to guide the interpretation of each category of data and its implications to healthcare, thereby, promoting meaningful use of the obtained data.

Systems and Staff Needed in the Design and Implementation Process and Team

The type of system to be selected depends largely on the needs of an organization. However, it is important that the selected system promote flexibility and ease use by the healthcare providers. It should enhance patient-healthcare provider interaction rather than deterring the nature of communication between them. The electronic health record is one such system. Therefore, the user interface of the selected system should be intuitive as well as easy to learn. The simplicity ensures that there is easy transition for the users and enhanced system effectiveness in delivering the needed productivity.

The staff that are needed in the design and implementation of healthcare technologies should comprise of administrative staff, medical assistants, nurses, lead super user, information technology professionals, and physicians.  They are needed in the design process as they provide their input on system features that should be included in the system. They are also needed in the implementation phase as they determine the usability of the system and ease of use. The staffs work as teams throughout the process of system design to evaluation.

Professional, Ethical, and Regulatory Standards that must be incorporated into Design and Implementation of the System

The design and implementation of electronic health systems are done with a consideration of professional, ethical, and regulatory standards. According to the American Nurses Association, healthcare information technologies should promote patient safety as well as enhanced patient outcomes. The data should be accurately as well as efficiently obtained, recorded, stored, analyzed, and reported. Ethical principles that guide the use of electronic health data should also be considered. This includes the principles of confidentiality, privacy, and security of electronic health data. The healthcare providers should also play an active role in the design, implementation, and evaluation of system use in their organizations (Stanhope & Lancaster, 2016).

Regulatory standards must also be incorporated into the design and implementation of health electronic systems. An example is the consideration of the provisions of the Health Information Technology for Economic and Clinical Health Act (HITECH) and HIPAA security standards. According to HIPAA, institutions of healthcare should take the responsibility of protecting the health data of their patients. The principles of privacy, confidentiality, and security should be upheld for efficient and effective use of electronic health data. The HITECH Act provides stricter measures that underpin the provisions of HIPAA standards (Sarkar, 2015). It increases the legal liability for any incidence of non-compliance to HIPAA provisions on the use and protection of electronic health data.

How EHR Team Will Ensure that All Order Sets Are Part of the New Record

The EHR team can use a four-step process to ensure that order sets are part of the new record. The steps include coming up with a system of governance for the order set structure, planning and tracking the maintenance and workflow of the order set, creating and making use of style guide that promote consistency, and encouraging practices that streamline order set use in clinical environment. The first step, governance, entails formulating a body to support communication as well as decision making for project coordination, integration, and customization. The governance group can comprise of any staff members and tasked with responsibilities such as providing oversight, establishing use of metrics, and communicating with other stakeholders. In the second step, planning, the expectations, goals, and deadlines of order sets are developed. The existing order sets are edited and integrated into the new systems. The third step, style guide, entails the development of an approach that will promote consistency in aspects such as layout, naming, order set sequencing, types of evidence, and size thresholds. Consistency in these aspects is important as it ensures easy search as well as data retrieval, use, and standardization. In the last step, physician engagement, the staffs involved in the use of order set are invited to review the system. Approaches such as webinars and meetings are used to create awareness among the users (Kelley, 2016). Healthcare provider involvement is critical as it ensures effective adoption of system use in the organization.

How to Communicate Changes in the Plan

Formal means of communication should be utilized in the design and implementation of electronic health systems. These include the use of posters, email, and arranging for meetings with the staff to communicate the progress, needs, and any alterations. These formal methods of communication create awareness among the healthcare providers on the needs of the electronic health systems, thereby, minimizing resistance to system adoption by the staffs. The communication should also be timely and updated to avoid any cases of surprises to the adopters. The environment of the organization should also foster open and free communication (Graña, Toro & Howlett, 2015). The staffs should be able to offer their inputs on the system design and implementation.

Measures and Steps to Evaluate the Success of EHR Implementation from Staff Setting and Patient’s Perspective

Measures of success of EHR implementation are varied. They include adoption process, culture, network and infrastructure efficiency, medical errors, and staff satisfaction with the system. The steps involved in the evaluation of success of EHR include planning, performing calculations on return on investment, assessing system efficiency, assessing quality of care with system, adoption, and evaluation of data input as well as quality. The team should conduct cost-benefit analysis to determine the profitability of the system to the organization and patients. The efficiency is evaluated by using data on patient throughput. The quality of healthcare is determined using surveys on patient satisfaction. Surveys are also administered to the physicians to determine their satisfaction and adoption process. Error rate is determined to evaluate the quality of data input (Gliklich et al., 2014). Through these methods, it is possible to evaluate the implementation of EHR.

Leadership Skills and Theories

Some of the leadership skills that one should have include effective communication, problem solving, project management, and technical proficiency. Open communication is important as it keeps the stakeholders aware of the progress of the implementation. It also ensures that team members communicate their concerns and ways of improving outcomes. The design and implementation of EHR involves people with diverse knowledge, experience, and perceptions. The diversity increases the risk of conflicts, which needs individuals with adept experience in problem solving. The members should also have experience in project management since it demands the setting and evaluation of various deliverables. Technical proficiency is needed to facilitating the understanding of information technology-related terms that are used in the process. The leadership theories that are needed include participatory and transformative leadership styles (Barrett, 2015). In participatory style, all the stakeholders are encouraged to play an active role in the whole project. It focuses on empowering the team members involved in the adoption process. In transformative leadership, the focus is placed on ensuring that individuals work collectively to achieve a common goal. The leaders influence those they lead through encouraging, inspiring, and motivating them to explore innovative ways of doing things.

Conclusion

In summary, electronic health records can be utilized to not only improve the quality of care but also identify opportunities in the healthcare system too. The stored data can be used to explore the trends that can be explored for business profitability. The design and implementation of electronic health records is a collaborative process. It incorporates the insights provided by stakeholders such as doctors, nurses, and information technology experts. Therefore, it is important that the desired leadership style and skills are employed to ensure that the adopted system meets the prioritized needs of the organization.

References

Barrett, A. K. (2015). Change is inevitable but compliance is optional: Coworker social influence and behavioral work-arounds in the EHR implementation of healthcare organizations. Austin, Tex: University of Texas.

Gliklich, R. E., Dreyer, N. A., Leavy, M. B., Quintiles Outcome (Firm),, United States., & Effective Health Care Program (U.S.). (2014). Registries for evaluating patient outcomes: A user’s guide. Rockville, MD: Agency for Healthcare Research and Quality.

Graña, M., Toro, C., & Howlett, R. J. (2015). Innovation in Medicine and Healthcare 2014. Burke: IOS Press.

Kelley, T. (2016). Electronic health records for quality nursing & health care. Lancaster, PA: DEStech Publications.

Sarkar, I. N. (2015). MEDINFO 2015: eHealth-enabled Health. IOS Press.

Stanhope, M., & In Lancaster, J. (2016). Public health nursing: Population-centered health care in the community. St. Louis, Missouri: Elsevier.

Description:

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 1,500-1,750 words, discuss the following:

1. Consider an opportunity for tracking care improvement. What key information would be needed in the database? Example: Time lapse from medication order documented in the EHR to delivery of medication to the patient for the cardiology service.
2. Describe the role informatics plays in the ability to capture this data. What type of project management strategies

and methodologies can be implemented to support informatics initiatives to help improve quality within the clinical practice?
3. Discuss which systems and staff members would need to be involved in the design and implementation process. What is the role of the advanced registered nurse in promoting evidence-based practice and leading quality and performance improvement initiatives within this setting?

4. Outline strategies for implementing the new EHR proposal. Consider communication changes, transitioning to the new EHR, and managing resources (human, fiscal, and health care resources).
5. Discuss what professional, ethical, and regulatory standards must be incorporated into the design and implementation of the system.
6. Describe the measures and steps you would take to evaluate the success of the EHR implementation from a staff, setting, andNUR 514 The adoption of electronic health records Essay patient perspective to measure effectiveness and ensure continuous quality improvement in practice?
7. Explain what leadership skills and theories would be needed to 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.

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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.

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.

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.

References

Aldosari, B. (2017). Causes of EHR projects stalling or failing: A study of EHR projects in Saudi

Arabia. Computers in biology and medicine, 91, 372-381. DOI: 10.1016/j.compbiomed.2017.10.032

Balestra, L. M. (2017). Electronic Health Records: Patient Care and Ethical and Legal

Implications for Nurse Practitioners. The Journal for Nurse Practitioners. Vol 13(2), 105-111. https://doi.org/10.1016/j.nurpra.2016.09.010

Bjarnadottir, R. I., Herzig, C. T., Travers, J. L., Castle, N. G., & Stone, P. W. (2017).

Implementation of electronic health records in US nursing homes. Computers, informatics, nursing: CIN, 35(8), 417. Computer Information in Nursing, 35(8):417-424. DOI: 10.1097/CIN.0000000000000344

Hansen, M. B., Nørup, I., Elmholdt, K. T., Kidholm, K., Nøhr, C., & Schmidt, T. (2019,

November). Managing Change of EHR Systems. In SHI 2019. Proceedings of the 17th Scandinavian Conference on Health Informatics, November 12-13, 2019, Oslo, Norway (No. 161, pp. 104-107). Linköping University Electronic Press. https://ep.liu.se/ecp/161/018/ecp19161018.pdf

Health IT.gov (2017). Improved Patient Care Using EHRs. Retrieved from

            https://www.healthit.gov/topic/health-it-basics/improved-patient-care-using-ehrs

Laukka, E., Huhtakangas, M., Heponiemi, T. & Kanste, O. (2020). Review: Identifying the Roles

of Healthcare Leaders in HIT Implementation: A Scoping Review of the Quantitative and Qualitative Evidence. International Journal of Environment Research and Public Health, 17(2865). doi:10.3390/ijerph17082865

McCrory, C., Benn, J., Johnson, O. A. & Scantlebury, A. (2019). Staff expectations for the

implementation of an electronic health record system: a qualitative study using normalization process theory. BMC Medical Informatics and Decision Making, 19 (222). https://doi.org/10.1186/s12911-019-0952-3

Yen, P. Y., McAlearney, A. S., Sieck, C. J., Hefner, J. L., & Huerta, T. R. (2017). Health

information technology (HIT) adaptation: refocusing on the journey to successful HIT implementation. JMIR medical informatics, 5(3), e28. DOI: 10.2196/misinform.7476

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

2.3: Develop leadership skills to collaborate on interprofessional teams in the provision of evidence-based, patient-centered care.

5.2: Apply professional, ethical, and regulatory standards of practice in the provision of safe, effective health care.

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.

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.

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.

References

Aldosari, B. (2017). Causes of EHR projects stalling or failing: A study of EHR projects in Saudi

Arabia. Computers in biology and medicine, 91, 372-381. DOI: 10.1016/j.compbiomed.2017.10.032

Balestra, L. M. (2017). Electronic Health Records: Patient Care and Ethical and Legal

Implications for Nurse Practitioners. The Journal for Nurse Practitioners. Vol 13(2), 105-111. https://doi.org/10.1016/j.nurpra.2016.09.010

Bjarnadottir, R. I., Herzig, C. T., Travers, J. L., Castle, N. G., & Stone, P. W. (2017).

Implementation of electronic health records in US nursing homes. Computers, informatics, nursing: CIN, 35(8), 417. Computer Information in Nursing, 35(8):417-424. DOI: 10.1097/CIN.0000000000000344

Hansen, M. B., Nørup, I., Elmholdt, K. T., Kidholm, K., Nøhr, C., & Schmidt, T. (2019,

November). Managing Change of EHR Systems. In SHI 2019. Proceedings of the 17th Scandinavian Conference on Health Informatics, November 12-13, 2019, Oslo, Norway (No. 161, pp. 104-107). Linköping University Electronic Press. https://ep.liu.se/ecp/161/018/ecp19161018.pdf

Health IT.gov (2017). Improved Patient Care Using EHRs. Retrieved from

https://www.healthit.gov/topic/health-it-basics/improved-patient-care-using-ehrs

Laukka, E., Huhtakangas, M., Heponiemi, T. & Kanste, O. (2020). Review: Identifying the Roles

of Healthcare Leaders in HIT Implementation: A Scoping Review of the Quantitative and Qualitative Evidence. International Journal of Environment Research and Public Health, 17(2865). doi:10.3390/ijerph17082865

McCrory, C., Benn, J., Johnson, O. A. & Scantlebury, A. (2019). Staff expectations for the

implementation of an electronic health record system: a qualitative study using normalization process theory. BMC Medical Informatics and Decision Making, 19 (222). https://doi.org/10.1186/s12911-019-0952-3

Yen, P. Y., McAlearney, A. S., Sieck, C. J., Hefner, J. L., & Huerta, T. R. (2017). Health

information technology (HIT) adaptation: refocusing on the journey to successful HIT implementation. JMIR medical informatics, 5(3), e28. DOI: 10.2196/misinform.7476

Rubric Criteria

Total210 points

Criterion

1. 1: Unsatisfactory

2. 2: Less Than Satisfactory

3. 3: Satisfactory

4. 4: Good

5. 5: Excellent

Systems and Staff Members Needed in Design and Implementation Process

Systems and Staff Members Needed in Design and Implementation Process

0 points

Systems and staff members needed in the design and implementation process are omitted.

13.44 points

Systems and staff members needed in the design and implementation process only partially discussed.

14.78 points

Systems and staff members needed in the design and implementation process are generally discussed. The general role of the advanced registered nurse in promoting evidence-based practice and leading quality and performance improvement initiatives within this setting is summarized.

15.46 points

Systems and staff members needed in the design and implementation process are discussed. The role of the advanced registered nurse in promoting evidence-based practice and leading quality and performance improvement initiatives within this setting is discussed.

16.8 points

Systems and staff members needed in the design and implementation process are detailed. The role of the advanced registered nurse in promoting evidence-based practice and leading quality and performance improvement initiatives within this setting is thoroughly discussed. The narrative is well developed and demonstrates a clear understanding of the design and implementation process.

Development, Structure, and Conclusion

Development, Structure, and Conclusion Advances position or purpose throughout writing; conclusion aligns to and evolves from development.

0 points

No advancement of the thesis, position, or purpose is evident. Connections between paragraphs are missing or inappropriate. No conclusion is offered.

13.44 points

Limited advancement of thesis, position, or purpose is discernable. There are inconsistencies in organization or the relationship of ideas. Conclusion is simplistic and not fully aligned to the development of the purpose.

14.78 points

The thesis, position, or purpose is advanced in most aspects. Ideas clearly build on each other. Conclusion aligns to the development of the purpose.

15.46 points

The thesis, position, or purpose is logically advanced throughout. The progression of ideas is coherent and unified. A clear and plausible conclusion aligns to the development of the purpose.

16.8 points

The thesis, position, or purpose is coherently and cohesively advanced throughout. The progression of ideas is coherent and unified. A convincing and unambiguous conclusion aligns to the development of the purpose.

Required Sources

Required Sources

0 points

Sources are not included.

5.04 points

Number of required sources is only partially met.

5.54 points

Number of required sources is met, but sources are outdated or inappropriate.

5.8 points

Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.

6.3 points

Number of required resources is met. Sources are current and appropriate for the assignment criteria and nursing content.

Opportunity for Tracking Care Improvement

Opportunity for Tracking Care Improvement

0 points

Opportunity for tracking care improvement is not discussed.

16.8 points

Opportunity for tracking care improvement is only partially discussed.

18.48 points

Opportunity for tracking care improvement is generally discussed. Some key information needed for the database is summarized.

19.32 points

Opportunity for tracking care improvement is discussed. Key information needed for the database is presented.

21 points

Opportunity for tracking care improvement is thoroughly discussed. Key information needed for the database is accurate and clearly presented. The narrative provides insight and is well supported.

Thesis, Position, or Purpose

Thesis, Position, or Purpose Communicates reason for writing and demonstrates awareness of audience.

0 points

The thesis, position, or purpose is not discernible. No awareness of the appropriate audience is evident.

11.76 points

The thesis, position, or purpose is discernable in most aspects but is occasionally weak or unclear. There is limited awareness of the appropriate audience.

12.94 points

The thesis, position, or purpose is adequately developed. An awareness of the appropriate audience is demonstrated.

13.52 points

The thesis, position, or purpose is clearly communicated throughout and clearly directed to a specific audience.

14.7 points

The thesis, position, or purpose is persuasively developed throughout and skillfully directed to a specific audience.

Professional, Ethical, and Regulatory Standards Implementation (B)

Professional, Ethical, and Regulatory Standards Implementation (C5.2)

0 points

A description of the professional, ethical, and regulatory standards used to design and implement the plan is not included.

16.8 points

A description of the professional, ethical, and regulatory standards used to design and implement the plan is incomplete or incorrect.

18.48 points

A description of the professional, ethical, and regulatory standards used to design and implement the plan is included but lacks supporting detail.

19.32 points

A description of the professional, ethical, and regulatory standards used to design and implement the plan is complete and includes supporting detail.

21 points

A description of the professional, ethical, and regulatory standards used to design and implement the plan is extremely thorough and includes substantial details.

Leadership Skills and Project Management to Collaborate With Interprofessional Teams (C2.3)

Leadership Skills and Project Management to Collaborate With Interprofessional Teams (C2.3)

0 points

A description of the leadership skills and project management knowledge used to collaborate with the interprofessional team and ensure the facility is providing evidence-based care is not included.

16.8 points

A description of the leadership skills and project management knowledge used to collaborate with the interprofessional team and ensure the facility is providing evidence-based care is incomplete or incorrect.

18.48 points

A description of the leadership skills and project management knowledge used to collaborate with the interprofessional team and ensure the facility is providing evidence-based care is included but lacks supporting detail.

19.32 points

A description of the leadership skills and project management knowledge used to collaborate with the interprofessional team and ensure the facility is providing evidence-based care is completed and includes supporting detail.

21 points

A description of the leadership skills and project management knowledge used to collaborate with the interprofessional team and ensure the facility is providing evidence-based care is extremely thorough and includes substantial details.

Outline Strategies for Implementing EHR Proposal

Outline Strategies for Implementing EHR Proposal

0 points

Strategies for implementing the new EHR proposal are omitted.

16.8 points

Strategies for implementing the new EHR proposal are only partially discussed.

18.48 points

General strategies for implementing the new EHR proposal are presented. Some general communication changes, transitioning to the new EHR and managing human, fiscal, and health care resources, are summarized.

19.32 points

Strategies for implementing the new EHR proposal are outlined. Communication changes, transitioning to the new EHR and managing human, fiscal, and health care resources, are generally discussed.

21 points

Strategies for implementing the new EHR proposal are detailed. Communication changes, transitioning to the new EHR and managing human, fiscal, and health care resources, are thoroughly discussed.

Evaluation of the Success of EHR Implementation

Evaluation of the Success of EHR Implementation

0 points

Measures and steps needed to evaluate the success of the EHR implementation from a staff, setting, and patient perspective to measure effectiveness and ensure continuous quality improvement in practice are omitted.

16.8 points

Measures and steps needed to evaluate the success of the EHR implementation from a staff, setting, and patient perspective to measure effectiveness and ensure continuous quality improvement in practice are only partially discussed.

18.48 points

General measures and steps needed to evaluate the success of the EHR implementation from a staff, setting, and patient perspective to measure effectiveness and ensure continuous quality improvement in practice are summarized.

19.32 points

Overall, measures and steps needed to evaluate the success of the EHR implementation from a staff, setting, and patient perspective to measure effectiveness and ensure continuous quality improvement in practice are discussed.

21 points

Clear measures and steps needed to evaluate the success of the EHR implementation from a staff, setting, and patient perspective to measure effectiveness and ensure continuous quality improvement in practice are detailed. The proposed evaluation measures are effective measures and relevant for the EHR implementation.

Role Informatics Plays in Ability to Capture Data

Role Informatics Plays in Ability to Capture Data

0 points

The role informatics plays in the ability to capture specified data is omitted.

11.76 points

The role informatics plays in the ability to capture specified data is only partially discussed.

12.94 points

The role informatics plays in the ability to capture specified data is summarized. Some general project management strategies and methodologies to implement and support informatics initiatives and help improve quality within the clinical practice are presented.

13.52 points

The role informatics plays in the ability to capture specified data is described. Project management strategies and methodologies to implement and support informatics initiatives and help improve quality within the clinical practice are presented.

14.7 points

The role informatics plays in the ability to capture specified data is clearly described. Project management strategies and methodologies to implement and support informatics initiatives and help improve quality within the clinical practice are discussed. The narrative is insightful and well supported.

Appendix

Appendix

0 points

The appendix and APA Writing Checklist are omitted.

3.36 points

The APA Writing Checklist is attached, but an appendix has not been created. The paper does not reflect the use of the use of the APA Writing Checklist during development.

3.7 points

The APA Writing Checklist is complete and attached in the appendix. The APA Writing Checklist was generally used in development of the paper, but some aspects are inconsistent with the paper format or quality.

3.86 points

The APA Writing Checklist is complete and attached in the appendix. It is apparent that the APA Writing Checklist was used in development of the paper.

4.2 points

The APA Writing Checklist is complete and attached in the appendix. It is clearly evident by the quality of the paper that the APA Writing Checklist was used in development.

Evidence

Evidence Selects and integrates evidence to support and advance position/purpose; considers other perspectives.

0 points

Evidence to support the thesis, position, or purpose is absent. The writing relies entirely on the perspective of the writer.

8.4 points

Evidence is used but is insufficient or of limited relevance. Simplistic explanation or integration of other perspectives is present.

9.24 points

Relevant evidence that includes other perspectives is used.

9.66 points

Specific and appropriate evidence is included. Other perspectives are integrated.

10.5 points

Comprehensive and compelling evidence is included. Multiple other perspectives are integrated effectively.

Mechanics of Writing

Mechanics of Writing Includes spelling, capitalization, punctuation, grammar, language use, sentence structure, etc.

0 points

Errors in grammar or syntax are pervasive and impede meaning. Incorrect language choice or sentence structure errors are found throughout.

8.4 points

Frequent and repetitive mechanical errors are present. Inconsistencies in language choice or sentence structure are recurrent.

9.24 points

Occasional mechanical errors are present. Language choice is generally appropriate. Varied sentence structure is attempted.

9.66 points

Few mechanical errors are present. Suitable language choice and sentence structure are used.

10.5 points

No mechanical errors are present. Skilled control of language choice and sentence structure are used throughout.

Format/Documentation

Format/Documentation Uses appropriate style, such as APA, MLA, etc., for college, subject, and level; documents sources using citations, footnotes, references, bibliography, etc., appropriate to assignment and discipline.

0 points

Appropriate format is not used. No documentation of sources is provided.

8.4 points

Appropriate format is attempted, but some elements are missing. Frequent errors in documentation of sources are evident.

9.24 points

Appropriate format and documentation are used, although there are some obvious errors.

9.66 points

Appropriate format and documentation are used with only minor errors.

10.5 points

No errors in formatting or documentation are present. Selectivity in the use of direct quotations and synthesis of sources is demonstrated.