Discussion: The Inclusion of Nurses in the Systems Development Life Cycle

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Discussion: The Inclusion of Nurses in the Systems Development Life Cycle

In the media introduction to this module, it was suggested that you as a nurse have an important role in the Systems Development Life Cycle (SDLC). With a focus on patient care and outcomes, nurses may not always see themselves as contributors to the development of new systems. Discussion: The Inclusion of Nurses in the Systems Development Life Cycle. However, as you may have observed in your own experience, exclusion of nurse contributions when implementing systems can have dire consequences.

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In this Discussion, you will consider the role you might play in systems development and the ramifications of not being an active participant in systems development.

To Prepare:

Review the steps of the Systems Development Life Cycle (SDLC) as presented in the Resources.
Reflect on your own healthcare organization and consider any steps your healthcare organization goes through when purchasing and implementing a new health information technology system.
Consider what a nurse might contribute to decisions made at each stage of the SDLC when planning for new health information technology. Discussion: The Inclusion of Nurses in the Systems Development Life Cycle.

By Day 3 of Week 9

Post a description of what you believe to be the consequences of a healthcare organization not involving nurses in each stage of the SDLC when purchasing and implementing a new health information technology system. Provide specific examples of potential issues at each stage of the SDLC and explain how the inclusion of nurses may help address these issues. Then, explain whether you had any input in the selection and planning of new health information technology systems in your nursing practice or healthcare organization and explain potential impacts of being included or not in the decision-making process. Be specific and provide examples. Discussion: The Inclusion of Nurses in the Systems Development Life Cycle.

*Please use APA style, no running head or cover page needed. At least three references dated the last 5 years. Please include doi and follow APA style particularly with in-text citations and references.

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NURS 6051C

Involving nurses in each stage of the SDLC when purchasing and implementing a new health information technology system is all about buy-in to innovation and change, a concern that is becoming increasingly important for the organization success. Failing to involve nurses can result in four consequences. Firstly, loss of initial engagement as the nurses’ attention is not grabbed. Secondly, loss of trust in the change process, and implementers experience and competence. Thirdly, difficulty to balance options as the new system introduces competing priorities that reduce the nurses’ interest causing frustration and burnout. Discussion: The Inclusion of Nurses in the Systems Development Life Cycle. Finally, loss of personal connection to the new system since the nurses’ core beliefs and individual goals may not be aligned with those of the organization (French-Bravo & Crow, 2015). Through including nurses in each stage of the SDLC, the nurses’ commitment to the new system will be stimulated through initial engagement. In addition, they will be able to relate the system to care delivery thereby developing a personal connection as they began motivated to help patients and seek to improve care. Also, this empowers them to focus their time and energy on the successful implementation of the new system (Cherry & Jacob, 2016; Stanley, 2017). On the other hand, failing to involve nurses implies that they will have first contact with the system at its implementation. This implies that the nurses did not know any details about the new system prior to its implementation and will only be given a very short period of time familiarize themselves with its operation. Some of the nurses will be unable to attend training on how to use the new system, reducing their capacity to use it and slowing up the workflow. It will not be surprising for some of them to make mistakes, entering random commands into the system and hoping for the best. The result would be the system’s benefits not being realized and being evaluated as a failure (Cherry & Jacob, 2016; Stanley, 2017) Discussion: The Inclusion of Nurses in the Systems Development Life Cycle.

References

Cherry, B. & Jacob, S. (2016). Contemporary nursing: issues, trends, & management. Amsterdam: Elsevier Health Sciences.

French-Bravo, M. & Crow, G. (2015). Shared Governance: The Role of Buy-In In Bringing About Change. OJIN: The Online Journal of Issues in Nursing, 20(2). DOI: 10.3912/OJIN.Vol20No02PPT02. Retrieved http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-20-2015/No2-May-2015/Articles-Previous-Topics/Role-of-Buy-In-In-Change.html

Stanley, D. (ed) (2017). Clinical leadership in nursing and healthcare: values into action (2nd ed.). Hoboken NJ: John Wiley & Sons, Ltd. Discussion: The Inclusion of Nurses in the Systems Development Life Cycle

Portfolio Assignment: The Role of the Nurse Informaticist in Systems Development and Implementation

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Portfolio Assignment: The Role of the Nurse Informaticist in Systems Development and Implementation

Introduction

Advancement in technology and its integration in healthcare to improve safety and efficiency has influenced additional roles and responsibilities to nurses in the field of informatics. A perfect example is the role of a nurse Informaticist who assists system developers to analyze problems and propose solutions in SDLC. The SDLC (Systems Development Life Cycle) describes the steps followed by system developers in designing, troubleshooting and implementing a system.

The entire process requires a systematic problem-solving approach that will provide solutions to an existing problem. As highlighted by McGonigle & Mastrian, (2018), the primary issue addressed by most nurse informacists in healthcare organizations is developing a documentation system that addresses the challenges of nursing documentation. Nurses are the majority in the health workforce and spend most of their time with patients. Therefore, they should be actively involved in developing the information systems used in healthcare organizations for more successful outcomes.

Steps of the SDLC (Systems Development Life Cycle)

The steps of an SDLC vary based on a type of a system being developed. However, the development of a system that supports nursing documentation has five major steps namely: planning and requirements definition, analysis, design, implementation, testing and maintenance (post-implementation) (McGonigle & Mastrian, 2018). Every stage of the cycle must involve nurses to improve chances for success since they are well-informed on the required output. For instance, nurse leaders can guide system developers in each stage of development and ensure that plans developed to identify and address organizational needs. On the other hand, to determine the most appropriate inputs to start development with, a system developer may consider using a reverse system development approach. A nurse informacist can identify and communicate any workflow issues witnessed in the system.

Planning and Requirements Definition

Planning is the most essential tool that guarantees high chances of a successful outcome of any program or operation. In the system development cycle, the lead nurse is responsible for giving a healthcare plan to the system developers. The information provided is used to plan the best approaches for system development. In the requirements definition, a nurse identifies the requirements for formulating specific outputs, which are incorporated into the system (Schoville & Titler, 2015). The system developer will later make plans on how to code the inputs provided.

Analysis

In the analysis stage, the system’s processes and workflows are established. A determination to ascertain whether the requirements provided are met and an evaluation of the processes for potential changes is done. In this phase, nurses can be useful in explaining and discussing the components that were working in the previous system with the system developer (Yen et al., 2017). This will help to determine components that need to be done-away-with or added. Besides, a nurse informacist can discuss with a system developer how to meet these requirements.

Design of the New System

In the design stage, the general look of the system is established. The implementation team makes several decisions including the required type of data. The team generates reports, prototypes, mockups, and screenshots to determine potential hitches that are likely to occur (Thomas, Seifert & Joyner, 2016). In this phase, a nurse Informaticist can scrutinize the developed flowcharts to ensure that they follow the appropriate performance path and display the expected output.

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Implementation

A student nurse who has basic knowledge in programming can apply the five-step approach by Everett Rogers to facilitate adoption and implementation of the system in the following phases: knowledge, persuasion, decision, implementation, and confirmation (Ronquillo, Currie & Rodney, 2016). Since implementation incorporates the use of a specific coding language to code designs, the nurse student can also check the coded flowcharts and assist to troubleshoot the system in case it provides an incorrect output. He/she can also: organize for meetings with staff, obtain feedback from nurses, identify potential facilitators and barriers of the system, make modifications on techniques to evaluate processes, use positive reinforcements to encourage other staff to adhere to the system requirements, track and monitor the rate at which staff comply with the new system and measure outcomes. Ronquillo, Currie & Rodney (2016) suggest that, in the implementation phase, a nurse manager can plan for appropriate training of staff to ensure a successful transition in the implementation of a new system.

Post-Implementation Support

The final phase incorporates testing and maintenance. The system should be tested before its delivery. Testing purposes to ensure that the system provides the appropriate output and solves all the issues it is required to solve. A nurse informaticist can help to ensure that the output given by the system aligns with the requirements of the health system. The system should be able to assist in nursing documentation in roles such as capturing and storing information. A nurse informacist should also organize training to educate other nurses about the system and its usage. As emphasized by McGonigle & Mastrian (2018),  the nurse informaticist should oversee the process of integration into the organization. As a maintenance role, the nurse Informaticist will notify the system developer on required changes where needed.

Conclusion

In today’s highly diverse and well-developed health sector, information technology has an integral role. Ensuring adequacy in nursing processes such as documentation requires a well-developed system that guarantees efficiency. This system should be able to address issues related to the maintenance of nursing processes such as nursing documentation. Steps in SDLC have addressed the burdensome process where nurses were required to manage information manually. When developing a system for nursing documentation or other nursing processes, it is advisable to involve nurses since they are informed on the issues that should be addressed and the expected solutions.

 

References

McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning

Ronquillo, C., Currie, L. M., & Rodney, P. (2016). The evolution of data-information-knowledge-wisdom in nursing informatics. Advances in nursing science, 39(1), E1-E18. DOI: 10.1097/ANS.0000000000000107

Schoville, R. R., & Titler, M. G. (2015). Guiding healthcare technology implementation: a new integrated technology implementation model. CIN: Computers, Informatics, Nursing, 33(3), 99-107. doi: 10.1097/CIN.0000000000000130

Thomas, T. W., Seifert, P. C., & Joyner, J. C. (2016). Registered nurses leading innovative changes. OJIN: The Online Journal of Issues in Nursing, 21(3). DOI: 10.3912/OJIN.Vol21No03Man03

Yen, P. Y., Phillips, A., Kennedy, M. K., & Collins, S. (2017). Nursing informatics competency assessment for the nurse leader: instrument refinement, validation, and psychometric analysis. JONA: The Journal of Nursing Administration, 47(5), 271-277. https://doi.org/10.1097/NNA.0000000000000478

Intermittent Wheezing and Asthma Essay

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Intermittent Wheezing and Asthma Essay

S.C. is a 21-year-old college student. She presents with intermittent wheezing. She has a history of asthma as a child but had been free of symptoms until this year. She has symptoms 1 to 2 days per week but denies nocturnal wheezing. Her symptoms do not interfere with her normal activities. She has never taken systemic corticosteroids and has never been hospitalized for asthma. On physical exam, you observe soft end-expiratory wheezing at the bases bilaterally. Pulmonary function tests today show an FEV1/FVC of 80% with an FEV1 90% of predicted. She has no other medical conditions and and is not taking any nonprescription, prescription or complementary alternative medicines. She has no known environmental or drug allergies. Intermittent Wheezing and Asthma Essay

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DX: Asthma

1. List specific goals for treatment for S.C.

2. What drug therapy would you prescribe? Why?

3. Write prescription for drug therapy prescribed.

4. What are the parameters for monitoring success of the therapy?

5. Discuss specific patient education based on the prescribed therapy.

6. List one or two adverse reactions for the selected agent that would cause you to change therapy.

7. What would be the choice for second-line therapy?

8. What over the counter and/or alternative medications would be appropriate for S.C.?

9. What lifestyle changes would you recommend for S.C.?

10. Describe one or two drug-drug or drug-food interactions for the selected agent.

MUST USE REFERENCE IN TEXT CITATIONS, NURSING JOURNALS ONLY WITHIN 5 YEARS Intermittent Wheezing and Asthma Essay

Adenopathy and vaginal and cervical lesions

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Adenopathy and vaginal and cervical lesions

J.R. is a 36-year-old white, middle class woman who has been sexually active with one partner for the past 2 years. She and her partner have no history of STIs, but her partner has a history of fever blisters. She reports genital pain, genital vesicles and ulcers, and fever and malaise for the last 3 days. Examination reveals adenopathy and vaginal and cervical lesions.

DX: Genital herpes

1. List specific goals for treatment for J.R.

2. What drug therapy would you prescribe? Why?

3. Write prescription for drug therapy prescribed.

4. What are the parameters for monitoring success of the therapy?

5. Discuss specific patient education based on the prescribed therapy.

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6. List one or two adverse reactions for the selected agent that would cause you to change therapy.

7. What would be the choice for second-line therapy?

8. What over the counter and/or alternative medications would be appropriate for J.R.?

9. What lifestyle changes would you recommend for J.R.?

10. Describe one or two drug-drug or drug-food interactions for the selected agent

IN-TEXT CITATIONS AND REFERENCES MUST MATCH. NURSING JOURNALS ONLY WITHIN 5 YEARS.

Community Health Care Agency Discussion Assignment

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Community Health Care Agency Discussion Assignment

At the community health care agency, the assigned nurse reviews with the assigned

student the conceptual foundations and core functions of community health practice

that are integrated into the various roles and settings of community health nursing.

After working at the agency for the day, the student has to prepare an oral report

to present to the class the next day.

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At the community health care agency, the assigned nurse reviews with the assigned

student the conceptual foundations and core functions of community health practice

that are integrated into the various roles and settings of community health nursing.

After working at the agency for the day, the student has to prepare an oral report

to present to the class the next day.

At the community health care agency, the assigned nurse reviews with the assigned

student the conceptual foundations and core functions of community health practice

that are integrated into the various roles and settings of community health nursing.

After working at the agency for the day, the student has to prepare an oral report

to present to the class the next day.

At the community health care agency, the assigned nurse reviews with the assigned

student the conceptual foundations and core functions of community health practice

that are integrated into the various roles and settings of community health nursing.

After working at the agency for the day, the student has to prepare an oral report

to present to the class the next day.

At the community health care agency, the assigned nurse reviews with the assigned

student the conceptual foundations and core functions of community health practice

that are integrated into the various roles and settings of community health nursing.

After working at the agency for the day, the student has to prepare an oral report

to present to the class the next day. Community Health Care Agency Discussion Assignment

IOM Future of Nursing Recommendations Paper

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IOM Future of Nursing Recommendations Paper

In a reflection of 450-600 words, explain how you see yourself fitting into the following IOM Future of Nursing recommendations:

Recommendation 4: Increase the proportion of nurses with a baccalaureate degree to 80% by 2020.

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Recommendation 5: Double the number of nurses with a doctorate by 2020.

Recommendation 6: Ensure that nurses engage in lifelong learning.

Identify your options in the job market based on your educational level.

How will increasing your level of education affect how you compete in the current job market?

How will increasing your level of education affect your role in the future of nursing?

Chemotherapy for breast cancer

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Chemotherapy for breast cancer

B. H. is a 72 year old man who presents for evaluation of several painful red bumps on his left side. The pain radiates around to his chest. The rash resembles blisters that are just forming. He noticed them yesterday and more are forming. His wife is receiving chemotherapy for breast cancer. His laboratory results are all normal and his creatinine is 1.2.

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Dx: Herpes Zoster

1. List specific goals of treatment for J. F.

2. What drug therapy would you prescribe? Why?

3. Write a prescription for the medication prescribed

4. What are the parameters for monitoring the success of this therapy?

5. Discuss specific patient education based on this prescribed therapy

6. List one or two adverse reactions for the selected agent that would cause you to change therapy

7. What would be the choice for second line therapy?

8. What over the counter and alternative medications would be appropriate for J. F.?

9. What lifestyle changes would you recommend to J. F.?

10. Described one or two drug-drug or drug-food interactions for the selected agent.

You must submit ALL parts of the scenario not just one question .

MUST HAVE REFERENCE WITHIN 5 YEARS AND BE NURSING JOURNALS!!

Assignment: Policy/Regulation Fact Sheet: HIPAA Security Rule

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Assignment: Policy/Regulation Fact Sheet: HIPAA Security Rule

Assignment: Policy/Regulation Fact Sheet

As a professional nurse, you are expected to apply your expertise to patient care. On occasion, you will also be expected to share that expertise.

With evolving technology and continuous changes to regulations designed to keep up these changes, there is usually a need to share information and expertise to inform colleagues, leadership, patients, and other stakeholders.

In this Assignment, you will study a recent nursing informatics-related healthcare policy, and you will share the relevant details via a fact sheet designed to inform and educate. Assignment: Policy/Regulation Fact Sheet: HIPAA Security Rule.

To Prepare:

  • Review the Resources on healthcare policy and regulatory/legislative topics related to health and nursing informatics.
  • Consider the role of the nurse informaticist in relation to a healthcare organization’s compliance with various policies and regulations, such as the Medicare Access and CHIP Reauthorization Act (MACRA).
  • Research and select one health or nursing informatics policy (within the past 5 years) or regulation for further study.

The Assignment: (1 page)

Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:

  • Briefly and generally explain the policy or regulation you selected.
  • Address the impact of the policy or regulation you selected on system implementation.
  • Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow.
  • Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific. Assignment: Policy/Regulation Fact Sheet: HIPAA Security Rule

 

No Running Head. APA style. Please ensure intext-citations and references are up to APA style. No references older than 5 years. Please include doi for any references dated after 2013.

 

HIPAA Policies

The Health Insurance Portability and Accountability Act (HIPAA) is a federal privacy rule that protects individuals from specific health information that is identifiable. The rule permits, though not obligates, covered healthcare providers to avail to their patients, the option to disclose their health information for specific purposes. The specific purposes include health care operations, payment, and treatment (DHHS, 2019). Assignment: Policy/Regulation Fact Sheet: HIPAA Security Rule

Impact of HIPAA on System Implementation, Clinical Care and Workflow

HIPAA protects privacy at different levels. Chen & Benusa (2017), note that breaches in healthcare data can cause adverse social and personal impacts for patients as well as their families. These breaches can incur large monetary costs that can affect both the Wall Street as well as health care organization investors (Jackson, 2015). Implementation requires that management and protection of private data should encompass machine learning and AI, allow for anonymization of healthcare genomic data while preserving utility; and ensure sensitive data does not leak.

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HIPAA protects patients and in some cases, healthcare provider information. The ‘seven habits’ format for ensuring that HIPAA guidelines are in compliance when delivering services and for workflow are used. The seven habits include documenting the policy and controlling the environment; assigning appropriate oversight for compliance management; ensuring compliance through communication and training; implementation of regular auditing, monitoring, and control; consistent enforcement of control environment; regular screening of personnel; and preventing and responding to gaps and incidence (Joshi, 2008) Assignment: Policy/Regulation Fact Sheet: HIPAA Security Rule. Figure 1 shows a representative workflow

Source: Joshi, (2008)

 

Organizational Policies and Procedures

The healthcare institution will ensure that it develops, adopts, and implements the HIPAA privacy and security procedures and policies by first documenting the same. This will include taking steps when a breach takes place and appointing a security and privacy officer. The officer will need to be well-versed with the HIPAA policies and regulations. Regular assessments for risks will be conducted at random times and frequencies, to identify if any vulnerabilities exist. Doing so will ensure that integrity and confidentiality are maintained with regard to health information. If any risks are identified, remediation and policies’ revision will be done if necessary. Any breaches that are identified will be documented and investigation results notified to relevant authorities. Additionally, all email containing health information and requested by a patient will be encrypted and patients made aware of the purpose of encryption in protecting their privacy. Portable devices containing health information will be regulated with regard to their removal from the healthcare facility Assignment: Policy/Regulation Fact Sheet: HIPAA Security Rule. Additionally, a Notice of Privacy Practices will be published and displayed on the healthcare facility’s website and also made available for distribution to the patients.
Reference

Chen, J. Q., & Benusa, A. (2017). HIPAA security compliance challenges: The case for small healthcare providers. International Journal of Healthcare Management, 10(2), 135-146.

Department of  Health and Human Services (2019). Summary of the HIPAA Security Rule. https://www.hhs.gov/hipaa/for-professionals/security/laws-regulations/index.html

Jackson, J. (2015). The Costs of Medical Privacy Breach. MD advisor: a journal for New Jersey medical community, 8(3), 4-12.

Joshi, S. (2008). HIPAA, HIPAA, Hooray?: Current Challenges and Initiatives in Health Informatics in the United States. Biomedical informatics insights, 1, BII-S2007.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4943069/#!po=8.33333    Assignment: Policy/Regulation Fact Sheet: HIPAA Security Rule

RN education and patient outcomes

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RN education and patient outcomes

There was a cross-sectional study conducted in 2013, with the use of data from 21 University Health System Consortium hospitals,that analyzed the association between RN education and patient outcomes. The results from this study showed that Hospitals with a higher percentage of RNs with baccalaureate or higher degrees had lower congestiveheart failure mortality, decubitus ulcers, failureto rescue, and postoperative deep vein thrombosis or pulmonary embolism and shorter length of stay. This particular article stated that how studies dating back to 2002, linked the percentage of RNs in a hospital with baccalaureate degrees to decreased patient mortality (in-hospital and 30-day mortality, failure to rescue) However, other studies have not found significant relationships between mortality and nursing education. It further mentinoed how the few studies that examined the impact of baccalaureate education on other patient outcomes, particularly those that are considered sensitive to nursing care, did not find beneficial effects. This study also mentioned how the ducation of RNs did not affect hospital-acquired infections once other characteristics were controlled, whereas nurse staffing levels did (Blegen, Goode, et al, 2013).

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Looking back on real life experiences, one thing I have observed is that some of the BSN prepared nurses that I have worked with were more skilled at critical thinking that the ADNs which now I can see why after being in this program which requires much more research. The BSN prepared Nurses are more detailed oriented in assessments and charting as well.

Begen, M, Goode, C, Park, S et al (2013). Baccalaureate Education in Nursing and Patient Outcomes. Retrieved 9/19/2017 from  http://www.aahs.org/aamcnursing/wp-content/uploads/Baccalaureate-Education-in-Nursing-and-Patient-Outcomes.pdf

Patient Education: Proper use of Emergency Department Leadership Learning Experience essay

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Patient Education: Proper use of Emergency Department Leadership Learning Experience essay

A.1.  The problem I identified revolves around educating patients on the proper use of benefits and services, mainly the use of the Emergency room as primary care. I work as a nurse Care Manager and find it quite difficult to get patients to stay out of the Emergency room for non-emergent needs. As a Care Manager I believe it would be beneficial to address the educational needs of the patients as it relates to disease management and the proper use of benefits and services. Thereby; decreasing the use of the Emergency room as primary care.

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  1. Patients who don’t have a primary care doctor will most often use the Emergency room as primary care. According to the New England Healthcare Institute (March, 2010) “The overuse of U.S. emergency departments (EDs) is responsible for $38 billion

in wasteful spending each year.” The overuse of the Emergency department can cause a ripple effect in the type of care the patient receives. As a Care Manager my goal is to make sure there is continuity of care for the patient. If the patient continues to utilize the ER, it makes it difficult to ensure continuity, in that it’s difficult to keep up with all of the prescribing doctors. New England Healthcare Institute (March, 2010) Patient Education: Proper use of Emergency Department Leadership Learning Experience essay

 

2.a. My investigation included the use of articles available via Ebscohost as well as the getting the view of my resource person within my department. The source in my department stated that” early intervention with patient follow and being able to answer questions patients may have concerning newly prescribed medications after a visit to the ED, helps to decrease the chance of the patient going back to the ED to seek care”.  One article in particular titled, Office- Based patient education decreases non-emergent emergency department visits (2011) stated that “patient education appears to have resulted in a statistically significant meaningful decrease in Emergency room visits”. Their research showed that timely follow up with the patient, educating the patient on disease/symptom management and educating the staff on how to triage the calls, showed a 6.2% decrease in ED visits from the pre-intervention of 6.83%.  Adesara, R., Spencer, J. P., & Bost, J. E. (2011)

 

 

  1. As stated above the use of the ED resulted $38 billion in wasteful spending in the U.S each year; NEHI (March, 2010). According to NEHI (March, 2010) Some of the root causes for the overuse of of the ED revolved around patients not having access to timely primary care, the ED being convenient because of the after hours and weekend care, and often times the primary provider will refer the patient to the ER Patient Education: Proper use of Emergency Department Leadership Learning Experience essay. The annual number of emergency department visits in the United States increased nearly 20%, from the 96.5 million to 115.3 million over a 10 year period ending in 2005. NEHI (March, 2010)

 

 

  1. Contributing to problem includes lack of patient education on the proper use of benefits and services as well as access to care. Patients are likely to use the ED when they can’t access their primary care provider. According to NEHI (March, 2010) patients feel as if the ED is easily accessible as compared to regular clinics or primary care settings. The ED is open 24/7 365 days a year, whereas; primary care clinics are limited to the availability in the hours and or days to which they are open. Also it has been stated previously that primary care provider will often refer their patients to the ED for issues that may be deemed as non-emergent. NEHI (March, 2010)

 

 

  1. Implementing Case Managers can help to decrease the number of patient who repeatedly use the ED. This is done by Case Management collaborating with the different providers to assess and create a care plan for the patient. This study found that the average number of yearly patient emergency department visits decreased from 26.5% to 6.5% following the implementation of Case Management.NEHI (March, 2010). Also providing patients with educational materials and empowering them through education to manage their own conditions, where appropriate, showed a reduction in ED usage. Patients who are able to access care and receive information related to their condition, offers the patient reassurance which may ED visits. New England Healthcare Institute (March, 2010) Patient Education: Proper use of Emergency Department Leadership Learning Experience essay

 

 

  1. As stated above implementing Case Management and educating the patients can reduce the percentage of patients who seek care in the ED from 26.5% to 6.5% on the average yearly basis.NEHI (March, 2010)

 

 

  1. Resources include disease specific management information sheets, and letters informing patients on how to properly access to assist in education. Also providing patients with access to things like telehealth, same day appointments, telephone access to after and urgent care facilities may also help to reduce the number of patients who seek care from the ED Patient Education: Proper use of Emergency Department Leadership Learning Experience essay. Also can offer patients Healthy incentives, the patient would earn points for each time they visited their PCP and completed follow-up appointments. These points can lead to $10 gas cards, gift cards or a waving of the office co-payment. NEHI (March, 2010)

 

  1. According to the Journal of healthcare management (2013) “healthcare cost decreased by an average 0f $1,042” per person per ER visit for patients had some type of intervention i.e patient education or were exposed to case management”. While that number may seem minimal compared to the overall yearly cost of $38 billion as stated earlier, it is a step in the positive direction. Enard, K. R., & Ganelin, D. M. (2013)

 

  1. The first step in helping to implement my proposal would be to utilize the admission system in my organization to alert me when patients of a particular PCP comes to the ER. Once a pattern has been established, I would then contact that PCP and see how as a care manager I can assist with the care of the patients who utilizes the ED as a primary care option. After receiving the green light from the PCP, I would then begin outreach to those patients who have identified to engage them in care management services. Once the patient is engaged, the Case manager, PCP and patient will come up with a plan of care to assist the patient with management of their condition, thereby; decreasing their need to use the ER. The total process should completed with 90 days.

 

  1. Primary key stakeholders would include the patient/patient’s family, physician, case manager and any other specialist the patient may be receiving care from. Other stakeholders may include ED department and hospitals Patient Education: Proper use of Emergency Department Leadership Learning Experience essay. By decreasing the use of the ED for non-emergent needs a decrease in the ED wait times, patient to staff ratio in the ED, and overcrowding may be prevented. New England Healthcare Institute (March, 2010)

 

 

  1. The patient and the care providers are instrumental in the process, in that compliance from all parties involved will provide for better care for the patient and allows for continuity, Thereby; decreasing the need to seek care in the ED. The care manager’s role would consist of educating the patient and making sure all of the pieces of the puzzle fit.

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  1. Summarize your engagement with the key stakeholders and/or appropriate partners, including the input and feedback you received.

 

  1. Working with the key stakeholders would initially involve a meeting to discuss the plan of care for the patient. After the initial contact weekly to bi-weekly contact will be made via telephone to address any questions or concerns the patient may have and to update the PCP and/or specialist on the patient’s care team. I would also explain to them the importance of continuity of care and how important it is to prevent a lapse in care.

 

  1. The first step in helping to decrease the use of the ED as a source of primary care would be to identify those patients who are considered high risk or repeat offenders. Once those patients are identified working with the primary care provider and patient; as a team we would create a plan of care which includes access to care and education on disease/symptom management Patient Education: Proper use of Emergency Department Leadership Learning Experience essay. Those patients considered high risk will be followed by Case management from 30-90 days to continually reinforce the importance of following the plan of care and receiving their care from their primary care providers. New England Healthcare Institute (March, 2010)

Discuss how your proposed solution or innovation could be implemented.

 

  1. The implementation will be evaluated by a decline in the notifications received from the admission system alerting the case manager to patients going to the ED and by keeping a log of patients who are being case managed to see if there is a decrease in their usage or an increase in their PCP visits.

 

  1. 1. As the scientist I had to research articles and journals to review data and statistics pertaining to my topic of choice.

 

  1. As a detective I had to identify the key stakeholders, identify the problem and come up with a solution to the proposed problem. I also had to identify a resource person within my organization who would be willing to help me implement my proposal.

 

  1. As the manager of the healing environment I would implement the practices learned throughout my research on a daily basis with the patients who have been identified as those needing care management. By working closely with the patients I have a chance of effectively changing the patient’s views on how to access care and by overall changing their views as it relates to their healthcare needs Patient Education: Proper use of Emergency Department Leadership Learning Experience essay.

 

 

  1. Submit the completed attached “Professional Verification Form” from the organizational leader advising you in your leadership experience.

 

  

 

D.

 

Enard, K. R., & Ganelin, D. M. (2013). Reducing Preventable Emergency Department Utilization and Costs by Using Community Health Workers as Patient Navigators. Journal Of Healthcare Management, 58(6), 412-427.

 

 

New England Healthcare Institute (March, 2010) A matter of urgency;Reducing Emergency Department overuse; Retrieved from: http://www.nehi.net/writable/publication_files/file/nehi_ed_overuse_issue_brief_032610finaledits.pdf

 

 

 

Suffoletto, B., Hu, J., Guyette, M., & Callaway, C. (2014). Factors contributing to emergency department care within 30 days of hospital discharge and potential ways to prevent it: differences in perspectives of patients, caregivers, and emergency physicians. Journal Of Hospital Medicine, 9(5), 315-319. doi:10.1002/jhm.2167

 

 

 

Adesara, R., Spencer, J. P., & Bost, J. E. (2011). Office-based patient education decreases non-emergent emergency department visits. The Journal Of Medical Practice Management: MPM, 27(3), 131-135. Patient Education: Proper use of Emergency Department Leadership Learning Experience essay