Patient Safety in Laboratory Medicine Matters

In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient-care efficiency. Your project proposal should include the following:

Describe the project you propose.

Identify the stakeholders impacted by this project.

Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving and explain how this improvement would occur. Be specific and provide examples.Patient Safety in Laboratory Medicine Matters

Identify the technologies required to implement this project and explain why.

Identify the project team (by roles) and explain how you would incorporate the nurse informatics in the project team.

Use APA format and include a title page and reference page.

Nursing Informatics: Effect on Patient Outcomes

Nursing informatics is a relatively novel specialty compared to the other nursing specialties. It can trace its roots to the report by the institute of Medicine published in 1999 and titled To Err Is Human. The report acknowledged that at the time about 98,000 preventable patient deaths were occurring because of errors committed by healthcare workers. These were found to be largely preventable errors and one of the most important recommendations was to embrace technology as part of the solution (Palatnik, 2016). Technological incorporation into healthcare was to be later legislated and made mandatory by laws such as the American Recovery and Reinvestment Act or ARRA of 2009. Tied to this law is the Health Information and Technology for Economic Clinical Health Act (HITECH). The Meaningful Use program in the HITECH provided incentives for those providers that implemented technology in healthcare in terms of electronic health record systems or EHRs. It also equally dispensed penalties to those who did not comply (Sweeney, 2017). Nursing informatics can be defines as the harnessing of technology including computer software and hardware to facilitate the delivery of quality healthcare. It is all about health information management (HIM) in the healthcare setting. Nurse informaticists manage healthcare information and data related not only to nursing alone but also the rest of the organization (Darvish et al., 2014). The nurse informaticist in the organization ensures the electronic system (EHR) is functioning well, data is captured as accurately as required, data is not lost in the system, and that the integrity of the system is maintained with no breaches (McGonigle & Mastrian, 2017). Nursing informatics is also about training the other healthcare workers on the proper use of the electronic system and maximization of data capture for better service delivery. One of the tools that nursing informatics makes use of is infographics. This is the depiction of nursing and other medical information in a visual manner using graphs, tables, and charts amongst others. A good nurse informaticist uses infographics to tell a story in very few words (Bradshaw & Porter, 2017). This paper is about the effect or impact that nursing informatics has had on patient outcomes and patient care efficiencies.

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A Description of the Proposed Project for Quality Improvement (QI)

In the organization in question, there is an existing EHR system that is meeting the needs of the organization and its user categories. However, it was discovered that the original software design had left out some details regarding the patient’s progress notes. Furthermore, the need arose to include newer laboratory tests and disease categories such as the SARS-CoV-2 condition or covid-19. This change is expected to affect the electronic medical records (EMRs) portion of the EHR and the computerized provider order entry (CPOE) part. The EMRs enables the electronic capturing of patient data related to laboratory and other test results, nursing notes or cardex, patient progress notes, and medication records of the patient. The CPOE on the other hand enables the physician or any other clinician such as the nurse practitioner to order patient treatment using pre-installed computerized algorithms that greatly minimize medical errors (Alotaibi & Federico, 2017). The project aims to upgrade the software in these particular areas of the EHR to bring them it to current standards and reality. In all, it aims to improve the quality of healthcare provided and ultimately patient outcomes. As the system is being upgraded, the operations in the healthcare facility will still go on as usual. This will be assured by the nurse informaticist who will work with the vendor of the EHR system to provide a functionality corridor in the system even as the CPOE and EMRs sections are upgraded.Patient Safety in Laboratory Medicine Matters

The Stakeholders Who Will be Impacted by This Project

The organization is a system made up of many separate ecosystems that coexist and depend on each other in a sort of symbiotic relationship. These separate ecosystems are made up of management, employees, patients, suppliers, creditors, and visitors. The top management of the organization is made u of the directors who formulate and guide policy implementation. Quality improvement initiatives also form part of the policy decisions that they make. The reason for this is that there is financial outlay in performing these kinds of quality improvements. In other words, there must be a budget set aside for this project and a timeline for completion. These are all decisions that must be made by the board of directors of the organization. When successful, the project will also impact them in that the improved efficiency will improve performance and corresponding revenue streams.

The other ecosystem is that of the patients. These are the recipients of the care given by the organization’s nurses and physicians. They are usually aware when things do not go as they are supposed to. As a result, rating by patients is one of the most useful barometers used to measure healthcare quality. With the upgraded EHR system, the patients will receive faster services that are more efficient and effective, timely, patient-centered, and safe. The employees will also be massively impacted by the project. They are the users of the system and therefore know first-hand what it means to have a system that has limited functionality. It is both frustrating and demoralizing and usually leads to the provision of poor quality healthcare services that may at times even be unsafe due to the possibility of errors. With the upgrading of the system, the employees will have an easier time interacting with the system and will therefore experience better job satisfaction. Suppliers and creditors will also be indirectly affected by the project. With better efficiency in the system, there will be a higher turnover of patients and lower turnaround time for services. Suppliers will therefore make more sales to the organization and creditors will get their payment on time because of the higher revenues. Lastly, visitors (who may be relatives or potential patients) will also come and observe the flow of patients and the speed of service delivery. With a seamless, smooth, and efficient system that does not delay patients; they will be impacted to make the decision of coming to the facility the next time they need medical attention.

Patient Outcomes and Patient Technologies

The patient outcomes expected to improve with the successful completion of this project will include reduced costs of healthcare, lower readmission rates, reduced hospital stay (hence a reduced risk of pressure injuries and hospital-acquired infections or HAIs), and better patient satisfaction. Because the interventions will be time as a result of the efficiency of the system, conditions will be treated in a timely manner. Recoveries will be faster and the stay in the hospital will be shorter. The trickle-down effect is that the cost of hospitalization will drop too. Because of better and prompt management of conditions, chances of preventable readmissions will be less. Patients will be more satisfied with these quality improvements and will have much less likelihood of contracting hospital-acquired infections (HAIs). They will be staying for shorter periods in the hospital and so this possibility will be remote.

The technologies required to implement this project include hospital EHR software packages provided by the vendor, remote server technology by the vendor for continuous system updates, an appropriate user interface, and the best contemporary computer hardware technology. All these will come together to give the project its success by a combination of these different technologies.Patient Safety in Laboratory Medicine Matters

The Project Team Members and Their Roles

The nurse informaticist will be the team leader in this project and will assume the title of project manager. She will oversee the completion of the project. The application developer is the computer software engineer who will design or install the software package containing the updated CPOE and EMRs. The application analyst gathers stakeholder views and transforms them into the technical information needed to tailor the system to organizational needs. Lastly, the quality assurance test engineer tests the system once the project is complete to see if it serves the purpose for which it was intended. He needs to have a medical background preferably, just like the project manager (Vant, 2017). All these other team members will work under the direction of the nurse informaticist.

References

Alotaibi, Y., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal, 38(12), 1173–1180. https://doi.org/10.15537/smj.2017.12.20631

Bradshaw, M.J. & Porter, S. (2017). Infographics: A new tool for the nursing classroom. Nurse Educator, 42(2), 57-59.  https://doi.org/10.1097/NNE.0000000000000316

Darvish, A., Bahramnezhad, F., Keyhanian, S. & Navidhamidi, M. (2014). The role of nursing informatics on promoting quality of health care and the need for appropriate education. Global Journal of Health Science, 6(6), 11–18. https://doi.org/10.5539/gjhs.v6n6p11

McGonigle, D., & Mastrian, K.G. (2017). Nursing informatics and the foundation of knowledge, 4^th ed. Jones & Bartlett Learning.

Palatnik, A. (2016). To err is human. Nursing Critical Care, 11(5), 4. Doi: https://doi.org/10.1097/01.CCN.0000490961.44977.8d

Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics (OJNI), 21(1). https://www.himss.org/library/healthcare-informatics

Vant, A. (2017). Four crucial members of an EHR implementation team. EHR In Practice. https://www.ehrinpractice.com/four-crucial-members-of-an-ehr-implementation-team-154.html 

Wang, Y., Kung, L., & Byrd, T.A. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126(1), 3–13. https://doi.org/10.1016/j.techfore.2015.12.019

Patient Safety in Laboratory Medicine Matters