Benchmark – Electronic Health Record Implementation Paper

Sample Answer for Benchmark – Electronic Health Record Implementation Paper

Benchmark – Electronic Health Record Implementation Paper

The advancement in technology and the demand for quality care delivery based on patient-centric and evidence-based practice implores healthcare organizations and providers to leverage electronic health records (EHRs) and other components of nursing informatics. Through EHR, providers and organizations collect and store individual health information using electronic means (McGonigle et al., 2024). The implementation of EHR systems in any organization requires the input of advanced registered nurses, especially those with informatics specialties (Aguirre et al., 2020). The purpose of this paper is to explore the role of an advanced registered nurse (ARN) in the implementation process of an EHR system. The paper identifies key information, the role of health informatics during the process, and project management strategies and methodologies required to support informatics, systems, and staff members required in the process, especially the role of ARN in promoting and leading quality and performance improvement initiatives. The paper also outlines implementation strategies and discusses professional, ethical, and regulatory standards. It also highlights success measures and steps in leadership skills and theories to facilitate inter-professional teams.

Key Information for Implementation of the Project

The use of electronic health records (EHRs) in healthcare provides several opportunities for nurses and other healthcare providers and teams to track opportunities to improve care delivery. For instance, delays in discharging of patients, and increased medication errors due to errors in bar code scanning of patient medications are opportunities for nurses and organizational managers to implement changes. Failure to scan patient medications based on their charts means that nurses are not developing a professional accountability culture. As such, through electronic health records, the facility can track the opportunity to improve the scanning of medications with

 bar codes (McGonigle et al., 2024). Time management is essential for patients to get medications as scheduled to avoid any adverse reactions. The key information in the database or the EHR in this case includes the patient’s name, diagnoses, treatment plan, and prescriptions. The frequency of taking medications and the number of medications requiring scanning of the bar code are important information to track improvement. The advanced registered nurse should also gather data on personal details, progress reports, medical histories, and physical examinations as well as diagnostic tests ordered and completed (Sipes, 2019). Acquiring this data is essential to determining any other errors that may have occurred and developing steps to correct the situation.

Role of Informatics and Project Management Strategies and Methodologies

Nursing informatics will play a critical role in gathering data required for care improvement within the facility. Informatics will facilitate the process of capturing data by ensuring that providers get vital information, especially structured data (Hussey et al., 2021). Informatics will make sense of the collected data by assigning value and extracting insights for the health system to reduce errors and inaccuracies. Through informatics, the system will increase the odds of attaining expected quality outcomes by reducing associated errors. Informatics will influence the capturing process by identifying the determinants and contextual factors relevant to the situation.

Project management strategies and methodologies are critical when implementing any project, including the EHR system in healthcare organizations. These strategies and methodologies like the agile approach and work-based structure, project timelines, and project plans support the use of informatics in this scenario. Further, the definition of project scope, and use of project management tools, effective communication, and management of risks are critical strategies to improve the outcomes of this project (Kerzner, 2022). These strategies will allow the informatics team to gather data in time and based on the methodology for better outcomes. For instance, being an EHR project, the agile methodology may be the most appropriate for the implementation of the care improvement initiative in the organization.

Systems and Staff Members in the Design and Implementation Process

The design and implementation process will require certain systems and staff members. Systems entail specific technologies to support staff members and enable them to perform logical functions to reduce medication errors. The design and implementation process will require personal health records or patient charts that contain information collected during the treatment process. The process will also require a clinical decision support system to enhance the understanding of all aspects of care and any decision about medications for the patient. The process will also require prescription history through the computerized physician order entry (CPOE) (McGonigle et al., 2024). These systems contain collected information about patients and reasons for providers to scan medications with bar codes.

Besides these systems, there are personnel who will form the implementation team. The staff members in the design and implementation process will include nurse informaticists, nurse leaders, nurses, and nurse assistants. The administrators and end-users like the information technology (IT) staff and support staff in critical departments will also be part of the process. For instance, informatics nurses will work through inter-professional and multidisciplinary teams to identify the root cause of the failure to scan medication with bar codes among nurses (Hussey et al., 2021). Nurses as end-users will have input to make the system user-friendly based on its interfaces. Information managers will also be critical in the process as they will determine the type of data to structure and produce relevant information for providers to act on and make decisions.

The advanced registered nurse (ARN) promotes evidence-based practice and leads quality and performance improvement initiatives in the setting by being a change agent and influencing others to embrace novel ideas to reduce errors (McGonigle et al., 2024). The ARN applies clinical knowledge and expertise to improve the implementation process. The ARN also provides input to design systems that meet the needs of various stakeholders.

Strategies for Implementing the Proposed EHR

The implementation of the new EHR proposal will require the application of better and evidence-based strategies, from the use of change implementation models to effective communication and resource management. The first strategy is to develop a change team and create an urgency for change within the nursing practice or department, especially in line with medication administration. The team will create change champions and communicate ways to reduce medication errors through efficient EHR systems connected to patient charts and scanners within the organization (Sipes, 2019). Secondly, the team should communicate their vision for change through meetings and relevant organizational forums. The implementation will also require an effective communication plan and training of the team to ensure that it understands all aspects of the EHR system and the possible effects of the integration with patient charts. The transition to the new integrated EHR system will require testing and trial before full implementation (McGonigle et al., 2024). The last strategy is sufficient and effective allocation of resources for the project. The organizational management and leadership should ensure that the team has sufficient resources, from skilled and technical staff to fiscal resources to acquire relevant software and hardware for the project. 

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

Informatics projects and systems like the integrated EHR system to reduce medication errors associated with the failure to scan medications with bar codes must comply with regulatory requirements and standards in their design and implementation. Professional and ethical standards focus on the conduct of those designing and implementing the system. These include informed consent, respect, honesty, transparency, and integrity. For instance, the integrity of the collected data or health information is essential and should comply with legal mandates like the Health Insurance Portability and Accountability Act of 1996 (McGonigle et al., 2024). The HIPAA provisions like privacy and protection of identifiable health information are critical when designing the project. As such, professional nurses like ARNs should comply with issues like accountability where they are responsible for their actions and decisions. The design and implementation process should develop the project based on “legal and ethical architecture for patient-centered care” as required by HIPAA and HITECH provisions (Kluge, 2020). Additionally, the design and implementation process should ascertain adherence to critical ethical principles like beneficence, respect, non-maleficence, justice, and autonomy. They must always design a system that seeks informed consent from patients.

Evaluation of Successful Implementation

 The success of the implementation of the proposed integrated EHR system will depend on the evaluation of certain measures and steps to reduce medication errors, especially those emanating from failure to scan medications with bar codes (McGonigle et al., 2024). The initial step to evaluate the success will be a reduction in such events within two weeks of the implementation. Secondly, having sufficient memos within the different departments will also demonstrate the effective implementation of the initiative. Thirdly, the implementation will be a success if the staff will have sufficient information and implement EBP interventions during medication administration (Piasecki et al., 2021). For instance, staff should have a strategy to remember the frequency of medication administration for their patients. Further, they should have effective handover during the shift through electronic reports to be posted or integrated into the patient’s records.

The implementation will be a success from the setting’s perspective if it reduces the cost of medication errors and improves safety. The setting should ensure that all stakeholders participate in the initiative and offer their feedback. The management and nurse leaders should integrate the new ways of administering medications to demonstrate the success of the implementation (McGonigle et al., 2024). Through tracking progress reports and identifying areas for improvement, the setting will demonstrate that the EHR implementation is a success for the benefit of the organization and its stakeholders.

 Patients will feel the effects of the implementation when they experience better care devoid of medication administration errors (Sipes, 2019). The implementation will be a success when patients record few readmissions and incur limited additional costs. For instance, reporting such errors will demonstrate that providers and patients understand the associated negative effects. Through these measures and steps, the organization and its stakeholders will develop approaches to ensure continuous quality improvement for better outcomes from the initiative.

Leadership Skills and Theories to Facilitate Collaboration in Inter-professional Team

Leadership skills and theories are critical to attain collaboration in inter-professional teams and offer evidence-based, patient-centered care in this scenario. The required leadership skills in this case would include effective communication, critical and analytical thinking skills, problem-solving abilities, and project management attributes (Piasecki et al., 2021). These skills will help leaders develop effective inter-professional collaboration as they implement the initiative to enhance the EHR system and avoid medication errors (Hassmiller et al., 2020). For instance, communication skills will enable the team and management to engage in all aspects of the project, including reporting and making any changes. Through critical thinking and analytical skills, the team will deliberate on areas of improvement and ways to engage all stakeholders, especially where a problem may arise. These skills will also be essential for nurse leaders to offer evidence-based and patient-centered care to patients.

Transformational and servant leadership theories will be the most effective in designing and implementing the proposed integrated EHR system in the facility. Transformational leadership will ascertain that stakeholders collaborate and embrace the novel approach to reduce errors. The leadership will motivate and inspire nurses to embrace aspects like prompt reporting of medication administration errors through the integrated EHR system (Morse et al., 2021). Servant leadership implies that the leader will employ active listening, building team, empathy, and other attributes to attain set goals. Servant leaders focus on better outcomes for their subordinates. As such, these skills and theories will be fundamental in attaining the set goals and objectives of the initiative.

Conclusion

Electronic health records (EHR) systems are a vital component of effective care delivery as they allow nurses and other providers to access patient health information effortlessly. Nursing informatics leverages EHR systems to improve decision-making and prevent and reduce errors like in medication administration. The proposed project in this scenario will require resources, strategies, and teams based on appropriate leadership skills and approaches to reduce and prevent medication errors arising from the failure to scan medications with bar codes.

Aguirre, R. R., Suarez, O., Fuentes, M., & Sanchez-Gonzalez, M. A. (2020). Electronic health

References

            record implementation: a review of resources and tools. Cureus, 11(9): e5649.

DOI: 10.7759/cureus.5649

Hassmiller, S. B., & Pulcini, J. (2020). Advanced Practice Nursing Leadership: A Global

            Perspective. Springer Nature.

Hussey, P., & Kennedy, M. A. (2021). Introduction to Nursing Informatics. Springer

            International Publishing.

Kerzner, H. (2022). Project management metrics, KPIs, and dashboards: a guide to measuring

            and monitoring project performance. John Wiley & Sons.

Kluge, E. H. W. (2020). Ethical and legal challenges for health telematics in a global world:

telehealth and the technological imperative. In The Ethical Challenges of Emerging Medical Technologies (pp. 223-227). Routledge.

McGonigle, D., & Mastrian, K. (2024). Nursing informatics and the foundation of knowledge.

            Jones & Bartlett Learning.

Morse, V., & Warshawsky, N. E. (2021). Nurse leader competencies: Today and tomorrow.

            Nursing Administration Quarterly, 45(1), 65-70. DOI: 10.1097/NAQ.0000000000000453

Piasecki, J., Walkiewicz-Żarek, E., Figas-Skrzypulec, J., Kordecka, A., & Dranseika, V. (2021).

Ethical issues in biomedical research using electronic health records: a systematic review. Medicine, Health Care and Philosophy, 24(4), 633-658.

DOI: 10.1007/s11019-021-10031-6.

Sipes, C. (2019). Application of Nursing Informatics: Competencies, Skills, and Decision-

            Making. Springer Publishing Company.

Tsai, C. H., Eghdam, A., Davoody, N., Wright, G., Flowerday, S., & Koch, S. (2020). Effects of

electronic health record implementation and barriers to adoption and use: a scoping review and qualitative analysis of the content. Life, 10(12), 327. DOI: 10.3390/life10120327

.

One of the benefits to telehealth is the patient can call from anywhere they can have a mobile device, or they can have a provider visit from their home on their computer. According to Delabano (2020) patients have a better experience by being virtual than in person. He states many times the provider is engaged with eye contact and asks the patient questions regarding their health goals. He states many providers do not ask their patient why they came in to be seen in the clinic setting and when they did the patient was interrupted within 11 seconds. Telemedicine can improve interactions with patients that are not comfortable going to see the provider face to face.

Telemedicine is a benefit for elderly patients who are unable to leave their home. During the pandemic, several of our nurse practitioners would talk to the elderly patients on the phone because they could not leave their home and they were not tech savvy enough to figure how to see the provider on the screen. 

Telemedicine can be challenging when it comes to exams as the patient cannot receive a hands on assessment. In my experience if the practitioner had the patient come to the clinic after a telehealth visit for further evaluation, it was a very smooth process. The receptionist called the patient and obtained the payment over the phone, and the patient called the receptionist when they arrived at the clinic.  The receptionist informed the nurse, and the nurse called the patient to come in and the patient was placed in the exam room. 

A drawback to telehealth is quality of care and continuity concerns. Delabano (2020) states lack of data for care continuity can be a risk for the patient as patient records may not reflect outcomes, treatment plans and diagnoses from the outside telehealth providers. 

Medicaid and Medicare have expanded their reimbursement so telehealth visits can occur at any location of the patient, and this has helped to broaden telemedicine options for all people. Providers should be using a HIPPA compliant platform that has encrypted data transmission that allows only those that have been trained on it to access it (Delabano, 2020).

Delabano, A. (2020). Access. Top 10 Telehealth Benefits and Challenges Concerning Hospitals. www.accessfm.com