Quality Improvement Project Plan Using Informatics/Technology
Introduction
Problem
Allen hospital’s mission is to provide quality patient care, but inept and poor infrastructure reduces the EHR efficacy in the hospital. The inefficient EHR system reduces clinical workflow due to low staff training. Moreover, the inefficient EHR cannot protect patient information in digital databases and violates confidentiality and privacy laws.
The stakeholders play a crucial role in optimizing the organization’s performance. The inefficient EHR system affects the IT, executive leaders, medical personnel, and finance departments. Data privacy breaches reduce patient satisfaction levels in healthcare settings, and the patient volume reduces, affecting an organization’s financial status. It also leads to medical and administrative personnel burnout, which further affects the organization’s performance. Poor electronic health records (EHR) can lead to several repercussions, so stakeholders work collaboratively to resolve the identified risks (Kaihlanen et al., 2020).
The EHR system can result in medical errors like medication errors, incorrect diagnoses, and treatment plans that reduce health outcomes, as the Leapfrog data labeled Allen Hospital’s Grade “C” in this regard (Leapfrog Hospital Safety Grade, 2019). Additionally, breaches of patient health information due to poorly designed EHR systems lead to severe repercussions on the healthcare organization, and they may face legal action. Inadequately maintained EHR systems may also frequently go down, causing delays in patient care that leads to negative patient outcomes, as informed by Medicare comparison. Allen hospital showed a 3-star patient survey rating as compared to the other two hospitals in the same locality such as Sartori Memorial Hospital (SMH) and Mercyone Waterloo Medical Center (MWMC) (Medicare., 2023). It also increased the workload for healthcare professionals and healthcare costs due to the lower standard of care provided to patients.
Proposed Solution
The vision is to enhance patient health outcomes to achieve financial success at Allen Hospital. The proposed solution is to implement the latest technology, such as an advanced EHR system, to increase the interoperability of the healthcare setting. Educational training will be provided to the personnel about EHR use to implement the solution. Furthermore, financial resources will be needed to incorporate the latest software, such as Computerized Physician Order Entry (CPOE) and Patient identification system (Beauvais et al., 2020). The planning for material and financial resources is necessary to implement the proposed solution in the healthcare setting. An electronic health record (EHR) system is used in healthcare settings to collect, store, retrieve, and analyze patient data. Healthcare professionals should use EHRs properly to enhance the standard and security of patient care (Gariépy-Saper et al., 2021). To produce and organize electronic health records, EHRs function as an informatics solution and rely on a combination of networking, software, and hardware technologies.
EHRs intend to increase patient care’s quality and safety by giving authorized healthcare providers complete patient health information. Additionally, they enable data analytics to enhance population health and support care coordination among various providers and patients (Vos et al., 2020). EHR adoption and effective use enhance interoperability, data security, and privacy in healthcare settings.
Measuring and Monitoring Three Data Points
- Patient satisfaction: A key indicator of how well healthcare organizations provide healthcare services to patients is patient satisfaction. Healthcare staff uses a patient satisfaction survey tool such as the Consumer Assessment of Healthcare Providers and Systems (CAHPS) to track patient satisfaction (Xenakis et al., 2020). The organization gathers healthcare patient feedback regarding healthcare provider behavior, provision of timely care, and hygienic environment.
- Hospital readmission rates: The hospital readmission rate is an important metric for assessing patient care in healthcare organizations. The readmission Reduction Dashboard created by the Agency for Healthcare Research and Quality monitors readmissions (Wong et al., 2020). Healthcare professionals spot high-risk patients and provide the best care to prevent the readmission rate with the help of this tool.
- Mortality rates: The mortality rate is one data that measures an organization’s performance in healthcare services. The death rate due to specific diseases such as pneumonia, heart, and kidney diseases informs the hospital care services. Using a mortality dashboard enables the detection of risk factors and possibilities for integrated care improvement. The dashboard depicts mortality data in categories such as by unit, healthcare provider, or patient population (Greco et al., 2021).
EHR Implementation Issues and challenges
The potential of various software programs to exchange data and enhance interoperability is challenging as the different departments use different standards in the healthcare organization. Data privacy and confidentiality is vital so enhancing interoperability through upgraded EHR needs collaboration between the stakeholders, so that patient data remain safe during transfer (Li et al., 2021). It can be achieved through appropriate communication channels between the departments. The use of telehealth will also be helpful in the safe dissemination of information between healthcare providers. The financial resources will be needed to implement the novel informatics in the healthcare organization (Shaw et al., 2020).
NURS FPX 8012 Assessment 5 Quality Improvement Project Plan
Implementing informatics technology may raise ethical issues if data privacy is breached due to cyber-attacks. The breach of patient privacy gives the patient the right to file a lawsuit against the practitioner and organization (Seh et al., 2020). To overcome this issue, the healthcare setting can use two-factor authentication to protect patient health statistics. Only authorized users access patient data by using a specific PIN or password (Xiang et al., 2021). Likewise, the nurse’s code of ethics will be taught to the staff, enabling them to protect the patient information by abiding by the HIPAA rules in the organization.
A skilled workforce is needed to operate the EHR system to get better patient outcomes. Accurate and up-to-date patient information is needed to make clinical decisions. Incorporating clinical decision support systems (CDSS) into the organization will be beneficial for positive outcomes. It enhances the current workflows of the organization and helps healthcare professionals to safeguard patient data under HIPAA rules (Muhiyaddin et al., 2020). So, CDSS and EHR integration require human resources, which will be challenging in implementing informatics. Staff educational training and practical sessions will improve their efficacy in using the EHR system and the clinical decision-making skills of healthcare professionals. Thus, it increases patient health outcomes.
Role of the Leaders in Change Strategy
Leaders direct the team to implement change strategies within an organization that brings positive results. Leaders define the vision for all the stakeholders and empower them to work for the organization’s shared vision (Frechette, 2019). The change management strategy is lengthy as it includes identifying the risk and pursuing a strategy to bring positive outcomes.
Leaders communicate with the stakeholders and create an effective plan by considering the preexisting resources and formulating a plan. The leader can use the Lewin Change model to enhance the organization’s healthcare industry performance. The three steps of this management change are freeze, change, and refreeze (Rwafa-Ponela et al., 2020). Under these three stages of the model, the leader addresses the need for change and helps the organization to accept the new processes to bring positive outcomes (Gemeda et al., 2020). For instance, the existing staff’s willingness to pursue the change insinuates towards organization’s readiness for the change strategy. Moreover, leaders also identify the organization’s strengths, such as the preexisting workforce. The workforce knows the organization’s procedures and policies and actively participates in the change strategy. It also averts the need for new recruitment, leading to a financial burden on the organization. Focusing on the change need, leaders also address the barriers hamper the change process. It can be low resources, minute funds, and lack of communication among stakeholders. So, leaders overcome these barriers by increasing communication and collaboration between the different departments (Harrison et al., 2021).
Communication Plan
A well-executed communication plan is the mainstay of the change strategy. It also helps the leader to pursue the change effectively. The outlines of the communication plan are as follows
- Stakeholder identification: The identification of stakeholders to pursue the change is necessary. The stakeholders are medical personnel, IT staff, executive leaders, and finance and administrative staff (Franco-Trigo et al., 2020).
- Defining main messages: They should generate concise and transparent messages that explain the change’s rationale and the tangible benefits it will bring. They also ensure that the communications between the stakeholder link with the change application’s overall goals.
- Regulate communication channel: The communication plan also determines the most effective communication method with each project stakeholder. Emails, media platforms, webinars, and posters could be used for communication.
- Communication materials: The leader establish a set of communication techniques that can be used to demonstrate the key messages to each stakeholder group, such as FAQs, seminars, video files, and marketing materials (Zdunek et al., 2020).
- Educating key communicators: Decision makers and other key communicators should receive education on effectively communicating the core message to their teams. It also grants them the tools needed for communication and ensures they are ready to handle queries or issues.
- Establishing timeframe: The decision-makers should establish a timeframe for all interpersonal communication, describing in detail when each stakeholder will receive critical information. Moreover, the schedule of council meetings and dissemination of communication materials are also set in the communication plan.
- Evaluate the efficacy: Lastly, the tracking and evaluation of the communication plans are needed to see the plan’s effectiveness at regular intervals. It is necessary to ensure that messages are conveyed to the stakeholders and target audience in the change management process. The evaluation can also be done through the feedback taken from the stakeholders and by making necessary modifications (Kang et al., 2020).
This communication plan will help the leaders to successfully handle initiatives related to change management. It assures that all decision-makers are informed and involved throughout the process by complying with this communication plan. It not only lowers resistance to change but also boosts investment that and increases the likelihood of change management initiative.
NURS FPX 8012 Assessment 5 Quality Improvement Project Plan
The information regarding the EHR implementation outlines the benefits of this informatics in the healthcare organization. It improves interoperability among the different departments, boosting patient satisfaction and financial success (Lite et al., 2020). Moreover, the cost-benefit analysis associated with the suggested change helps the executive leaders in budget planning. The cost of software purchasing, education materials, and staff training will be included. It also insinuates the leaders about the stakeholders contributing to the change management process to make a successful organizational change.
Workflow Analysis
Existing Workflow Mapping in Healthcare Setting
Workflow Mapping in Healthcare Setting after EHR Implementation
The preexisting workflow has low compliance software, leading to data inconsistency and data breaches. Moreover, the manual record of patient data exhausts the medical staff due to overload and affects the patient care quality standards (Dunn Lopez et al., 2021). The implementation of EHR help in overcoming the challenges associated with poor workflow. The low infrastructure leads to low-quality patient care, human-led medical errors, and violation of data. Moreover, the lack of communication between healthcare professionals also influences health outcomes.
The preexisting plan depicted that patients arrive in the healthcare settings and get treated for their healthcare needs, and data is recorded manually. The unavailability of previous health information makes the treatment ineffective, and the patient’s condition may worsen. So, inculcating EHR in the healthcare setting checks for data inconsistency and averts the associated medical-related errors (Avendano et al., 2022) The post-implemented system has appropriate infrastructure that reduces data duplication due to the same name. For instance, EHR uses the registration number rather than a patient name, which helps identify the patient and is considered a value-added step (Fortman et al., 2020). However, the data entered by the unnecessary healthcare professional leads to time wasted, a non-value-added step in EHR implementation. It makes the system slow and disturbs the workflow in the organization.
NURS FPX 8012 Assessment 5 Quality Improvement Project Plan
The healthcare professional workload leads to ineffective patient care and reduces health outcomes. The EHR technology helps the professional review the patient’s medical history. Moreover, they are aware of adverse drug reactions that alert the staff to be cautious before administering the medications (Basil et al., 2022). After analyzing any significant adverse side effects, the patient will be provided with appropriate medication that increases the patient’s health outcomes.
Cyberattacks and data breaches threaten patient safety in the healthcare setting. Protecting patient information is necessary to boost patient satisfaction, so EHR implementation using blockchain technology increases the interoperability of databases. Moreover, it also increases the authorized access to patient data among professionals (Han et al., 2022). Blockchain technology will enhance the organization’s performance as it increases data privacy by adhering to HIPAA rules which are considered a value-added step. EHR implementation enhances professional capabilities by providing quality care on time and reducing healthcare costs.
Summary: Final Recommendations and Conclusions
All stakeholders, such as medical professionals and administrative and IT staff, must support EHR implementation. It is important for the healthcare setting to deal with their respective issues and engage them in the decision-making process. The need analysis also evaluates the organization’s unique requirements and the capabilities of the EHR system. The EHR system smooths the workflows of organizations and is user-friendly to use. Furthermore, the consumers should receive training to use the system effectively. Lastly, the EHR systems should be protected by security measures to maintain patient data privacy in the healthcare organization.
Healthcare organizations’ performance increased after implementing EHR technology as it enhanced patient health standards and reduced costs. Monitoring the data points helps in evaluating the organization’s performance. Patient survey rating provides feedback that helps the organization take necessary measures to enhance patient satisfaction. Moreover, the leader’s role in the change management strategy also helps enhance the organization’s performance. The workflow after EHR implementation will help the organization’s smooth workflow transition and enhance patient data privacy by abiding by confidentiality and security laws. The ultimate objective of the quality improvement project plan is to enhance the patient health outcome, leading to financial success in the organization.
References
Avendano, J. P., Gallagher, D. O., Hawes, J. D., Boyle, J., Glasser, L., Aryee, J., & Katt, B. M. (2022). Interfacing with the electronic health record (EHR): A comparative review of modes of documentation. Cureus, 14(6).
https://doi.org/10.7759/cureus.26330
Beauvais, B., Kruse, C., Fulton, L., Shanmugam, R., Ramamonjiarivelo, Z., & Brooks, M. (2020). Electronic health record vendors: An evaluation of the association with hospital financial and quality performance (Preprint). Journal of Medical Internet Research, 23(4).
Basil, N. N., Ambe, S., Ekhator, C., & Fonkem, E. (2022). Health records database and inherent security concerns: A review of the literature. Cureus, 14(10).
https://doi.org/10.7759/cureus.30168
Dunn Lopez, K., Chin, C.-L., Leitão Azevedo, R. F., Kaushik, V., Roy, B., Schuh, W., Banks, K., Sousa, V., & Morrow, D. (2021). Electronic health record usability and workload changes over time for provider and nursing staff following transition to new EHR. Applied Ergonomics, 93, 103359.
https://doi.org/10.1016/j.apergo.2021.103359
Fortman, E., Hettinger, A. Z., Howe, J. L., Fong, A., Pruitt, Z., Miller, K., & Ratwani, R. M. (2020). Varying rates of patient identity verification when using computerized provider order entry. Journal of the American Medical Informatics Association, 27(6), 924–928.
https://doi.org/10.1093/jamia/ocaa047
NURS FPX 8012 Assessment 5 Quality Improvement Project Plan
Franco-Trigo, L., Fernández-Llimós, F., Martínez-Martínez, F., Benrimoj, S. I., & Sabater-Hernández, D. (2020). Stakeholder analysis in health innovation planning processes: A systematic scoping review. Health Policy, 124(10).
https://doi.org/10.1016/j.healthpol.2020.06.012
Frechette, J. (2019). Shared vision in nursing. The Health Care Manager, 38(2), 156–165.
https://doi.org/10.1097/hcm.0000000000000259
Gemeda, H. K., & Lee, J. (2020). Leadership styles, work engagement and outcomes among information and communications technology professionals: A cross-national study. Heliyon, 6(4). NCBI.
https://doi.org/10.1016/j.heliyon.2020.e03699
Gariépy-Saper, K., & Decarie, N. (2021). Privacy of electronic health records: A review of the literature. Journal of the Canadian Health Libraries Association / Journal de l’Association Des Bibliothèques de La Santé Du Canada, 42(1).
https://doi.org/10.29173/jchla29496
Greco, K. J., Rao, N., Urman, R. D., & Brovman, E. Y. (2021). A dashboard for tracking mortality after cardiac surgery using a national administrative database. Cardiology Research, 12(2), 86–90.
https://doi.org/10.14740/cr1220
NURS FPX 8012 Assessment 5 Quality Improvement Project Plan
Han, Y., Zhang, Y., & Vermund, S. H. (2022). Blockchain Technology for Electronic Health Records. International Journal of Environmental Research and Public Health, 19(23), 15577.
https://doi.org/10.3390/ijerph192315577
Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where do models for change management, improvement and implementation meet? A systematic review of the applications of change management models in healthcare. Journal of Healthcare Leadership, Volume 13(13), 85–108. NCBI.
https://doi.org/10.2147/jhl.s289176
Kaihlanen, A.-M., Gluschkoff, K., Hyppönen, H., Kaipio, J., Puttonen, S., Vehko, T., Saranto, K., Karhe, L., & Heponiemi, T. (2020). The associations of electronic health record usability and user age with stress and cognitive failures among finnish registered nurses: Cross-sectional study. JMIR Medical Informatics, 8(11), e23623.
Kang, S. K., Doshi, A. M., Recht, M. P., Lover, A. C., Kim, D. C., & Moore, W. (2020). Process improvement for communication and follow-up of incidental lung nodules. Journal of the American College of Radiology, 17(2), 224–230.
https://doi.org/10.1016/j.jacr.2019.11.023
Leapfrog Hospital Safety Grade. (2022). Allen hospital – IA – Hospital Safety Grade. Hospitalsafetygrade.org.
NURS FPX 8012 Assessment 5 Quality Improvement Project Plan
Li, E., Clarke, J., Neves, A. L., Ashrafian, H., & Darzi, A. (2021). Electronic health records, interoperability and patient safety in health systems of high-income countries: A systematic review protocol. BMJ Open, 11(7), e044941.
https://doi.org/10.1136/bmjopen-2020-044941
Lite, S., Gordon, W. J., & Stern, A. D. (2020). Association of the meaningful use electronic health record incentive program with health information technology venture capital funding. Journal of the American Medical Association Network Open, 3(3), e201402.
https://doi.org/10.1001/jamanetworkopen.2020.1402
Medicare. (2023). Medicare.gov. Www.medicare.gov.
https://www.medicare.gov/care-compare/compare?providerType=Hospital&providerIds=160110
Muhiyaddin, R., Abd-Alrazaq, A. A., Househ, M., Alam, T., & Shah, Z. (2020). The impact of clinical decision support systems (CDSS) on physicians: A scoping review. Studies in Health Technology and Informatics, 272, 470–473.
https://doi.org/10.3233/SHTI200597
Rwafa-Ponela, T., Eyles, J., Christofides, N., & Goudge, J. (2020). Implementing without guidelines, learning at the coalface: A case study of health promoters in an era of community health workers in South Africa. Health Research Policy and Systems, 18, 46.
https://doi.org/10.1186/s12961-020-00561-5
Seh, A. H., Zarour, M., Alenezi, M., Sarkar, A. K., Agrawal, A., Kumar, R., & Khan, R. A. (2020). Healthcare data breaches: Insights and implications. Healthcare, 8(2), 133. NCBI.
https://doi.org/10.3390/healthcare8020133
NURS FPX 8012 Assessment 5 Quality Improvement Project Plan
Shaw, R., Stroo, M., Fiander, C., & McMillan, K. (2020). Selecting mobile health technologies for electronic health record integration: Case study. Journal of Medical Internet Research, 22(10), e23314.
Vos, J. F. J., Boonstra, A., Kooistra, A., Seelen, M., & van Offenbeek, M. (2020). The influence of electronic health record use on collaboration among medical specialties. BMC Health Services Research, 20(1).
https://doi.org/10.1186/s12913-020-05542-6
Wong, T., Brovman, E. Y., Rao, N., Tsai, M. H., & Urman, R. D. (2020). A dashboard prototype for tracking the impact of diabetes on hospital readmissions using a national administrative database. Journal of Clinical Medicine Research, 12(1), 18–25.
https://doi.org/10.14740/jocmr4029
Xenakis, L., Quigley, D. D., Qureshi, N., AlMasarweh, L., Pham, C., & Hays, R. D. (2020). Some aspects of patient experience assessed by practices undergoing patient-centered medical home transformation are measured by CAHPS, others are not. Quality Management in Health Care, 29(4), 179–187.
https://doi.org/10.1097/qmh.0000000000000263
Xiang, D., & Cai, W. (2021). Privacy protection and secondary use of health data: Strategies and methods. BioMed Research International, 2021, 1–11.
https://doi.org/10.1155/2021/6967166
Zdunek, K., Schröder-Bäck, P., Alexander, D., Vlasblom, E., Kocken, P., Rigby, M., & Blair, M. (2020). Tailored communication methods as key to implementation of evidence-based solutions in primary child health care. European Journal of Public Health, 31(1), 92–99.
