NUR 514 Benchmark – Electronic Health Record Implementation Paper

Sample Answer

Health care delivery evolves in multiple dimensions as nursing professionals and stakeholders invent new strategies for addressing complex patient needs. Central to this advancement is nursing informatics, which involves synthesizing nursing, information, and computer sciences to manage and communicate data and information (McGonigle & Mastrian, 2021).

Nursing informatics enables providers to integrate tools, technologies, and methods to collect, analyze, and apply vast health care data. Such improved capabilities empower nurses to implement electronic health records (EHRs) for improved patient outcomes.

The purpose of this paper is to describe the process of implementing a new EHR within a practice setting purposed to capture data to inspire improvements and quality change.

Opportunity for Tracking Care Improvement

Opportunities for tracking care improvement are characterized by intensive and accurate data collection, analysis, and management to address performance gaps. A suitable opportunity in the current practice where EHR implementation would be highly beneficial is using real-time data to identify high-risk patients to prevent 30-day unscheduled readmission.

According to Ashfaq et al. (2019), precise readmission risk prediction could effectively guide health care practitioners in deciding whether a patient is ready for discharge or should be enrolled in an intervention program. An EHR-driven prediction model would enable the health care facility to collect the relevant data when the patient is receiving care to predict the readmission probability at discharge.

The problematic nature of readmissions requires nursing practitioners to have timely, accurate, and sufficient data for informed decision-making. A database is critical to operations management since it promotes precise, consistent data storage.

In the present tech-based nursing, the sequence of primary care visits usually represents the patient in an EHR. In this case, the most critical data is what identifies patients and their health conditions. Ashfaq et al. (2019) categorized this data into demographic features and the patient’s clinical state.

Demographic features include the patient’s age, gender, residence, and the type of visit. Clinical state data include lab results, diagnoses, and vitals recorded during an inpatient visit.

Role Informatics Plays in Ability to Capture Data

Informatics is the spine for data-driven nursing and informed use of innovative technological systems for high-quality care. Among many roles, informatics enables nurses and other health care staff to collect timely data in different formats from multiple sources.

Nursing informatics facilitates the safe storage of essential data since it can be backed up by ensuring it is available in multiple devices and systems. As Dash et al. (2019) mentioned, nursing informatics facilitates data organization during collection for easy analysis.

Such organization is witnessed when patient’s clinical data is matched with their needs. Generally, informatics makes data readily available for decision-making and ensures care providers can access it in multiple formats as situations necessitate.

Implementing electronic health systems is intensive since they consume time and resources. Applying the appropriate project management strategies and methodologies can effectively support informatics initiatives to improve quality within the clinical practice.

Valuable strategies to manage and implement complex projects include goal-oriented leadership and utilizing a work breakdown structure. Visionary leadership allows a team to work together for a common goal. It prevents potential conflicts when executing projects by clarifying roles and supervising progress.

Alam and Gühl (2022) described a work breakdown structure as organizing the work into manageable sections. These sections (smaller components) allow efficient resource allocation, planning, and evaluation of key deliverables.
Leaders apply different project management methodologies depending on the scope and type of work involved.

Inevitably, nursing informatics projects require precision and integration of models that promote efficient resource utilization. The waterfall methodology can be used to support informatics initiatives. Rubio (2022) represented the waterfall model as flowing the project’s phases downward. Nurse leaders and other health care staff implementing change must complete one project’s phase before moving to the next.

The other methodology is the agile approach, characterized by adaptive work management and project planning (Rubio, 2022). In this method, quality improvement leaders are open to change and embrace a flexible management approach to realize the targeted goals.

Systems and Staff Members Needed in Design and Implementation Process
Effective EHR implementation combines multiple systems, staff members, and skills. A health information system would be critical since it helps care providers gather, organize, and collect data to improve health outcomes and reduce costs.

A robust technological system is also necessary to ensure the new EHR captures, analyzes, and shares data safely. Regarding staff members, the nurse informaticist should be involved in all critical phases, including design and implementation. According to McGonigle and Mastrian (2021), nurse informaticists combine clinical skills and health information technology (IT) to guide organizations in advancing technology to improve care quality.

Their skills and guidance are essential for positive outcomes as far as the system’s design and implementation are concerned. Other staff members include system designers, physicians, departmental leaders, and IT technicians.

The advanced registered nurse is critical in promoting evidence-based practice and leading quality and performance improvement initiatives within this setting. One such role is serving as a change agent to address performance gaps. Change agents use their clinical and analytical skills in nursing to identify areas where the desired goals are not achieved (Ericson-Lidman & Strandberg, 2021).

In response, they propose evidence-based interventions to reduce the gap between the achieved and desired health outcomes. The advanced registered nurse is also responsible for policy change and advocacy. Nsiah et al. (2019) illustrated patient advocacy as promoting patient safety and high-quality care by protecting patients and advancing their interests.

The nurse plays similar roles by designing interventions for improving patient safety and achieving high-quality care, like burnout reduction programs, environmental modification strategies, and patient monitoring via telehealth. The organization fosters a culture of change to encourage innovative projects.

Strategies for Implementing EHR Proposal

Implementing a new EHR system could be seamless or challenging, depending on the approaches used in critical phases. As Aguirre et al. (2019) stated, the entire process commences with an in-depth evaluation of the workflows, followed by defining preferences and user needs. In the proposed project, such needs include software, hardware, and user requirements to ensure the EHR runs efficiently and executes its roles as expected.

The next step is communication to ensure clinicians and all targeted users understand the purpose of the new EHR and how to use it in predicting and preventing readmissions. Aguirre et al. (2019) further recommended staff education to equip users with the foundational knowledge for safe and effective EHR use.

Transition to the new EHR should happen after piloting and when all user needs are addressed. To ensure effective management of resources, teamwork should be embraced at all levels. Nurses should also be trained in groups to save time and training resources.

Professional, Ethical, and Regulatory Standards Implementation

EHRs are characterized by massive data collection, storage, and exchange between providers. Adherence to the established standards is critical for safe and competent use. Professional standards for the system’s design and implementation include EHR usability and interoperability.

Usability denotes an easy-to-use system that allows nursing professionals to perform different tasks accurately and with minimal effort. Li et al. (2021) illustrated interoperability as health information systems’ ability to work together within and across organizational boundaries to facilitate effective patient care. Interoperable systems promote safe and quick information exchange between care providers. A lack of interoperability increases clinician workload and is a key barrier to patient safety.

Ethical standards in the design and implementation of the new EHR are centered on privacy, security, and confidentiality essentials. To promote these principles and ensure data integrity, EHR systems should have the appropriate technical and physical safeguards for data protection (Basil et al., 2022).

Regulatory considerations have much to do with using certified EHR technology. Certified technology that allows clinicians to store data in a structured format facilitates efficient data capturing and sharing (CMS.gov, 2023). Such structuring enables nursing professionals to retrieve and transfer patient data easily for improved patient outcomes.

Evaluation of the Success of EHR Implementation

EHR implementation is cumbersome since it introduces new technologies, tools, and processes into routine patient care. Evaluation is critical to determining whether the project achieved the desired goals (Hamilton et al., 2020). From a staff perspective, the new EHR should enable nurses to track and respond to potential readmissions more effectively.

A post-implementation feasibility study can help to determine how the EHR empowers nurses to achieve better outcomes. From a setting perspective, the new EHR should reduce costs associated with readmissions. As a result, a comparative analysis of the readmissions rate six months before and after its implementation would be an accurate reference point.

To patients, implementing the new EHR would reduce readmissions and improve care experiences. To ensure continuous quality improvement in practice, nurses should be regularly trained on key aspects of the system, including usage, security, and ethical compliance. The system should also be upgraded as situations oblige to optimize capacity and secure it from emerging security threats.

Leadership Skills and Project Management to Collaborate with Interprofessional Teams Interprofessional teams comprise members with diverse skills, values, and work approaches. Leadership skills to enable such teams to collaborate and provide evidence-based, patient-centered care include clear goals, respect, and active engagement of members.

Respect and engagement foster a culture of inclusion, enabling a diverse workforce to work together to achieve a shared goal (Stanford, 2020). Clear goals, open communication, and problem-solving are valuable project management skills for an interprofessional team to collaborate and provide evidence-based, patient-centered care.

Leadership theories also guide nursing professionals in change management and decision-making regarding effective patient care. The adaptive leadership theory underlines supporting staff competencies to achieve patient-centered care (Kuluski et al., 2021). Adaptive leadership is founded on the precept that different situations require different skills, knowledge, and approaches. A similar approach is crucial in the complex nursing environment to deliver the best possible patient care.

Conclusion

Nursing informatics has improved organizations’ capacity to use data and technologies to improve patient care. EHRs contain patient data in electronic formats for quick access, sharing, and decision-making. A new opportunity for EHR implementation should enable nurses to use data and technologies to achieve higher outcomes for patients, health care staff, and the organization. A new EHR system for readmission prediction and prevention is crucial for the organization to prevent adverse outcomes of readmissions.

References

• Aguirre, R. R., Suarez, O., Fuentes, M., & Sanchez-Gonzalez, M. A. (2019). Electronic health record implementation a review of resources and tools. Cureus, 11(9), e5649. https //doi.org/10.7759/cureus.5649
  Alam, D., & Gühl, U. (2022). Project management for practice a guide and toolbox for successful projects. Springer.
  Ashfaq, A., Sant’Anna, A., Lingman, M., & Nowaczyk, S. (2019). Readmission prediction using deep learning on electronic health records. Journal of Biomedical Informatics, 97, 103256. https //doi.org/10.1016/j.jbi.2019.103256
  
• 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), e30168. https //doi.org/10.7759/cureus.30168
  
• CMS.gov. (2023). Certified EHR technology. https //www.cms.gov/medicare/regulations-guidance/promoting-interoperability-programs/certified-ehr-technology
  Dash, S., Shakyawar, S. K., Sharma, M., & Kaushik, S. (2019). Big data in healthcare management, analysis and future prospects. Journal of Big Data, 6(1), 1-25. https //doi.org/10.1186/s40537-019-0217-0
  
• Ericson-Lidman, E., & Strandberg, G. (2021). Change agents’ experiences of implementing a new organizational culture in residential care for older people a qualitative study. Nordic Journal of Nursing Research, 41(3), 149-157. https //doi.org/10.1177/2057158521995994
  
• Hamilton, S., Jennings, A., & Forster, A. J. (2020). Development and evaluation of a quality improvement framework for healthcare. International Journal for Quality in Health Care journal of the International Society for Quality in Health Care, 32(7), 456–463. https //doi.org/10.1093/intqhc/mzaa075
  
• Kuluski, K., Reid, R. J., & Baker, G. R. (2021). Applying the principles of adaptive leadership to person‐centred care for people with complex care needs Considerations for care providers, patients, caregivers and organizations. Health Expectations, 24(2), 175-181. https //doi.org/10.1111/hex.13174
  
• 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. http //dx.doi.org/10.1136/bmjopen-2020-044941
  
• McGonigle, D., & Mastrian, K. (2021). Nursing informatics and the foundation of knowledge. Jones & Bartlett Learning.
  Nsiah, C., Siakwa, M., & Ninnoni, J. P. K. (2019). Registered Nurses’ description of patient advocacy in the clinical setting. Nursing Open, 6(3), 1124–1132. https //doi.org/10.1002/nop2.307
  
• Rubio, M. (2022). The mini book of agile everything you really need to know about agile, agile project management and agile delivery. Packt Publishing.
  Stanford, F. C. (2020). The importance of diversity and inclusion in the healthcare workforce. Journal of the National Medical Association, 112(3), 247–249. https //doi.org/10.1016/j.jnma.2020.03.014