NUR 514 Implementing Change With an Interprofessional Approach Presentation
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Over the years, there has been a higher demand for enhanced care and patient safety in the healthcare sector. While various strategies have been explored to meet such demands, technology has been at the center of almost every effort. One of such technological applications that have attracted a lot of interest and experienced growth in recent years is electronic health records (Garcelon et al., 2020). Electronic health records have widely been applied in the healthcare sector to improve care efficiency and enhance patient outcomes through better decision support systems. In addition, electronic health records improve the clarity and accuracy of patients’ medical information, which helps lower the chances of medical errors occurring.
This paper, therefore, seeks to consider an opportunity for tracking care improvement and identify some of the fundamental information required for an EHR database. In addition, informatics’ role in capturing the data and methodologies and management strategies for supporting the informatics initiative will be explored. Staff need for the implementation process, strategies for implementation, ethical and regulatory standards, evaluation and leadership skills, and theories will be discussed.
The Needed Key Information
As indicated earlier, EHR is critical for ensuring that patient’s medical records are accurate and clear. Various key information is also needed for the database. One of the key patient information required includes imaging reports, laboratory results, progress notes, immunization history, vital signs, past and current medications, past medical and surgical history, current medical issues, and patient demographics (Schopf et al., 2019). With such information, patient outcomes are the center of focus. Such a focus is instrumental in coming up with or formulating appropriate interventions that can lead to the most desired outcomes. In addition, possible disease risks factors or complications can be appropriately identified timeously. The healthcare providers can then take appropriate preventive interventions.
Computational systems analyzing the large volume of data, data storage, and information retrieval are central to informatics. Informatics plays various roles in capturing data for the electronic health records databases in various ways. One of the roles is the provision of operational applications and clinical tools that are primarily applied in capturing health information to boost patient care and security (Braunstein, 2018). In addition, informatics is central in the organization of the patient data obtained from various data collection devices and systems such as diagnostic systems, health tracking devices, patient portals, and electronic medical records. Informatics also helps in capturing data from various systems and databases in various formats and converts such data into the same format before the eventual storage in the database.
Design and implementation of a system such as EHR require the collaboration and participation of every team member. As such, it is vital to identify relevant team members that can effectively perform designed tasks and responsibilities. Since an EHR implementation needs the incorporation of medical data from various departments of the organization, it is imperative to draw team members from various departments. In addition, it is vital to integrate various systems to effectively offer the needed information in real-time (Braunstein, 2018). As such, the following systems will be needed for an efficient EHR design and implementation, a report generation system, an e-prescibing system, a billing and reimbursement system, and a documentation system.
The report generation system is useful in helping the providers formulate reports by utilizing particular information such as procedures involved, medication, and patient demographics. In addition, the e-prescribing system is essential for tracking the medications that have been prescribed for a particular patient, evaluate drug interactions, medication side effects, and allergies, thereby enabling the clinicians to come up with informed decisions regarding a patient’s medication regimen (Braunstein, 2018). Besides, the billing and reimbursement system will also be incorporated to assist in health services efficient payments and insurance company reimbursement. Finally, the documentation system will be critical for the creation of charts and structuring of information to facilitate seamless access by patients and practitioners.
Apart from the systems, various individuals will be needed to form the implementation team. The team will be obtained from both external consultants and internal stakeholders. As such, the following team members will be essential, the billing advocate, a nurse, a physician, a quality assurance test engineer, an application developer, application analysts, and a project manager (Braunstein, 2018). The project manager is responsible for leading the team and ensuring that the activities are within the proposed project timeline.
The application analysts will carry out a critical part of data migration and making the data lean before handing the work over to the application developer, who will then customize the system. The quality assurance test engineer will test the functionality and performance of the system (Braunstein, 2018). The billing advocate, nurse, and physician will represent their various departments and offer insights on the system’s testing, data, and needed training.
Strategies For Implementing the New EHR Proposal
Implementation of a proposed project is one of the most challenging tasks. Indeed, it is easy to have a good proposal, but the realization of the vision will only come true if proper implementation strategies are put in place. Therefore, various strategies for implementing the proposal are discussed in this section. The first strategy is to offer strong leadership that can work hard to ensure that everyone buys into the project goals and, therefore, supports the project (Fragidis & Chatzoglou, 2018). It is also important to let everyone understand why the new EHR system is needed and will be good for the organization. It is also vital to make the project clinically driven. The implication is that every clinician should be involved from the very early stages of the project and stay on course with constant communication of wins and steps.
For better outcomes, another important strategy is the optimization of workflows and configuration of the systems to ensure that efficiency is top-notch. Testing the system is key since it will help determine if there are some malfunctions that need to be addressed before starting official operations (Fragidis & Chatzoglou, 2018). In addition, it is important to arrange for training sessions for the staff, such as clinicians, for they may resist the new systems for fear of not knowing what to do. Effective management of resources will be key for a successful implementation since the whole project can end up being too expensive if the resources are wasted and not properly managed.
The Professional, Ethical, and Regulatory Standard
Since EHR involves data and confidential information about patients, it is imperative to consider the professional, ethical, and regulatory standards to be incorporated in the system design and implementation. Some of the relevant professional standards include the acquisition of the HIPAA-compliant business associate agreement document, encryption of the patient’s electronic health information, and a detailed system risk analysis (Keshta & Odeh, 2021). Upholding the professional standards will imply that if there is a system breach, then every user is informed.
The ethical standards to be incorporated include protection of patient’s private and confidential information such as clinical visiting notes, diagnostic notes, claims procession, and billing information. In addition, the regulatory standards will have to be aligned so that the system complies with the HITECH and HIPAA regulations (Keshta & Odeh, 2021). As such, the distribution, programming, system design, and software development for the system will also have to follow HITECH and HIPAA regulations.
Measures for System Evaluation
Evaluation is one of the most vital stages of implementing a system change in an organization. Through evaluation, the change leaders gain insight into the system’s success from various perspectives. Therefore, the success of the proposed new electronic health records will be evaluated by patients, setting, and staff to help accurately identify areas that need immediate improvement and long-term improvement plans (Goldstein, 2017). As such, one of the tools which will give vital information from the staff perspective is the use of surveys. An appropriate survey will be designed with system-specific questions to help get the view from the staff. The survey can prompt the staff to give their views and rate the new electronic health system in terms of documentation, evidence-based decisions, patient information access, healthcare delivery, and user-interface friendliness.
The system will also be evaluated from the perspective of the operation settings. An analysis of rates of data error will be accomplished to give an insight into how well the new system has enhanced data quality and input. The return on investments is critical for evaluating whether a project has been or is profitable or not (Goldstein, 2017). As such, the return on investment for the project will be computed after a period of operation. Patients are central to the development of the new system; therefore, evaluating their satisfaction is the suitable yardstick for evaluating the system. Therefore, the patients will be given a specially designed patient survey to complete by responding to various questions. Patient wait times will also be measured to find out if there is any improvement as compared to when the new system was still not in place.
Leadership Skills and Theories for Interprofessional Team Collaboration
Electronic health records are mainly developed and implemented to help in boosting patient outcomes. Therefore many individuals from Interprofessional teams are involved, and so there is a need for effective collaboration. Leadership skills and leadership theories can be applied in ensuring that the collaboration is effective. According to Folkman et al. (2019), competition and power wrangles between the Interprofessional teams can bring friction and confusion, hence derailing the implementation process of a project. As such, leadership skills should be used to help navigate the rough path. Some of the leadership skills that can help foster an effective collaboration include acting as a role model, meaning the team leaders have to lead by example. The other skills include the ability to initiate and maintain collaboration and to show benevolence to each and every Interprofessional collaboration team member (Hu & Broome, 2020). Applying these skills would be key for a sustained working relationship.
Some of the most appropriate leadership theories that can be applied include innovation and social cognitive theories. These theories can appropriately guide implementation, process development, and model evaluation as Interprofessional teams collaborate. While the social cognitive theory offers an understanding of the interdependence between the team members to deliver adequate care, diffusion theory gives a framework for a successful change adoption for the EHR implementation and efficient Interprofessional team collaboration.
In conclusion, electronic health records are essential for improved patient outcomes by ensuring that patient data is accurate and clear, hence preventing medical errors that can lead to adverse impacts on the patient. Therefore, this write-up has proposed an EHR design, implementation, and evaluation. The role of informatics in data capture, various professional, ethical, and regulatory standards, and leadership skills and theories for Interprofessional teams have been discussed.
Braunstein, M. L. (2018). Health Informatics on FHIR: How HL7’s New API is Transforming Healthcare. Springer International Publishing.
Folkman, A. K., Tveit, B., & Sverdrup, S. (2019). Leadership in interprofessional collaboration in health care. Journal of multidisciplinary healthcare, 12, 97. https://dx.doi.org/10.2147%2FJMDH.S189199.
Fragidis, L. L., & Chatzoglou, P. D. (2018). Implementation of a nationwide electronic health record (EHR): The international experience in 13 countries. International journal of health care quality assurance. https://doi.org/10.1108/IJHCQA-09-2016-0136
Garcelon, N., Burgun, A., Salomon, R., & Neuraz, A. (2020). Electronic health records for the diagnosis of rare diseases. Kidney International, 97(4), 676-686. https://doi.org/10.1016/j.kint.2019.11.037.
Goldstein, N. D. (2017). Improving population health using electronic health records: Methods for data management and epidemiological analysis. CRC Press.
Hu, Y., & Broome, M. (2020). Leadership characteristics for interprofessional collaboration in China. Journal of Professional Nursing, 36(5), 356-363. https://doi.org/10.1016/j.profnurs.2020.02.008.
Keshta, I., & Odeh, A. (2021). Security and privacy of electronic health records: Concerns and challenges. Egyptian Informatics Journal, 22(2), 177-183. https://doi.org/10.1016/j.eij.2020.07.003
Schopf, T. R., Nedrebø, B., Hufthammer, K. O., Daphu, I. K., & Lærum, H. (2019). How well is the electronic health record supporting the clinical tasks of hospital physicians? A survey of physicians at three Norwegian hospitals. BMC health services research, 19(1), 1-9. https://doi.org/10.1186/s12913-019-4763-0.
As an advanced registered nurse, you will serve as a leader within your organization. Part of this role will entail being a change agent and spurring positive change on behalf of patients, colleagues, and the industry.
Consider a situation you experienced previously where change did not go as planned in your health care organization. Create a 10-15-slide PowerPoint presentation in which you will assess the situation and the steps that should have been taken to successfully implement change. Create speaker notes of 100-250 words for each slide. Include an additional slide for the title and references. For the presentation of your PowerPoint, use Loom to create a voice-over or a video. Refer to the study materials for additional guidance on recording your presentation with Loom. Include an additional slide for the Loom link at the beginning and another at the end for References.
Include the following in your presentation:
- Describe the background of the situation and the rationale for and goal(s) of the change. Consider the ethical, social, legal, economic, and political implications of practice change in your response.
2. Outline the advanced registered nurse’s role as change agent within the interprofessional and dynamic health care environment.
3. Identify the key interprofessional stakeholders (both internal and external) that should be involved in change efforts.
4. Discuss an appropriate change theory or model that could be used to achieve results. Explain why the theory or model selected is best for the situation. Include the ethical, social, legal, economic, and political implications of applying the change management strategies to practice change in your response.
5. As an advanced registered nurse, outline how you would initiate the change.
6. Describe the impact to the organization if the change initiative is unsuccessful again, and potential steps the interprofessional team could take if the change is unsuccessful.
7. Predict what additional factors will drive upcoming organizational change for the organization and outline the advanced registered nurse’s role as change agent.
Re: Topic 2 DQ 2
The servant leader in nursing is genuinely compassionate and caring towards employees. This type of leader is inclusive and engaging without being coercive toward personnel (Sherman, 2019). The leader shares governance and responsibilities for the unit and organization. The leader seeks to support staff through empowerment and inspiration. The servant-leader assists employees to resolve problems and supports their professional development. According to Sherman (2019), there are characteristics associated with servant leadership including “listening, empathy, healing, awareness, persuasion, conceptualization, foresight, stewardship, commitment to the growth of people, and building community” (para. 4). These are all qualities that show caring and consideration to others. Many bedside nurses perform exceptionally for their patients utilizing many of these elements up to and including going up the chain of command to advocate for their patients. In nursing, this is a component of the definition of our work. We are tasked within our capacity to assist our patients in achieving healthful outcomes in a caring and empathetic manner that places each patient at the forefront of all care. We utilize limited resources to maximize our performance for the benefit of our patients. Nurses think ahead and foresee potential dangers to our patients. We are persuasive when necessary to attain the help our patients may need. We are interested in the growth and development of our patients through the hospitalization event and onward. We partner with the patient and others to deliver exceptional care. These qualities are utilized for patients who experience an early postoperative complication but are true for the care delivered to all patients.
Sherman, R. (2019). The case for servant leadership. Nurse Leader, 17(2), 86–87.
Topic 3 DQ 1
Describe an organizational change model that can be used in a dynamic health care environment. Based on this model, how is organizational change is managed? What role do stakeholders play during organizational change?
Topic 3 DQ 2
You have been selected to serve on a community outreach committee within your state’s nursing organization. The committee includes registered nurses of different specialties. At your first meeting, it becomes evident that not everyone is in agreement with a recent position statement about the role of spiritual care, with some members arguing they will no longer support the committee if the position statement is not revised or reversed. As a nurse leader and change agent, how would you approach the committee? How could you draw from change theory to address these concerns and encourage collaboration on the committee?
Topic 3 Participation
Topic 3: Organizational Change Theories and Strategies
- Discuss the advanced registered nurse’s role as change agent within the interprofessional health care environment.
2. Analyze factors driving organizational change within health care organizations.3. Evaluate change theories and collaborative models for promoting change.
4. Evaluate the ethical, social, legal, economic, and political implications of practice change.
Topic 4: Nurse Leadership and Health Care Policy and Advocacy
- Propose strategies to support patient advocacy in health care policy making as an advanced practice nurse.
2. Analyze the impact health care policy on health care organizations and cost-effective quality care.
Review Chapter 23 in Advanced Practice Nursing: Essential Knowledge for the Profession.
Leadership in Nursing Practice: Changing the Landscape of Health Care
Read Chapters 11 and 13-15 in Leadership in Nursing Practice: Changing the Landscape of Health Care.
Preparing Nurses for Leadership in Public Policy
Read “Preparing Nurses for Leadership in Public Policy” (2014), located on the Robert Wood Johnson Foundation website.
Arizona State Legislature
Explore your state legislature website and access legislation information. The link to the Arizona State Legislature website is provided, but learners living in other states should access their state departments. This resource will be used for the Topic 5 assignment.
Consumer Information and Insurance Oversight
Re: Topic 2 DQ 2
What differentiates servant leadership from other styles of leadership is the primary focus on the follower first. Most styles of leadership direct their focus first on a mission and second on empowering followers to achieve that mission. Servant leadership directs its focus first on the ability of the individuals to succeed and then on the success of the mission. Servant leaders help their followers to grow and succeed, which in turn aids in accomplishing the organizational mission. The perception of a servant leader should be one of a courageous steward who holds people accountable for their own good. Servant leaders are those individuals who develop and empower others to reach their highest potential. This speaks directly to the individual potential of the followers rather than the organization. Servant leadership assumes that if the followers are maximizing their potential, it will directly translate to the potential of the organization and its overall performance. When servant leadership is applied correctly and with proper intentions, an authentic and natural form of reciprocity takes place between the leader and follower, which in turn increases workforce engagement and improves organizational performance (Gandolfi & Stone, 2018).
Servant leadership includes ten characteristics- listening, empathy, healing, awareness, persuasion, conceptualization, foresight, stewardship, commitment to growth of people, and building community (Gandolfi & Stone, 2018). Communication begins with listening. A servant leader hears what others are saying through both verbal and nonverbal communication and reflect upon what they hear to lead a group to its full potential. Having empathy or understanding and sharing the feelings of followers allow servant leaders to be placed in a position at the level of those followers. Servant leaders are further able to identify the characteristics hat make each individual unique and provide them with the ability to understand how best to support and lead their followers to achieve success in the mission, in this case how the staff nurses respond to their patients’ needs. While the leaders may not always accept the performance or actions of followers, the leader always accept each follower as an individual.
When the servant nurse leader displays a genuine interest in the team and further support through meeting the needs of the team, the quality of care increases within the organization (Thomas, 2018). Listening and empathy displayed by the servant nurse leader to their patients provides for interprofessional communication as the nurse will include the patient and family to identify the patient needs, make decisions regarding the patient’s care, solve problems together, and evaluate the planned treatment.
As a Nurse Manager, I employed servant leadership especially during the annual employee evaluation process. The employee evaluation process simply stated only evaluates if the individual is meeting the expectations of the organization. It lacks personal development features. I created a format that tasked each nurse to assess areas of strengths and opportunities. Then together we discussed strategies to develop those areas. For example, a nurse with two years of experience felt she was not ‘experienced’ enough to consider growth in the department when viewed alongside nurses with more years of experience. A goal we set together was to attend a preceptor course to then begin first mentoring nursing students and later to precept new hire nurses to the department.
A servant leader is a skilled communicator, a compassionate collaborator, a system thinker, and someone who leads with moral authority. Nursing practice and the vocation of nursing lends itself to the servant leadership model through its dedication of service.
Gandolfi, F., Stone, S. (2018). Leadership, Leadership Styles, and Servant Leadership. Journal of Management Research (09725814), 18(4), 261-269. Retrieved from https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?direct=true&db=bth&AN=132968632&site=eds-live&scope=site
Thomas, J.S. (2018). Applying servant leadership in practice. Nursing Leadership and Management: Leading and Serving. 1, Ch. 3. Retrieved from https://lc.gcumedia.com/nrs451vn/nursing-leadership-and-mangement-leading-and-serving/v1.1/#/chapter/3