NURS FPX 6016 Assessment 2 Quality Improvement Initiative Evaluation

Name

Capella university

NURS-FPX 6016 Quality Improvement of Interprofessional Care

Prof. Name

Date

Quality Improvement Initiative Evaluation

This assessment will analyze the Electronic Health Records (EHRs) quality improvement initiative at North American Specialty Hospital. The Quality Improvement (QI) initiatives play a crucial role in improving the current deteriorating quality of a system. In healthcare systems, the hospital administration drives these QI initiatives to ensure patients receive high-quality care treatments that enhance patient safety and satisfaction (Coles et al., 2020). Furthermore, this assessment will evaluate the success of EHRs with the help of benchmarks. Later, the interprofessional perspectives relevant to the success of actions will be highlighted. Lastly, additional protocols and measures will be described to boost outcomes and expand the outcomes of EHR.

Analysis of EHRs as QI Initiative

The current EHR initiative was implemented due to patient expiration, which took place due to adverse events of medication error. The patient, Julia, was admitted to the Intensive Care Unit (ICU) at North American Specialty Hospital due to a critical cardiac emergency. The patient’s health was intricately monitored and stabilized by healthcare professionals. However, nurses’ strenuous working hours led them to experience work burnout and reduced adequate communication (Babatope et al., 2023).

The physician prescribed changes in the dosage of cardiac medication, which was not appropriately conveyed to the following nursing staff. Moreover, the medication chart was not updated, and the nurse on the next shift administered the outdated dosage of the prescribed medication. The patient’s health condition worsened due to insufficient dosage and required immediate care, which was delayed and caused the loss of the patient (Wondmieneh et al., 2020).

During the implementation process of EHR within the healthcare system, various challenges arose and problems were faced. One of the biggest challenges that healthcare organizations face is high upfront costs, including software, hardware, training, and support (Highfill, 2019). Moreover, the organization also needed to address the maintenance costs of systems and updates. Other challenges were related to the integration of EHR within the hospitals due to the complexity of IT systems and technologies. Furthermore, the shift to EHR disrupted established workflows as healthcare professionals with limited understanding of technologies resisted transitioning from paper-based records to electronic systems (Joukes et al., 2019).

Knowledge Gaps and Missing Information 

The knowledge gaps around the security of patient health data and compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations during EHR use persisted and required additional information to improve the analysis. Other missing information was related to whether the healthcare professional was adequately trained about EHR use to overcome user frustration and hindrances related to the resolution of issues (Samadbeik et al., 2020).

Evaluation of Success of QI Initiative (EHR)

The success of EHR implementation can be evaluated by outcome measures such as decreased medication errors, reduced mortality rates, increased patient safety, reduced hospital readmission rates, and improved patient well-being. When healthcare professionals appropriately utilize EHR technology in prescribing, dispensing, and administering medication for double checking, the chances of medication errors diminish (Gates et al., 2020). Moreover, through EHR use, patient safety is enhanced as the errors due to writing-based mistakes and communication are avoided. Ultimately, patient health outcomes improve, and hospital readmission rates are reduced, resulting in enhanced patient satisfaction (North et al., 2020). 

Another way to evaluate EHR’s positive results is by comparing EHR performance with recognized benchmarks provided by HIPAA. The safe and secure sharing of patient health data among healthcare professionals according to HIPAA guidelines dictates the correct performance and success of the EHR technology (Rosenbloom et al., 2019). Other benchmarks are related to reducing medication errors to enhance patient safety (Gates et al., 2020). After integrating and implementing the EHR technology, the medication error rates were measured and compared to prior performance. The errors were reduced from 20 per 1000 patients to 3 per 1000 patients. This significantly improved patient care and showed the success of EHR within the hospital (Gates et al., 2020).

Assumptions 

The assumptions on which this analysis is based are: 1) EHR implementation should improve productivity and reduce adverse events like medication errors, 2) Healthcare professionals must show compliance to HIPAA regulations for safe and secure sharing of patient health data, and 3) EHR use should improve the quality-of-care treatments and medication management (Gates et al., 2020).

Interprofessional Perspectives Related to Success of Actions

The interprofessional perspectives and actions are critical to any innovative QI initiative’s success as they are the integrated initiative’s driving force. In the present case, the interprofessional team of healthcare professionals, healthcare informaticists, quality control department, and hospital administration collaboratively integrated and implemented EHRs within the hospital. Healthcare professionals were eager to improve workflow efficiency and care coordination to reduce adverse events like medication errors (Robertson et al., 2022). Moreover, nurse informaticists proactively worked to provide insights into technical aspects of EHR functionality, including patient health data security, user-friendly interoperability through training and education, and customizing systems to the desired needs of patients and healthcare professionals (Beckmann et al., 2021). 

Hospital administration ensures all healthcare professionals abide by the regulations provided by HIPAA to avoid any privacy breaches. The quality control department was responsible for evaluating the improvements in care treatments and reducing adverse events post-implementation of the EHR (Bitaraf et al., 2021). The interprofessional team members were interviewed separately and collaboratively, and most of the staff were motivated to utilize this technology. They shared their perspectives on challenges and opportunities in care coordination using EHR to enhance interdisciplinary team communication. Moreover, the interviews with IT teams and healthcare administration discussed the technical issues and resource allocation to align the EHR initiative with overall quality improvement plans (Negro-Calduch et al., 2021).

Knowledge Gaps and Additional Information

Some knowledge gaps are still in the analysis, such as what measures are in place to ensure EHR systems’ long-term sustainability and adaptability. How are patients and families involved in the EHR initiative, and are there any opportunities to enhance transparency and engagement through the system (Lyles et al., 2020)? There is also a need to include perspectives from patients and their families to comprehend their experience following EHR use and its impact on their engagement in care (Lyles et al., 2020). These knowledge gaps and additional information would be required to understand EHR implementation successfully.

Additional Indications and Protocols

The continuous success of EHR requires ongoing monitoring and adaptations to the system to deal with rising challenges. Some additional protocol changes that are recommended to improve the quality of EHR use can be as follows:

• Use of voice recognition technology and natural language processing to automate certain areas of documentation and reduce its burden on healthcare professionals (Goss et al., 2019). This will help streamline data entry and improve the efficiency of workflow. Moreover, the productivity among healthcare professionals will be improved as burnout is reduced with easy workflows. However, the cons of this recommendation include concerns about the accuracy of automated documentation and challenges in adopting new technologies (Goss et al., 2019).
• Another recommendation is to develop and implement regular update policies and training sessions to ensure optimal use of EHR functionalities. This will enhance user proficiency, reduce risks of errors, and support the adoption of newly added features. However, the cons to this strategy include requiring resources to commit to these training sessions and the need for a well-structured training curriculum. Moreover, potential workflow disruptions can be encountered during training periods (Tomašev et al., 2021).

NURS FPX 6016 Assessment 2 Quality Improvement Initiative Evaluation

• Another recommendation is to implement indicators such as access to educational resources, participation in shared making, and the use of online portals to measure patient engagement (Lyles et al., 2020). The pros of this recommendation are enhanced patient-centered care, promotion of self-management, and improvements in communication between patients and healthcare professionals. However, this will require additional patient education and support resources, burdening healthcare organizations financially (Holmgren et al., 2021).
• The technology that can be integrated with EHR is remote patient monitoring to monitor patients’ health parameters remotely. This will require implementing protocols to alert healthcare professionals to potential issues, enabling proactive interventions. This will result in early detection of health deterioration and continuous monitoring of chronic conditions. The cons of this recommendation are privacy and security concerns, the need for infrastructure support, the training of healthcare professionals, and challenges in patient compliance with monitoring devices (Gandrup et al., 2020).

Conclusion

 The EHR integration and implementation following the medication errors at North American Specialty Hospital are evaluated in this paper. The success of this initiative is conducted based on outcome measures and benchmarks set by accreditation authorities like HIPAA. All interprofessional team members were optimistic about positively changing the quality of care treatments. The additional protocols suggested are related to improving the documentation process in EHR, implementing patient engagement within EHR, and integrating remote monitoring with EHR.

References

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Beckmann, M., Dittmer, K., Jaschke, J., Karbach, U., Köberlein-Neu, J., Nocon, M., Rusniok, C., Wurster, F., & Pfaff, H. (2021). Electronic patient record and its effects on social aspects of interprofessional collaboration and clinical workflows in hospitals (ecoco): A mixed methods study protocol. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06377-5

Coles, E., Anderson, J., Maxwell, M., Harris, F. M., Gray, N. M., Milner, G., & MacGillivray, S. (2020). The influence of contextual factors on healthcare quality improvement initiatives: A realist review. Systematic Reviews, 9(1). https://doi.org/10.1186/s13643-020-01344-3  

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Gandrup, J., Ali, S. M., McBeth, J., van der Veer, S. N., & Dixon, W. G. (2020). Remote symptom monitoring integrated into electronic health records: A systematic review. Journal of the American Medical Informatics Association, 27(11). https://doi.org/10.1093/jamia/ocaa177 

Gates, P. J., Hardie, R.-A., Raban, M. Z., Li, L., & Westbrook, J. I. (2020). How effective are electronic medication systems in reducing medication error rates and associated harm among hospital inpatients? A systematic review and meta-analysis. Journal of the American Medical Informatics Association, 28(1), 167–176. https://doi.org/10.1093/jamia/ocaa230 

NURS FPX 6016 Assessment 2 Quality Improvement Initiative Evaluation

Goss, F. R., Blackley, S. V., Ortega, C. A., Kowalski, L. T., Landman, A. B., Lin, C.-T., Meteer, M., Bakes, S., Gradwohl, S. C., Bates, D. W., & Zhou, L. (2019). A clinician survey of using speech recognition for clinical documentation in the electronic health record. International Journal of Medical Informatics, 130, 103938. https://doi.org/10.1016/j.ijmedinf.2019.07.017 

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Joukes, E., de Keizer, N., de Bruijne, M., Abu-Hanna, A., & Cornet, R. (2019). Impact of electronic versus paper-based recording before EHR implementation on health care professionals’ perceptions of EHR use, data quality, and data reuse. Applied Clinical Informatics, 10(02), 199–209. https://doi.org/10.1055/s-0039-1681054 

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NURS FPX 6016 Assessment 2 Quality Improvement Initiative Evaluation

Negro-Calduch, E., Azzopardi-Muscat, N., Krishnamurthy, R. S., & Novillo-Ortiz, D. (2021). Technological progress in electronic health record system optimization: Systematic review of systematic literature reviews. International Journal of Medical Informatics, 152, 104507. https://doi.org/10.1016/j.ijmedinf.2021.104507 

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Robertson, S. T., Rosbergen, I. C. M., Burton-Jones, A., Grimley, R. S., & Brauer, S. G. (2022). The effect of the electronic health record on interprofessional practice: A systematic review. Applied Clinical Informatics, 13(03), 541–559. https://doi.org/10.1055/s-0042-1748855 

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Samadbeik, M., Fatehi, F., Braunstein, M., Barry, B., Saremian, M., Kalhor, F., & Edirippulige, S. (2020). Education and training on Electronic Medical Records (EMRs) for health care professionals and students: A scoping review. International Journal of Medical Informatics, 142(1), 104238. https://doi.org/10.1016/j.ijmedinf.2020.104238

NURS FPX 6016 Assessment 2 Quality Improvement Initiative Evaluation

 

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