Electronic Health Record Implementation Essay Assignment

One of the opportunities for tracking care improvement that EHR can facilitate is timely medication administration. Delays in administering medications to patients have been documented as leading causes of medication administration errors (MAEs). Vaidotas et al. (2019) noted that the National Coordinating Council (NCC) for Medication Error Reporting and Prevention (MERP) classifies wrong frequency as a type of medication error. The error occurs when a nurse or clinician fails to follow the time ordered by the physician when giving drugs to patients. It is a non-compliance of one of the five rights of drug administration: right patient, right drug, right time, right route, and right dose. Adherence to these rights limits medical errors and ensures patient safety. Drug administration at the right time promotes patient recovery and prevents fatalities. Monitoring wrong-time MAEs can inform measures for improving healthcare quality and safety. Electronic Health Record Implementation Essay Assignment

Data best guides quality care improvement. The Agency for Healthcare and Research Quality (AHRQ) provides benchmarks of process, structural, and outcome measures that healthcare organizations can apply to improve the quality and safety of care (AHRQ, n. d.). Addressing wrong-time MAEs would require information on “time-lapse from prescribed medication time in the EHR to administration to the patient in acute care settings.” The data will help demonstrate the time a clinician takes before giving a patient medication. It will also show if they follow a particular frequency (Wondmieneh et al., 2020). The difference between the prescribed time and administering time would help guide interventions for reducing delays in drug administration.

ORDER HERE A PLAGIARISM-FREE PAPER 

Role of Informatics and Project Management Strategies

Informatics can enhance the ability to capture data on wrong-time medication administration errors.  Cortes et al. (2019) explained that health informatics combines clinical competencies and technology to manage the drug administration process to promote safety. The technology enables healthcare organizations to handle data, information, and knowledge. For instance, when correcting data on the time lapse between prescribed and administration time as recorded in EHR, informatics helps clinicians compare the two data sets to identify delays.   Informatics also ensures data accuracy. Also, they enable healthcare providers to analyze and report the data and understand the incidence and prevalence of wrong-time MAEs. Besides, they provide analytics solutions that guide clinicians in point-of-care to minimize health risks due to the wrong frequency of drug administration.  Health informatics also informs quality improvement measures based on the tracked data (Cortes et al., 2019). Overall, informatics improves data collection, organizing, analysis, reporting, and application.  Electronic Health Record Implementation Essay Assignment

Some project management strategies and approaches can be applied to support informatics to improve medication administration safety in clinical practice. The project team, including nurse informaticists, should apply project management concepts in implementing the health informatics project. Usually, a project has four major phases: initiation, planning, execution/control, and closing.  The success of the project will depend on the completion of these stages. In a healthcare information technology project, informaticists should ensure the system can perform accurate data capture. They should also define measures for end-user experience. The technology should improve workflow and should be easy to use. The team should also inform, listen,  and communicate with colleagues and other stakeholders. Furthermore, the project team leader should support and manage resistance among staff to streamline data capture, analysis, and translation (Cortes et al., 2019). Effective project management will enhance support for informaticists for capturing delays in medication administration to promote safety.

Systems and Staff Members to be involved in the Design and Implementation Process

               Systems essential in the design and implementation of an EHR that can track delays in drug administration include computerized physician order entry (CPOE) and clinical decision support (CDS). The CPOE is a feature that allows physicians to digitize all their orders, including lab tests and medications. Other clinicians, including nurses, can access the physician orders from the system and apply them in caring for the patient.  The CDS informs clinical decision-making and also alerts if there are anomalies, such as missed doses. These systems will enable the organization to monitor wrong-time MAEs. Electronic Health Record Implementation Essay Assignment

Key stakeholders will be involved in designing and implementing an EHR to track wrong-time MAEs. They include project manager, team leader, physician lead, nurse lead, pharmacist lead, information technology (IT) lead, and EHR designer/builder. Each of these professionals plays a specific role in the EHR implementation. The project manager is the overall coordinator. They ensure the project is completed based on the plan. They manage resources and human capital. The leader also coordinates vendor selection, hardware, and software procurement and deliveries. The manager also ensures the project is completed per the schedule and budget. Also, they delegate duties to other members of the implementation team.  The physician champion acts as the link between the project team and other physicians. They also inform the group about what the EHR should look like from a clinical perspective. Another essential role is that of the advanced registered nurse.  The nurse leader acts as a change agent among nurses and ensures the EHR team designs a system that promotes care quality and safety (Office of the National Coordinator for Health Information Technology, 2019). For example, in the proposed quality improvement initiative, the nurse leader may brainstorm evidence-based approaches for enhancing data capturing and addressing wrong frequency in medication administration.

Additionally, the pharmacist lead, EHR designer, and IT lead are other crucial implementation team members. The pharmacist lead will help in designing the EHR to facilitate documentation, medication reconciliation, and patient monitoring. The designer will customize the system to align with the facility’s needs, including workflow redesign. They will also ensure compliance with HIPAA by training the staff to apply the technology based on the “meaningful use” requirements. The IT lead will be the leading consultant to assist other staff members in understanding how to utilize EHR to document drug orders and track medication administration (Office of the National Coordinator for Health Information Technology, 2019).

Implementation Strategies for The New EHR Proposal

Successful EHR implementation depends on how the project manager communicates change, handles the transition to the new system, and manages resources.  The team leader should develop a communication plan that will help create awareness, update stakeholders on progress, resolve differences, and communicate outcomes. The communication plan should illustrate the current status and the expected change. For instance, based on the proposed quality improvement opportunity, the plan should indicate wrong-time MAEs as a safety issue and demonstrate the need for capturing relevant data to mitigate the problem. It is also crucial for communication to be regular and via different channels. The project leader should communicate with the team at least biweekly and produce monthly reports on the implementation progress. They should also utilize multiple channels. Aside from communication, the project leader should apply strategies for streamlining the transition, including staff training, stakeholder engagement, and post-implementation evaluation and support. They also require managing the healthcare, fiscal, and human resources. The project manager should ensure the implementation has adequate resources while tracking their usage to improve efficiency (Vassell-Webb, 2019). All these approaches will facilitate the implementation and achievement of the expected outcomes. Electronic Health Record Implementation Essay Assignment

Professional, Ethical, And Regulatory Standards

The new EHR should meet certain professional, ethical, and regulatory standards. The project team should test the system to ensure smooth data entry, proper data storage, and easy retrieval.  The team should also assess if the interfaces are working correctly and if workflows are adjusted accordingly.   Systems’ interoperability and overall performance, including the response team, are other aspects the team should check (Aguirre et al., 2019).

The ethical considerations to make when designing and implementing a new EHR are meaningful use, non-maleficence, data privacy and confidentiality, and reciprocity. The system should be tested to ensure it generates valid data on medication administration to inform proper quality improvement measures. EHR also collects vital patient data, including medication information that requires protection.  Staff training should integrate ethics of applying EHR to minimize unethical practices.  It is also crucial for the team to design the system to enable users’ participation, such as nurses, physicians, and patients (Afzal & Arshad, 2021).

The system should also be regulatory compliant. The EHR should adhere to HIPAA guidelines. It should have the necessary structures for preventing data breaches. HIPAA also mandates healthcare organizations to report any data threats. Non-compliance attracts fines and charges (Afzal & Arshad, 2021; Aguirre et al., 2019).

Evaluating the Success of EHR Implementation

EHR implementation evaluation is a critical step in the system adoption. The evaluation should focus on the setting, staff, and patient perspective.   Using surveys, the evaluators should determine if the staff understands how to use the system to capture, analyze, and report data on medication administration.  The system should support the practice needs, including clinical decision-making. They should test the system for workflow impact, integration, and interoperability. The e-prescribing and administration functions should also allow timely data collection and sharing. It should also enable tracking of dose and medication frequencies and producing alerts.  From the patient’s perspective, the EHR should allow access to patient medication data to clinicians and patients. The team should further evaluate if the EHR helps the organization meet its core goals (Tsai et al., 2020).  For instance, they should question if the system has improved data capturing, the quality of data collected, and if the data informs quality improvement measures. Electronic Health Record Implementation Essay Assignment

Leadership Skills and Theories Needed to Facilitate Collaboration

Leadership is an essential pillar of EHR implementation. Laukka et al. (2020) identified different leadership roles of healthcare leaders in implementing information technology systems. These are a supporter, advocate, change manager, facilitator, project manager, decision maker, and champion. The project leadership team should have the skills to play all these roles because implementing EHR requires an interprofessional approach. The collaboration of the project team and the rest of the healthcare organization depends on how a leader acts in these roles.  The project leader has to support the staff during the implementation process. Support involves listening and providing feedback, availing necessary resources, and acting like a role model. They should also advocate for the interests of all stakeholders. They should ensure the EHR serves the intended needs of patients, staff, and setting perspectives. The leader should also manage change by addressing concerns and issues related to the new proposal. They should steer the implementation and be the key decision-makers. Also, the leader should ensure the project is completed in time and meets set goals and outcomes, including informing evidence-based practice and patient-centered care.  Adopting transformational leadership theory, which embodies most of the listed roles, could enable a leader to create an enabling environment for EHR adoption. A transformative leader supports, empowers, role models, and manages change to focus the staff towards shared objectives.  The leadership skills and theory discussed will promote collaboration and enhance outcomes. Electronic Health Record Implementation Essay Assignment

References

Afzal, S., & Arshad, A. (2021). Ethical issues among healthcare workers using electronic medical records: A systematic review. Computer Methods and Programs in Biomedicine Update, 1(100030), 1-7. https://doi.org/10.1016/j.cmpbup.2021.100030.

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.

AHRQ (n. d.). AHRQ quality indicators: Measures. Agency for Healthcare Research and Quality (AHRQ). https://qualityindicators.ahrq.gov/measures/qi_resources.

Cortes, D., Leung, J., Ryl, A., & Lieu, J. (2019). Pharmacy informatics: Where medication use and technology meet. The Canadian Journal of Hospital Pharmacy, 72(4), 320-326. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6699873/.

Laukka, E., Huhtakangas, M., Heponiemi, T., & Kanste, O. (2020). Identifying the roles of healthcare leaders in hit implementation: A scoping review of the quantitative and qualitative evidence. International Journal of Environmental Research and Public Health, 17(8), 2865. https://doi.org/10.3390/ijerph17082865.

Office of the National Coordinator for Health Information Technology (2019, May 21). Building the EHR implementation team. HealthIT.gov. https://www.healthit.gov/faq/who-are-key-stakeholders-during-electronic-health-record-ehr-implementation.

Tsai, C. H., Eghdam. A., Dayoody, N., Wright, G., Flowerday, S., & Koch, S. (2020). Effects of electronic health record implementation and barriers to adoption and use: A scoping review and qualitative analysis of the content. Life, 10(12), 327. https://doi.org/10.3390/life10120327.

Vaidotas, M., Yokota, P. K. O., Negrini, N. M. M., Leiderman, D. B. D., de Souza, V. P., dos Santos, O. F. P., & Wolosker, N. (2019). Medication errors in emergency departments: Is electronic medical record an effective barrier? Einstein (San Paulo), 17(4), eGS4282. https://doi.org/10.31744/einstein_journal/2019GS4282.

Vassell-Webb, C. (2019). Strategies for implementation of electronic health records. Walden Dissertations and Doctoral Studies. https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=8537&context=dissertations.

Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: a cross-sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC Nursing, 19(4), 1-9. https://doi.org/10.1186/s12912-020-0397-0. Electronic Health Record Implementation Essay Assignment

Benchmark – Electronic Health Record Implementation Paper
Start Date

Sep 7, 2023, 12:00 AM

Due Date

Sep 13, 2023, 11:59 PM
Points
210
Rubric
View Rubric
Status
Upcoming
Assessment Traits
Benchmark
Requires Lopeswrite
Assessment 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:

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.
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?
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?
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).
Discuss what professional, ethical, and regulatory standards must be incorporated into the design and implementation of the system.
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?
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. Electronic Health Record Implementation Essay Assignment

ORDER HERE 

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.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Electronic Health Record Implementation Essay Assignment