Benchmark – Electronic Health Record Implementation Paper

The nursing essay below discusses Benchmark – Electronic Health Record Implementation Paper and the provision of evidence-based, patient-centered care and the application of ethical, professional, and regulatory standards to offer efficient and safe palliative care services to patients.

Benchmark – Electronic Health Record Implementation Paper

Introduction

The implementation of new electronic health records (EHR) system is a phenomenal mission for all healthcare stakeholders, including the boardroom and the emergency room. The paper will emphasize the necessity of exceptional leadership skills to cooperate in interprofessional groups and for the provision of evidence-based, patient-centered care and the application of ethical, professional, and regulatory standards to offer efficient and safe palliative care services to patients. Sound leadership qualities and the use of proper change management theories are necessary for success in the implementation of EHR systems.

Management of Data and Informatics for the Benchmark – Electronic Health Record Implementation Paper

Through data accessibility, availability, and analysis, one can monitor and identify patterns and opportunities for care improvement in healthcare system databases. EHR is typically comprehensive, offers easy access to patients’ information at the point of care, and facilitates multidisciplinary access to data. Mined and analyzed EHR data can be used to improve critical aspects of quality and patient safety, particularly in prevention of adverse drug reactions, and identifying a patient’s health risk factors such as falls. Besides EHR facilitates better documentation, which positively improves the clinical performance of nurses and patient outcomes. Electronically stored documentation can be easily retrieved, monitored and cross-analyzed to extract critical information such as patient satisfaction and experiences. The information also helps identify staffing issues and barriers to better care delivery in the clinical setting thereby providing an avenue to identify areas of improvement.

Role Informatics Plays in the Ability to Capture This Data in the Benchmark – Electronic Health Record Implementation Paper

Informatics in healthcare involves the management of data and application of IT, information technology to unify health records, thus optimizing health outcomes and control data assemblage from patients’ records. Health informatics has to interpret, manage, and communicate health information, with the critical role of the improvement of patient care. Informatics plays the integral role of facilitating enhanced documentation, a decrease in medical errors, and upgraded coordinated care (Rupp, 2014). Patient care begins with an adequate collection of a patient’s medical history, allergy history, clinical symptoms, and the latest medication data. The entire data is gathered and documented in the automated database. Medical practitioners and nurses are thus enabled to record or retrieve data in real-time. Hence, lessening medical errors with the incorporation of ‘soft stops,’ interaction medications, and alerts of the patients’ allergies are among the ways patient care is improved. Therefore, the comprehensive clinical database is excellent care for the achievement of the desired outcomes.

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Benchmark - electronic health record implementation paper
Benchmark – Electronic Health Record Implementation Paper

The Systems and Staff Members that Would Need to Be Involved in the Design and Implementation Process and Team – Benchmark – Electronic Health Record Implementation Paper

            Implementation of Health systems requires the use of a multidisciplinary team approach. The approach ensures that the design and implementation process incorporates the input of end users (nurses), nurse leaders, administrator and other directly involved practitioners. The coordination guarantees security and privacy compliance, training of care teams, designing practice workflows, and the management of the adoption process of the clinical database implementation effectively. The external systems stakeholders are software corporations, patients, and EHR vendors. The internal stakeholders include the nurses, physicians, nursing and medical assistants, IT staff, administrative personnel, and the EHR developers.

External stakeholders such as the systems architect play a pivotal role in transforming system requirements into functional requirements and later into the system. Lead Physician or administrators lead the institution during the entire implementation process while nurse leaders and managers collaborate with the staff in practice and vendors to track daily and progress issues of the design and implementation. The involvement of direct care nurses is critical, as they are the lead users who serve as the in-house specialist collaborating and coordinating with developers in design and nurse leaders and project managers in the EHR implementation (Hodgkins, 2015).

Professional, Ethical, and Regulatory Standards That Must Be Incorporated Into the Design and Implementation of the System (5.2) -Benchmark – Electronic Health Record Implementation Paper

Professional, ethical and regulatory standards guide each step of contemporary design and implementation of clinical information systems. The sensitivity of patient data, its access and availability, mandates guidelines and regulations aimed at protecting the patient and facilitating care. The Health Insurance Portability and Accountability Act, HIPPA, of 1996 is a federal law that aims at protecting the security and privacy of singly identifiable health data. The privacy policy screens health data in any form while the security regulations deal with electronically protected information (HealthIT, 2019). In America, the web of complex ethical and legal legislations has rendered the protection difficult, particularly the advancing sector of health-related research and the field of PCOR, patient-centered outcomes research. In 2017, the ONC, Office of National Coordinator for Health Information Technology, established a new section titled ‘Legal and Ethical Architecture for PCOR Data’ under the Privacy and Security Framework for PCOR (HealthIT, 2019). The Architecture is developed to assist stakeholders in steering the ethical ad legal scene for PCOR. Amid the three core, moral concepts in medical ethics are justice, beneficence, ad respect for individuals- the primary significant value is respect for individuals. Respect for persons entails two principle- individual autonomy and protection of people with diminished autonomy. This forms the foundation for the medical practice of informed consent. The process of approval for any medical participation or treatment in research must contain participant’s or patient’s adequate information to help comprehend the risks, procedure, benefits, alternative procedures available, and the knowledge that they can retract consent at whichever time (The George Washington University, 2017).

How the EHR Team Would Ensure That All Order Sets Are Part of the New Record -Benchmark – Electronic Health Record Implementation Paper

In palliative care, the cotemporary practice is evidence-based. Today’s application of clinical order sets establishes an observance of evidence-based guidelines within the EHR system, thus resulting in improved outcomes and reduced errors. For updated and effective order sets, the EHR team would need to guarantee that all order sets are integrated into the system. To ensure buy-in, the success of the venture and the satisfaction of medical practitioners, a formal governance structure guided by the Lead Physician must be created. Clinical order sets must epitomize excellent practices and institutional standards that encompass the identification and selection of data content sources, review of the content, maintenance, and update of information. This is especially valid when clinical data is highly customized since it requires considerably more effort and time to preserve and maintain the personalized content. The process in use should identify and replace data that can influence patient safety or quality of care provided when the information/content is obsolete (Bushman, 2018).

Communication is an essential means. Change management is a set of techniques, principles, and prescriptions used to the human facets of effecting chief change initiatives. It is the ‘what’- the data that has to be communicated, the ‘how’- the preparation of individuals to engross the implications influencing them, and the ‘when’- scheduling the communication that must take place (Creasey, 2018). To effect change, it aids if the entire organization wants the difference since there must be urgency around the necessity for change. This assists in sparking the initial motivation to keep things in motion. Through John Kotter’s 8-Step Model for effective change, a spark can be produced to shift or stimulate the change.

The steps include; (Benchmark – Electronic Health Record Implementation Paper)

  • Step 1: Create Urgency
  • Step 2: Establish a Powerful Coalition.
  • Step 3: Form a Vision for Change
  • Step 4: Communicate the Vision
  • Step 5: Remove Obstacles
  • Step 6: Create Short-Term Wins
  • Step 7: Build on the Change
  • Step 8: Anchor the Changes in Corporate Culture (Mindtools content team, 2019).

The advancement of technology has increased and improved communication methods. For the implementation of the EHR system, various ways of communication are required to notify the stakeholders of the impending changes. Different advertisement ways such as posters, flyers, and banners to personal emails should be carried out. Emails are efficient and a quick way of communication between interprofessional teams. It is accessible through mobile devices and personal computers and can be encrypted for security purposes, and they have various attachments as well as large graphic files. This lets the team members read and state their input. Mobile text messages are also a way of communication as they are an efficient and quick means of getting solutions and contributions while on the go.

Evaluation of the success of the EHR implementation – Benchmark – Electronic Health Record Implementation Paper

Before the implementation of the system, a set of parameters envisioning success should be established. John-Kotter’s Model for effective change can offer guidelines for the indicators at each implementation step. Establishing milestones and small wins are some objectives that can be developed in the original plan before the implementation. Some goals and milestones that can be created are evaluating the readiness of the internal stakeholders to make a shift, arranging how to ‘go-live’ considering the assessment and attaining meaningful usage. Thorough preparation at the kick-off is vital for success in implementing the EHR system, although developing realistic expectations and an achievable timeline is crucial. After the completion of the implementation, constant tracking is necessary to gauge how internal stakeholders are faring in the new system (Kushan, 2017). The monitoring ensures consistent successful implementation of the EHR system.

Conclusion for the Benchmark – Electronic Health Record Implementation Paper

The implementation of new electronic health records takes thorough planning, having buy-in from all stakeholders, and the application of change management apparatuses to propel the change. Mapping out the implementation process as a journey and not merely as a destination ensures success. Adequate communication and proper leadership are chief factors for success in implementing the new EHR system. Servant leadership requires the leader to be a servant first to guide the team, and the use of John Kotter 8-Step Model for effective change to handle the individuals’ side of the implementation aids the entire institution to understand, commit to, and adopt deviations to new HER implementation.

References to the Benchmark – Electronic Health Record Implementation Paper

Bushman, S. (2018, December 5). Three Steps for Success with Clinical Order Sets. Retrieved from https://www.optimumhit.com/insights/blog/ehr-implementation/3-steps-success-clinical-order-sets

Creasey, T. (2018). What is change management? Retrieved from http://www.howtochangemanagement.com/p/what-is-change-management.html

Health IT. (2019). Health IT Legislation | HealthIT.gov. Retrieved from https://www.healthit.gov/topic/laws-regulation-and-policy/health-it-legislation

Hodgkins, M. (2015, March 29). Electronic Health Record (EHR) Implementation. Retrieved from https://edhub.ama-assn.org/steps-forward/module/2702512

Kushan, D. (2017, December 4). How to Track and Measure Success During an EHR System Transition. Retrieved from https://www.healthcareis.com/blog/how-to-track-and-measure-success-during-a-transition

Mind Tools Content Team. (2019). Kotter’s 8-step change model. Retrieved from https://www.mindtools.com/pages/article/newPPM_82.htm

ReThinkPhil. (2017). Servant leadership: A journey, not a race. Retrieved from https://healthmanagement.org/c/healthmanagement/issuearticle/servant-leadership-a-journey-not-a-race

Rupp, S. (2014, November 14). How Nurses Are Using Health Informatics to Improve Patient Care. Retrieved from https://electronichealthreporter.com/nurses-using-health-informatics-improve-patient-care/

The George Washington University. (2017, September 28). Legal and Ethical Architecture for PCOR Data. Retrieved from 02/PCOR%20Architecture_Chapter%201_S_ONC%20FINAL.pdf

Paper details for Benchmark – Electronic Health Record Implementation Paper

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. Benchmark – Electronic Health Record Implementation Paper

In a paper of 1,250-1,500 words, address the following questions related to the advanced registered nurse\’s role during this type of scenario: Benchmark – Electronic Health Record Implementation Paper

  1. What key information would be needed in the database that would allow you to track opportunities for care improvement?
  2. What role does informatics play in the ability to capture this data?
  3. Which systems and staff members would need to be involved in the design and implementation process and team?
  4. What professional, ethical, and regulatory standards must be incorporated into the design and implementation of the system?
  5. How would the EHR team ensure that all order sets are part of the new record?
  6. How would you communicate the changes, including any kind of transition plan?
  7. What measures and steps would you take to evaluate the success of the EHR implementation from a staff, setting, and patient perspective?
  8. What leadership skills and theories would 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.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. Benchmark – Electronic Health Record Implementation Paper

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

This benchmark assignment assesses the following programmatic competencies:

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.

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