NUR 514 Benchmark – Electronic Health Record Implementation

Sample Answer for NUR 514 Benchmark – Electronic Health Record Implementation Included After Question

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?

A Sample Answer For the Assignment:  NUR 514 Benchmark – Electronic Health Record Implementation

Title: NUR 514 Benchmark – Electronic Health Record Implementation

Role Informatics Plays in Ability to Capture Data

Information is vital to patient care, and health informatics has advanced in the past years to focus on the acquisition, storage, and utilization of data in health care, emphasizing technology. Informatics can capture the key data needed to assess fall risk by obtaining and managing data from multiple sources, including patient tracking devices, electronic medical records, and fall assessment tools (Estiri et al., 2018). Informatics facilitates the transfer of data systems to enable information sharing across health units and organizations. Besides, informatics will capture data including all patient encounters, medications ordered, diagnoses, and diagnostic tests performed. It will capture the data from multiple sources in various formats and convert it to a single format compatible with the EHR database.

Project management strategies are approaches the informatics project manager applies to address various challenges and to enable every party to understand the needs of an informatics initiative or project. The strategies that can be used to foster informatics initiatives include defining the initiative’s goals early and keeping them adaptable. The informatics project leader should keep the team adaptable through frequent, clear communication about the project scope, expectations, and proposed changes (Naseer et al., 2022). In addition, the informatics project manager should have a deep understanding of the informatics initiatives, which guides the allocation of resources and gives a more realistic view of the project’s timeline. The project manager should also encourage teamwork, manage the project risks, and ask for team feedback to promote the informatics initiatives’ success.

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?

1. 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, and 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.

Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

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A Sample Answer 2 For the Assignment:  NUR 514 Benchmark – Electronic Health Record Implementation

Title: NUR 514 Benchmark – Electronic Health Record Implementation

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.

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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.

NUR 514 Benchmark – Electronic Health Record Implementation 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

Benchma rk 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.

Topic 8 DQ 1

Description:

Open and clear communication is critical for the effective functioning of the interprofessional team and the delivery of safe patient care. Discuss the way communication technologies can enhance coordination of care by interprofessional teams. Be sure to discuss a specific communication technology in your response.

Effective communication across disciplines is imperative to the care of patients. In case management for example having an up-to-date chart because we rely heavily on the information that is presented in the chart. Are they going home on oxygen? What are their current needs, what was their walking room air, were they using this prior to admission, where do they live. It seems simple enough but if there is no room air the DME company cannot justify the need and in order to get reimbursed for services. In times like this having AI, computer on wheels, cell phones, secure chat or Vocera helps to cut the gap on what is documented, what is occurring with the nurse’s caseload and the needs of the team. Having communication technologies are tools that help to get the information that is needed quickly. In my current facility Vocera is often used between the interdisciplinary team as well as a mode to call outside lines if needed. Vocera is a technology that also needs to be improved, for instance the only mode to hear is on speaker mode where PHI may be overheard. Wooden & Blair (2019) report that technology is an effective tool to enhance communication between teams and results indicate that with the use these tools there is decreased length of stays, improved patient outcomes and improved nursing care.

NUR 514 Benchmark – Electronic Health Record Implementation References:

Wooden, K &Blair, K (June 15, 2019). The use of technology in multidisciplinary communication to improve patient-centered care coordination: A systemic review. The Use of Technology in Multidisciplinary Communication to Improve Patient-Centered Care Coordination: A Systemic Review – Oncology Nurse Advisor

A Sample Answer 2 For the Assignment:  NUR 514 Benchmark – Electronic Health Record Implementation

Title: NUR 514 Benchmark – Electronic Health Record Implementation

The latest communication technologies have enhanced coordination of care by interprofessional teams in tremendous ways. Secure mobile applications are some of the most effective that I have experienced recently. My hospital implemented an application called Voalte using iphones for all patient-facing staff while on duty. The iphone connects through a secure network in the hospital, requires a login and password, is locked out from being used in any other fashion, and will not work outside the hospital. This app eliminates the need to keep track of unit numbers and offers convenient ways to communicate on-the-go. There is a desktop version available as well as a secure application that can be used on a personal device for physicians and supervisory staff that need to be contacted off-site. Once signed in, the employee can select a unit and role, as well as an indicator of “busy” or “available”. This icon helps other staff identify who may be the contact person for such roles as charge nurse, unit manager, or on-call physician. It also eliminates the need to contact the answering service and delays for paging. Staff nurses are assigned to patient rooms by the unit secretary during their shift. This information connects through middleware software to the EHR creating a direct connection to the nurse assigned to a specific patient. Clear and direct communication for such things as critical labs, family questions, report, and many other important matters go immediately to the assigned nurse. Because these devices are secure, text messages with wound pictures or an EKG during a chest pain event can be sent to the covering provider for a quick assessment. Overall, this application has decreased delays and allowed for better communication amongst the healthcare team.

Reference:

Hillrom. (n.d.). Voalte healthcare mobile messenger app. https://www.hillrom.com/en/products/care-comms-mobile/

Topic 8 DQ 2

Description:

Virtual care and telehealth technologies have the capability to greatly expand access to quality health care. Discuss some benefits and drawbacks of virtual care/telehealth, particularly related to the collaboration and coordination of care and the role of the advanced registered nurse.

Topic 8: Interprofessionalism and Interrelationships in Informatics and Information Systems

Description

Objectives:

1. Analyze the role of the advanced registered nurse in promoting evidence-based practice and leading quality and performance improvement initiatives.
   2. Analyze quality standards and performance measures related to the use of informatics for continuous quality improvement in practice settings.
   3. Discuss project management strategies and methodologies for implementing health care informatics initiatives that improve quality within clinical practice.
   Study Materials

Nursing Informatics and the Foundation of Knowledge

Description:

Read Chapters 16 and 20 in Nursing Informatics and the Foundation of Knowledge.

Health IT

Description:

Explore the HealthIT.gov website.

Artificial Intelligence Research: The Utility and Design of a Relational Database System

Description:

Read “Artificial Intelligence Research: The Utility and Design of a Relational Database System,” by Diling, from
Advances in Radiation Oncology (2020).

Application of Project Management Tools and Techniques to Support Nursing Intervention Research
Description:

Read “Application of Project Management Tools and Techniques to Support Nursing Intervention Research,” by Rew, Cauvin, Cengiz, Pretorius, and Johnson, from Nursing Outlook (2020).

How Data Can Save Lives: Informatics for Health 2017

Description:

Read “How Data Can Save Lives: Informatics for Health 2017,” by Cookson, from BMC Series Blog (2017), located on the BioMed Central website.

Electronic Health Record (EHR) System Testing Plan

Description:

Read “Electronic Health Record (EHR) System Testing Plan,” located on the HealthIT.gov website.

EHR Testing: Specifics and Best Practices

Description:

Read “EHR Testing: Specifics and Best Practices,” by Mikhailau (2019), located on the Health IT Outcomes website.

Health IT Standards

Description:

Read “Health IT Standards,” located on the HealthIT.gov website.

Perspectives of Healthcare Practitioners: An Exploration of Interprofessional Communication Using Electronic Medical Records
Tasks

Topic 8 Participation

Description:

NA

Grade Categories

Assignments (%) Points Percentile
APA Assignment: Leadership Style Reflective Essay 125.0 —
Emerging Technology Brief 125.0 —
Benchmark – Electronic Health Record Implementation Paper
210.0
—
The Evolution of Nursing Informatics Presentation 150.0 —
Implementing Change With an Interprofessional Approach Presentation
150.0

A Sample Answer 3 For the Assignment:  NUR 514 Benchmark – Electronic Health Record Implementation

Title: NUR 514 Benchmark – Electronic Health Record Implementation

Quality improvement in patient care is one of the ways in which healthcare organizations achieve their desired goals and objectives. The improvement in quality of care is achievable using methods such as the utilization of electronic health records (EHR) to optimize on care outcomes. Electronic health records enable health organizations to achieve their desired efficiency, quality and safety in the use of health technologies in patient care. They use it in data collection, organization, analysis, and retrieval for easy decision making on the care needs by the patients. Therefore, the purpose of this paper is to explore the opportunities that exist for tracking care information with the adoption of a new electronic health records system. It also focuses on the roles of informatics in the new system as well as those of the advanced registered nurse in the use of health information systems and the leadership styles and approaches needed to facilitate the success of the process.

Key Information in the Database

The newly adopted system should enable opportunities for tracking improvements in the organization. The database should therefore contain a number of information that would be used for tracking improvements. One of the information relates to those for tracking patient response to treatment. The database should be able to capture the problems of patients at the time of contact with the provider, the adopted interventions, and assessment of their effectiveness in facilitating health, wellbeing and recovery. The other information is the demographics of the patient. The database should be able to capture the key demographic data that relates to health. The information will be used for tracking trends of health problems in the population. An additional information is progress notes, diagnostic, and laboratory information. The information will be used for evaluating the need for specific interventions and their effectiveness in facilitating the effective management of the health problem. The other type of information relates to indicators of safety and quality in the organization (Hussey & Kennedy, 2021). The database should capture information such as rates of adverse events in the organization to enable the determination of safety and quality of care given to patients in the institution.

Role of Informatics

Informatics plays a critical role in the ability to capture the above information. Firstly, informatics comprises clinical tools as well as applications that facilitates the capturing of health-related data in the electronic databases. The capture data is important for use in advancing the medical care that patients receive. The informatics applications and tools also organize the data obtained from different sources of care in the organization (Sipes, 2019). It organizes the data into forms such as the electronic medical records and devices for tracking health. The organization of data seeks to ensure efficiency in use in making clinical decisions. Informatics also enables easy retrieval of information by the healthcare providers. Accordingly, healthcare providers have enhanced opportunities to access stored data whenever needed to facilitate decision-making. Besides capturing, storing, and retrieval, informatics has security systems embedded in them to ensure data integrity (Barrett, 2018). The systems have advanced levels of security that eliminates any potential access of the private and confidential data by unauthorized parties.

Systems and Staff Members

The successful implementation of the new EHR system will require the use of a number of systems as well as the involvement of different staff members. There is a need for systems such as billing, documentation, and reimbursement systems. There is also the need for systems to facilitate e-prescribing, telehealth, and report generation. The reimbursement and billing system will enhance the efficiency of paying for healthcare services and making insurance claims. The e-prescribing will be used to order electronic prescriptions for patients. The documentation system will be used for keeping the health records of the patients. The report generation system will be used in developing summaries of healthcare services given and their effectiveness in delivering the expected institutional outcomes (Hussey & Kennedy, 2021).

The staff that will be involved in the project will be varied. They will include nurses, physicians, IT officer, system developer, and project manager. Nurses and physicians will be the direct adopters of the new electronic health records system. Their involvement in the implementation entails ensuring that the system is user-friendly and facilitates their needs in the provision of patient care. The IT officer will provide the technical support needed for the efficient use of the new system. The system developer will train the staffs on the use of the new system. The developer will also address any technical issues that may be experienced with the use of the system in patient care. The project manager will oversee the whole process of implementation (Hussey & Kennedy, 2021). The manager will ensure efficient use of resources to achieve optimum outcomes with the newly adopted system.

The advanced registered nurse will play a number of roles in promoting-evidence based practice and leading quality and performance improvement initiatives within the setting. Firstly, the nurse will ensure the use of evidence-based interventions in the use implementation of the new system. The nurse will use their knowledge and skills gained in nursing informatics to influence the utilization of best interventions in the implementation process. The advanced registered nurse will also act as coach and mentor in the use of the new system (Cowie et al., 2017). They will promote competency development in the users of the new system for the realization of the desired goals in its use in the organization.

Strategies for Implementing the New EHR Proposal

The successful implementation of the new EHR proposal will require the consideration of a number of strategies. One of them will be communication. The users of the new system will be informed about the intended changes in EHR system. Communication will be achieved through internal memos in the organization. The second strategy will be training. The users will be trained to ensure they are competent in using the new system. Training will also minimize the risk of resistance to change from the users (Hussey & Kennedy, 2021). The implementation process will also be systematic. Accordingly, new order sets related to the system will be introduced gradually for use in the organization, as the old system is replaced. A plan for human resource management during the implementation will also be developed. The plan will guide the use of the allocated resources as well as the evaluation of whether the set goals and objectives of the new system are being achieved (Barrett, 2018). Regular assessments will be done to ensure that continuous quality improvement is achieved in system implementation process.

Professional, Ethical and Regulatory Standards

Professional, ethical, and regulatory standards should be incorporated into the implementation of the new electronic health records system. The professional regulatory standards that must be considered include undertaking risk analysis of the system as well as acquiring HIPAA compliance certificate. A risk analysis will enable the identification of institutional weaknesses that should be addressed for the efficient use of the new system (Rathert et al., 2019). The organization also has to obtain HIPAA certificate to ensure that its practices align with those of the regulation as well as promoting the safe use of information technologies in healthcare. The institution should abide with the regulatory provisions of HIPAA and HITECH regulations by performing regular assessment of the systems and undertaking the necessary improvements. The institution should also train its providers on a regular basis to ensure the staffs have the needed competencies in ensuring safe use of the new system. Ethical standards must also be adhered to in the adoption of the new system. The institution and its staffs must ensure the protection of data privacy and confidentiality. They ensure the safe use of health information system by eliminating unintended access and use of the patient data. The healthcare providers must also demonstrate their compliance with HITECH and HIPAA regulations in all the processes of the new system use such as assessment, planning, implementation, monitoring, and evaluation (Hussey & Kennedy, 2021).

Evaluating Success

The success of the new EHR system will be evaluated from staff, setting, and patient perspectives to determine the effectiveness of the system as well as ensure continuous quality improvement. Surveys will be administered to the staffs to obtain information about their experiences with the new system. The surveys will provide information about the success of the new system and the things that should be improved to facilitate its optimum functioning. Questionnaires and surveys will also be administered to the patients. Patients will provide crucial information about their subjective experiences with the care given in the organization. They will provide information related to their perceived safety, quality, and efficiency of care they receive in the organization. The evaluation of the new system from the perspective of the setting will focus on safety and quality metrics of care (Sipes, 2019). It will focus on aspects such as timeliness of care, changes in safety and adverse events, and cost-efficiency and effectiveness of its operations.

Leadership Skills and Theories

One of the leadership skills that would be needed to facilitate collaboration with the interprofessional team and provide evidence-based, patient-centered care is team building. Team building is needed for effective inter-professional and evidence-based patient-centered care. The healthcare providers should be able to work in teams in assessing, planning, implementing, monitoring, and evaluating the plans of care utilized to address patient needs. The other skill is open communication. Open communication is important to eliminate errors in care, as well as strengthen the effectiveness of the inter-professional interventions utilized to achieve optimum outcomes in patient care (Hassmiller & Pulcini, 2020). The last skill is creativity. The leader should motivate the followers to utilize creative and innovative solutions that are unique to the needs of their patients. Creativity advances the safety, quality, and efficiency of patient care. The leadership theories that may be utilized include transformational, servant, and democratic leadership theories, as they aim at empowering team members take responsibility for the care given to patients (AL-Dossary, 2017).

Conclusion

The newly adopted EHR system should be able to facilitate the tracking of care improvements in the organization. It should also facilitate the efficient management of care across the different levels in the organization. Professional, ethics, and regulatory standards will influence the adoption of the new system. Healthcare providers and institutions should therefore strive to ensure that ethics and regulations that guide the use of health information systems are considered in the implementation process.

NUR 514 Benchmark – Electronic Health Record Implementation References

AL-Dossary, R. N. (2017). Leadership in Nursing. IntechOpen.

Barrett, A. K. (2018). Technological appropriations as workarounds: Integrating electronic health records and adaptive structuration theory research. Information Technology & People, 31(2), 368–387. https://doi.org/10.1108/ITP-01-2016-0023

Cowie, M. R., Blomster, J. I., Curtis, L. H., Duclaux, S., Ford, I., Fritz, F., Goldman, S., Janmohamed, S., Kreuzer, J., Leenay, M., Michel, A., Ong, S., Pell, J. P., Southworth, M. R., Stough, W. G., Thoenes, M., Zannad, F., & Zalewski, A. (2017). Electronic health records to facilitate clinical research. Clinical Research in Cardiology, 106(1), 1–9. https://doi.org/10.1007/s00392-016-1025-6

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.

Rathert, C., Porter, T. H., Mittler, J. N., & Fleig-Palmer, M. (2019). Seven years after Meaningful Use: Physicians’ and nurses’ experiences with electronic health records. Health Care Management Review, 44(1), 30–40. https://doi.org/10.1097/HMR.0000000000000168

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

A Sample Answer 4 For the Assignment:  NUR 514 Benchmark – Electronic Health Record Implementation

Title: NUR 514 Benchmark – Electronic Health Record Implementation

Nursing is an evolving practice that readily embraces opportunities for care quality and patient safety improvement. In this evolving practice, the role of science, data, and technology is critical; thus, organizational management and nurse leaders should continually integrate innovation into patient care (Lunden et al., 2021). Opportunities for tracking care improvement involve data collection, analysis, and evaluation. Accordingly, health care organizations should invest in robust systems that capture real-time data using electronic health records (EHRs) and protect sensitive information from unauthorized access and other risks. The purpose of this paper is to describe the processes and key considerations for implementing a new EHR system in a practice setting.

Opportunity for Tracking Care Improvement and Key Information in the Database

Advanced registered nurses should play a central role in improving care quality. They should be involved in developing initiatives for reducing service delays, improving teamwork, and promoting technology use in health care delivery. A perfect opportunity for tracking care improvement is the time lapse from when a patient’s visit to the emergency room is recorded in the EHR to when the patient receives medical attention. From a health dimension, long waiting time characterizes delays and increases patient dissatisfaction and discomfort (Biya et al., 2022). Long waiting time also reduces health care utilization, increases the chances of health complications, and discourages patients from returning to the health care facility.

Data helps health care practitioners to make timely, accurate decisions. Key information that would be needed in the database includes patient demographics, type of health conditions, and time-lapse before medical attention. Information on time-lapse is critical to improving care outcomes since it would help health care practitioners to identify potential delays and their causes. Common causes of delays in the emergency room include extended waiting lists, shortage of hospital beds, and inadequate testing equipment (Caesar et al., 2018). Such data can help the organization’s management and advanced registered nurses to collaborate and develop evidence-based interventions for delay prevention.

Role of Informatics and Project Management Strategies

Role of Informatics

The role of informatics is integral in advancing nursing practice since it encourages innovation and promotes efficiency. Alexander et al. (2019) described informatics as integrating science and technology for better patient outcomes. In data capturing, informatics helps health care practitioners to collect timely and accurate data. In this case, data on patient demographics, illnesses, and the time spent before receiving medical assistance would be collected timely and accurately. Informatics would also help to capture data in multiple formats. For instance, data for patients who have visited the emergency room before can be collected via demographics. Informatics can also help to capture data into categories. A suitable example is a graphical representation of waiting time to facilitate a detailed analysis of the severity of the situation.

Project Management Strategies and Methodologies

Effective patient care combines nursing and other concepts outside the health practice. Project management strategies to support informatics initiatives to help improve quality within the clinical care settings include planning, risk management, and goal-setting. Typically, informatics initiatives are complex, time-consuming, and resource-intensive hence the need for adequate planning. Risk management entails developing adequate measures for assessing risk potential, measurement, and mitigation measures (NEJM Catalyst, 2018). Goal-setting is also crucial to ensure that the purpose and deliverables of an initiative are clear and measurable. Suitable project management methodologies include the application of work breakdown structure (WBS) and Gantt charts. WBS and Gantt charts help in planning and scheduling tasks for easy implementation (Vaagaasar et al., 2020). A similar approach is necessary for EHR implementation to ensure that deliverables are clear and resources channeled towards supporting informatics initiatives are used prudently.

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

Systems and Staff Members for Design and Implementation Process

New EHR systems and other technology-driven initiatives can only thrive with proper designs and implementation. Regarding systems, technology implementers should pay attention to hardware, software, and operating systems for new initiatives. It is crucial to ensure that the design will promote safe and effective use. Staff members that should be involved in the design and implementation process include system analysts, risk managers, project managers, and end users. The system analysts and risk managers would provide technical knowledge regarding the new system, while the project manager would facilitate a smooth implementation. As Dopp et al. (2020) suggested, EHRs should have user-centered designs to encourage their use. Hence, end users should be involved in the design and implementation process to give views on the type of system they would like to use and its features. They can also be involved in its piloting to assess efficiency, performance gaps, and opportunities for further improvement.

The Role of the Advanced Registered Nurse

The advanced registered nurse plays a leading role in promoting evidence-based practice (EBP) and leading performance improvement initiatives. In this setting, the advanced registered nurse is centrally involved in identifying opportunities for change and responding by developing evidence-based interventions. Evidence-based interventions are supported by scientific research and guide nurses in implementing positive change to improve health outcomes (Lunden et al., 2021). The other role of the advanced registered nurse is leading change through EBP models. Such models provide a systematic, procedural approach to quality improvement. Above all, the advanced registered nurse promotes a culture of innovation in the setting. Commonly, organizations that encourage innovation are ready for change and support it. As a result, EBP and quality improvement projects face minimal resistance in such settings since the organizational staff is ready for change.

Strategies for Implementing the New EHR Proposal

Implementing a new EHR system typifies engagement in practice change. As a result, resistance to change is possible hence the need for change implementers to be prepared and outline potential interventions. Communication is essential when introducing a new EHR. In change initiatives, communication allows the nursing staff to understand the importance of change from staff and patient care perspectives. Milella et al. (2021) underlined the importance of communication in change projects since it prepares people for the change. Preparation for the new EHR would make the transition easier. The transitioning process should include user training to equip nurses with the skills necessary to use the EHR competently. Competence would also ensure that organizational resources are effectively managed by minimizing errors. The implementers also need to implement sustainability strategies to promote continuous and comfortable use of the new EHR. Such strategies include continuous performance assessment, progressive user training, and proper orientation of new users.

Professional, Ethical, and Regulatory Standards

Technology systems present significant risks to health care organizations, users, and patients that can be controlled if they meet some standards. The most important professional standards that should be incorporated into the system’s design and implementation are meaningful use and user-friendliness. Meaningful use implies that the system is designed to facilitate the easy exchange of health information between users to improve clinical quality and other measures (Alexander et al., 2019). Ethical standards include beneficence and non-maleficence. The implication is that the new system should be designed and implemented to benefit patient care and should be free from harm. Patients and users should be protected from all possible risks. Regulatory standards include developing secure systems and protecting private health information as outlined under the Health Insurance Portability and Accountability Act (HIPAA) security rule (Alexander et al., 2019). Adherence to the rule’s requirements implies that the new system must have adequate security measures to protect private patient data from unauthorized access and malicious use.

Measures and Steps for Evaluating the Success of the EHR Implementation

Successful EHR implementation should improve outcomes from a staff, setting, and patient care perspective. Process and outcome measures can be used to determine the effectiveness of EHR implementation. From a staff perspective, the new EHR system should improve efficiency, minimize errors, and allow nurses to respond to patient issues timely and more effectively. From a setting perspective, successful EHR implementation should be characterized by high efficiency to optimize resource utilization. It should enable nurses to detect and categorize patient care concerns in terms of severity and facilitate interprofessional collaboration for better responses to patient problems and holistic care. From a patient perspective, timely care increases patient satisfaction (Biya et al., 2022). As a result, reducing delays would be instrumental in improving patient satisfaction. To ensure quality improvement in practice, the advanced registered nurse should engage in continuous process and outcome assessment. Similarly, I should be involved in performance assessment and lead change by implementing appropriate evidence-based interventions.

Leadership Skills and Theories to Facilitate Collaboration and Provide Evidence-Based, Patient-Centered Care

Effective patient care is multidimensional, and the role of leadership for better outcomes cannot be underestimated. One of the best strategies for facilitating collaboration with the interprofessional team is clear communication. Leaders who communicate clearly allow nursing staff to work together without conflicting roles. Besides communication, health care leaders should also be emotionally intelligent. Prezerakos (2018) described emotional intelligence as a leader’s ability to understand and interpret personal and others’ feelings and emotions. It is a crucial skill when leading diverse teams and helping them to work for a common goal.

The most appropriate theory for promoting interprofessional collaboration is the transformational leadership theory. A transformational approach to leadership entails inspiring teams to work toward achieving a shared vision (Chu et al., 2021). Collaboration, engagement, and individual brilliance are highly encouraged in transformational leadership. The element of collaboration enables diverse health care practitioners to blend their skills to tailor patient care according to patient needs. Transformational leaders also support team members’ creativity, provided that it translates to the best possible patient outcomes. A similar approach would be needed when implementing new systems to improve patient care.

Conclusion

Health care organizations should be continually committed to improving patient outcomes. EHR systems offer a massive opportunity for integrating patient care with data, technology, and science. As discussed in this paper, the advanced registered nurse should lead change in EHR implementation by ensuring that such systems are risk-free and adhere to the established ethical, professional, and regulatory standards. They should also be actively involved in promoting a culture of change in health care to ensure leaders and other practitioners are ready for innovation and practice change for better patient outcomes.

NUR 514 Benchmark – Electronic Health Record Implementation References

Alexander, S., Frith, K. H., & Hoy, H. (Eds.). (2019). Applied clinical informatics for nurses (2nd ed.). Jones & Bartlett Learning.

Biya, M., Gezahagn, M., Birhanu, B., Yitbarek, K., Getachew, N., & Beyene, W. (2022). Waiting time and its associated factors in patients presenting to outpatient departments at public hospitals of Jimma Zone, Southwest Ethiopia. BMC Health Services Research, 22(1), 1-8. https://doi.org/10.1186/s12913-022-07502-8

Caesar, U., Karlsson, J., & Hansson, E. (2018). Incidence and root causes of delays in emergency orthopaedic procedures: a single-centre experience of 36,017 consecutive cases over seven years. Patient Safety in Surgery, 12, 2. https://doi.org/10.1186/s13037-018-0149-1

Chu, H., Qiang, B., Zhou, J., Qiu, X., Yang, X., Qiao, Z., … & Yang, Y. (2021). The impact of transformational leadership on physicians’ performance in China: a cross-level mediation model. Frontiers in psychology, 12, 586475. https://doi.org/10.3389/fpsyg.2021.586475

Dopp, A. R., Parisi, K. E., Munson, S. A., & Lyon, A. R. (2020). Aligning implementation and user-centered design strategies to enhance the impact of health services: Results from a concept mapping study. Implementation Science Communications, 1(1), 1-13. https://doi.org/10.1186/s43058-020-00020-w

Lunden, A., Kvist, T., Teräs, M., & Häggman-Laitila, A. (2021). Readiness and leadership in evidence-based practice and knowledge management: a cross-sectional survey of nurses’ perceptions. Nordic Journal of Nursing Research, 41(4), 187-196. https://doi.org/10.1177/2057158520980687

Milella, F., Minelli, E. A., Strozzi, F., & Croce, D. (2021). Change and innovation in healthcare: Findings from literature. ClinicoEconomics and Outcomes Research: CEOR, 13, 395–408. https://doi.org/10.2147/CEOR.S301169

NEJM Catalyst. (2018). What is risk management in healthcare? https://catalyst.nejm.org/doi/full/10.1056/CAT.18.0197

Prezerakos, P. E. (2018). Nurse managers’ emotional intelligence and effective leadership: a review of the current evidence. The Open Nursing Journal, 12, 86–92. https://doi.org/10.2174/1874434601812010086

Vaagaasar, A. L., Skyttermoen, T., & Clegg, S. R. (2020). Project management: a value creation approach. SAGE.

A Sample Answer For the Assignment:  NUR 514 Benchmark – Electronic Health Record Implementation

Title: NUR 514 Benchmark – Electronic Health Record Implementation

Effective or open and clear communication among team members promotes effective teamwork and encourages clarity within the patient care team. Basically, clear and open communication is important in fostering collaboration and teamwork and plays a critical role in ensuring that errors are minimized (McGonigle & Mastrian, 2018). Several communication technologies have been instrumental in promoting effective communication within interprofessional teams. These technologies have been successful in achieving interprofessional communication and care delivery coordination. For instance, telemedicine technologies seeks to enhance patient health through application of interactive communication between the health care providers and the patients remotely via video, audio, and other electronic technologies (Falconer & Kho, 2018).

In addition to enhancing the communication between the health care providers and the patients, communication technologies also enhance coordination of care amongst the interprofessional team members. For example, coordination of care is enhanced by timely updates of the EHRs by the health care providers thus allowing others to effectively receive the patient’s health care information (Falconer & Kho, 2018). Likewise, communication technologies such as the web-based communication devices enable collaborative decision making within the interprofessional teams.

Communication systems in healthcare include secure messaging, mobile phones, video conferencing, telehealth, secure apps, email, and secure fax. It involves relaying and sharing information between health professionals as well as patients. The use of these communication technologies can impact the way nurses assess, formulate care plans, provide care, document care provided and even clinical decision making (Rouleau et al., 2017). The use of communication technology enhances the collaboration and coordination of the interprofessional team since there are now multiple, secure ways to relay health information to other related providers.

High-quality interprofessional communication helps reduce errors and improves quality care and patient outcomes (Bardach et al., 2017). Most, if not all healthcare providers in the US have now transitioned to the use of electronic health records system so there have been various technology development to enhance the communication technology within the electronic healthcare record system which will make it easier for providers to securely relay health information which can be tracked and maintained within the system. In the current electronic health record system that we use in our organization, my favorite feature is being able to send secure messages to physicians, nurses, and other healthcare team members and instantly get responses. And for providers that are not using the same electronic health care system, I like the health information exchange system that we have which allows us to access the health records of our common patients. It eliminates the need to pick up the phone and be placed on hold for a long time just to get in touch with our other providers.

References:

Bardach, S., Real, K., & Bardach, D. (2017). Perspectives of healthcare practitioners: An exploration of interprofessional communication using electronic medical records. Journal of Interprofessional Care, 31(3), 300–306. https://doi.org/10.1080/13561820.2016.1269312

Rouleau G., Gagnon M., Côté J., Payne-Gagnon J., Hudson E., Dubois, C. (2017).

Impact of information and communication technologies on nursing care: Results of an overview of systematic reviews. Journal of Medical Internet Research, 19(4), 122. https://doi.org/10.2196/jmir.6686