NURS 6421: Supporting Workflow in Healthcare Systems 

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NURS 6421: Supporting Workflow in Healthcare Systems 

NURS 6421 Entire Course Weekly Discussions And Assignments

NURS 6421 Week 1: Introduction to the Systems Development Life Cycle (SDLC)

The health of our population is dependent on the quality of our health care system. Consequently, the term “health care reform” is a hot topic in politics, the news, and even general conversation. Much of the current debate about health care reform centers on managing the cost, quality, and accessibility of care. These issues can be improved within individual health care organizations through workflow redesign, the implementation of informatics, and the use of the systems development life cycle (SDLC).

This week, you explore the SDLC and how it is handled within health care organizations. You also examine the role of the nurse informaticist and how this position is intertwined with the SDLC in health care.

Learning Objectives

Students will:

  • Assess the effectiveness of the systems development life cycle (SDLC) in an organization
  • Assess the role of the nurse informaticist
  • Explain the relationship between nurse informaticists and the SDLC

NURS 6421: Supporting Workflow in Healthcare Systems

The systems development life cycle (SDLC) is a model for planning and implementing change within an organization. It is important for many individuals to be represented in the process, especially the end users of the system or the employees who must live with the change. As informatics become more and more widespread throughout the health care field, collaboration between information technology (IT) professionals and health care practitioners is becoming increasingly important. The nurse informaticist is able to combine the perspective of the information technology side with the clinical nursing perspective.

While the titles and specific responsibilities of nurse informaticists vary across organizations and practice settings, the fundamental purpose of the role remains the same. Nurse informaticists synthesize their knowledge of how technology can improve health care with an understanding of clinical practice and workflow. This is why nurse informaticists can be instrumental in facilitating the SDLC for informatics in health care. For this Discussion, you examine the relationship between the nurse informaticist and the use of the SDLC.

To prepare:

  • Review the information in this week’s Learning Resources on the SDLC and the role of the nurse informaticist. Reflect on Chapter 1 of the Dennis, Wixom, and Roth course text and consider how the information about the systems analyst role translates into nursing and health care.
  • Consider a recent change in your organization related to the implementation of a new technology or system. How was this change handled? What was the general SDLC process? Who was involved, and what were the outcomes?
  • Identify whether your organization (or one with which you are familiar) has a formal title or position for the nurse informaticist. This position may be called by a different name, such as nurse informatics specialist or informatics analyst, so be sure to review the position description.
  • If your organization has a position for the nurse informaticist, what are the responsibilities of that position? If your organization does not have such a position, conduct research in the Walden Library and at credible online sources on the role of the nurse informaticist.
  • Reflect on the role of the nurse informaticist in the overall health care field. How is this position connected to the SDLC? Assess the benefits of having this specialized position within health care organizations and involving the nurse informaticist in the SDLC.

By Day 3

Post a description of how the systems development life cycle is utilized in your organization, or in one with which you are familiar, and assess its effectiveness. Assess the role of the nurse informaticist in your organization. If the nurse informaticist is not a current position within your organization, provide a description of the generally accepted role of the nurse informaticist based on this week’s Learning Resources and your own research. Explain why it is important for the nurse informaticist to be involved in the SDLC process and the overall organizational benefits of having such involvement.

Read a selection of your colleagues’ responses. Focus particularly on those questions raised to which you can add comments based on shared experiences or situations. Consider how your colleagues’ postings reflect and/or differ from your own perceptions and opinions.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

  • Ask a probing question, substantiated with additional background information, evidence, or research.
  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

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NURS 6421: Supporting Workflow in Healthcare Systems

NURS 6421 Week 2: Clinical Decision Support

In May, 2011, Deborah Kogan’s 4-year-old son Leo came down with a fever. When the fever lasted for several hours and Leo’s face started to look puffy, Deborah took him to the pediatrician, who tested Leo for strep throat and then sent him home. The strep test came back negative, but a few days later, according to his mother, Leo’s face had swelled to about twice its normal size. She posted a picture of Leo on Facebook, and within a few hours she started receiving comments from friends and acquaintances who thought Leo might have Kawasaki disease. Deborah rushed Leo to the hospital where doctors confirmed this diagnosis and treated Leo for the disease (NPR, 2012).

Although this story ended well and Leo made a full recovery, it highlights a major concern in health care. For medical conditions that are rare, emerging, or that share symptoms with other conditions, physicians or nurses run a risk of misdiagnosing or failing to diagnose a patient at all, as in Leo’s case. This has significant implications not only for patient outcomes, but also for health care organizations and the public’s faith in the health care system. Fortunately, there are many emerging health care technologies and clinical decision support (CDS) systems that can reduce the likelihood of misdiagnosis, patient injuries, liabilities, and other risks.

This week, you explore the use of CDS systems in health care practice settings.

Learning Objectives

Students will:

  • Analyze the requirements and guidelines that influence the design of clinical decision support (CDS) systems
  • Analyze the benefits and potential problems of CDS systems in health care practice settings

NURS 6421: Supporting Workflow in Healthcare Systems

Clinical decision support (CDS) systems refer to a variety of computer-based tools and software that health care professionals, including nurses, can use to inform the choices they make at the point of care. CDS systems are informatics tools that are aimed at increasing the effectiveness and quality of health care by connecting evidence, best practices, and knowledge with decisions made in the practice setting. Because of its focus on improving outcomes, CDS is included as one of the core components of meaningful use in the Health Information Technology for Economic and Clinical Health (HITECH) Act.

In this Discussion, you analyze the elements that can influence the design of a CDS system. You also assess the benefits of CDS and identify challenges that may occur in practice related to a CDS system.

To prepare:

  • Review the information in this week’s Learning Resources on CDS systems. Reflect on why and how these systems are used in health care organizations and specific practice settings.
  • Search in the Walden Library for an article on a specific CDS system that has recently been researched, implemented, or evaluated. The article you select must have a publication date within the past 3 years.
  • Consider the requirements and guidelines (meaningful use, evidence-based practice guidelines, organizational regulations, core measures, etc.) that influenced the design of the CDS system.
  • Reflect on the benefits of using this CDS system in a practice setting. Why would an organization implement this specific system? What organizational, legal, or practice-related needs or issues does the system address?
  • Reflect on the practice-related problems that the system caused or could cause. For example, do you see an issue with alert fatigue, with too few alerts, with override capabilities, or with some other aspect of the system?

By Day 3

Post a brief summary of the CDS system highlighted in the article you selected, including the practice setting in which it can be or was used and the requirements and guidelines that influenced its design. Explain the benefits of the CDS system to the practice setting. Identify potential problems that could or did arise related to the CDS system.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days. Provide any additional insights you may have on the benefits and potential problems of the CDS system they described. Then propose at least one way the system could be revised to address the potential issues.

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NURS 6421 Week 3: Gap Analysis, Part 1

Take a moment to reflect on your experiences working as a nurse. Have you ever encountered a process that you thought was inefficient and could be done in a better way? As a result of the knowledge you have gained in your MSN coursework, you may have noticed many things in your own practice setting that could be improved using new technologies, informatics, best practices, research evidence, etc. Every time you notice something that could be improved to support better outcomes, you are identifying a “gap.”

In this week you begin to explore the process of gap analysis. You also investigate how the Health Information Technology for Economic and Clinical Health (HITECH) Act and its criteria for the meaningful use of electronic health records (EHRs) can be used to help identify gaps. In addition, you begin working on your Course Project by selecting a workflow issue or gap in your own health care setting.

Learning Objectives

Students will:

  • Analyze gaps in workflow related to meaningful use
  • Develop a Gap Analysis Plan for a specific workflow issue
  • Analyze the integration of evidence-based practice resources and clinical guidelines within a CDS system
  • Analyze the benefits and challenges of CDS systems in health care practice settings

Workflow is a term used to describe the interconnected steps and processes that nurses and other health care professionals complete on a day-to-day basis. Many existing workflows contain inefficiencies and areas that could be improved using new technologies or evidence-based practice. Workflow issues are often referred to as “gaps” because they indicate a disparity between the current state and the optimal, future state. Many gaps in health care exist related to the implementation and optimization of electronic health records (EHRs). The Health Information Technology for Economic and Clinical Health (HITECH) Act was passed in 2009 to assist organizations in identifying these gaps and encouraging the “meaningful use” of EHRs. The meaningful use objectives seek to fulfill the IOM six aims of patient care (patient-centered, timely, effective, efficient, equitable, and safe).

In this Discussion, you examine scenarios that feature workflow issues related to the HITECH Act and its meaningful use objectives. You identify specific workflow gaps and consider how you would conduct a gap analysis to gather more information about the gaps. This Discussion allows you to explore workflow gaps and meaningful use objectives to prepare you for completing the Course Project, which is also centered on workflow gaps and their relevance to meaningful use objectives.

Scenario 1:

Stephanie is a nurse practitioner at Central Care Hospital who is often involved in administering prescribed medications for patients in the general care ward. When a physician sees a patient, he or she uses the hospital’s EHR system to document findings and recommendations for treatment, but submits medication and drug orders by faxing prescriptions to the hospital’s pharmacy. Before Stephanie administers the medications from the pharmacy, she must cross-check the medication and dosage with the physician’s notes and patient information in the EHR system. In doing so, Stephanie often identifies problems with the medication the physician prescribed; patients are sometimes prescribed a medication to which they have a known allergy or one that conflicts with another medication they are currently taking. In addition, the pharmacy sometimes sends the wrong medication or the wrong dosage. Furthermore, for patients who have been transferred from other parts of the hospital such as the intensive care unit or the maternity ward, Stephanie often encounters duplicate drug orders or incorrect medications sent from the pharmacy.

Scenario 2:

General Health Hospital is implementing new outreach programs and preventive care support groups for patients with certain conditions or health risks such as diabetes, smoking, and obesity. Philip, a nurse leader, is the manager of a team of nurses who have been asked to organize these programs and groups and to identify patients who would be eligible for and interested in being involved in these opportunities. However, Philip and his team have run into a variety of challenges and problems as they attempt to complete these tasks. In identifying patients to contact about the outreach programs and support groups, Philip’s team has had to browse the hospital’s EHR system. The team has also run across significant holes in the EHR system as they try to contact patients; many patients’ contact information is inaccurate or out of date. Furthermore, Philip’s team has partnered with the hospital’s Appointments Desk personnel in sending reminders about meeting dates and times to patients who express interest. However, the Appointments Desk often either neglects to send out these reminders or sends duplicate reminders to only a few patients because the personnel do not have a way of tracking who should be contacted and when.

Scenario 3:

Robert works in the medical records office at Garden View Hospital. Because the hospital does not have a policy of providing clinical summaries to patients after each visit, Robert frequently receives calls from patients requesting copies of their health information (such as test results, vital statistics, diagnostic information, and medication lists and dosages). For every request, Robert must retrieve the patient information from the hospital’s EHR system, print out hard copies of the records, and then either mail the records or wait for the patient to retrieve them in person. Additionally, Robert’s hospital often receives lab test results for patients from certified third party providers. These results are not automatically transferred from the provider’s EHR system to the hospital’s EHR system, so Robert often must contact the providers before responding to a patient’s request. Robert also finds that he and his colleagues in the office spend a considerable amount of time printing, mailing, and faxing immunization records to patients’ workplaces, schools, and volunteer organizations, which can be disruptive to the office’s other responsibilities.

To prepare:

  • By Day 1 of this week, your Instructor will have assigned you to respond to a specific scenario. Review this week’s Learning Resources on workflow, gap analysis, and meaningful use, and consider how they connect to the scenario you were assigned.
  • Determine the most prominent workflow gap you see in the scenario you were assigned. Where does the gap lie, what factors contribute to the gap, and what are the consequences of the gap?
  • Explore how this gap relates to one meaningful use objective. Refer to the articles in this week’s Learning Resources for more information on meaningful use.
  • If you were involved in the scenario, consider how you would go about conducting a gap analysis to gather more information about the gap you identified, and determine possible strategies for addressing the gap. How would you gather data? Who would you contact, interview, and/or observe? How would you determine strategies for addressing the gap?

Note: Before you submit your initial post, replace the subject line (“RE: Discussion – Week 3) with “Review of Scenario ___.” Fill in the blank with the number of the scenario you reviewed.

By Day 3

Post an explanation of the most prominent workflow gap in the scenario you were assigned, including who is responsible for the gap and the outcomes or consequences. Identify the meaningful use objective to which the gap relates, citing specific points in the Brown article. Explain how you would conduct a gap analysis to gather further information and determine strategies for addressing the gap.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who responded to a different scenario than you did. Provide any additional insights you may have on the main workflow gaps and how you could conduct a gap analysis. Identify additional meaningful use objectives that might also be related to the scenario.

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NURS 6421: Supporting Workflow in Healthcare Systems essay help

NURS 6421 Week 4: Gap Analysis, Part 2

Think about the last time you bought a new car. You probably researched online and read about a number of different cars. You asked friends for advice and then reviewed performance ratings, style, and special features you hoped to add. You probably even had an idea of a fair price before you ever went to a car dealership. Advanced planning helps ensure you are satisfied with the final results and are not faced with unexpected, poorly researched decisions made at the last minute.

Before you undertake any large-scale project or endeavor, it is a good idea to first gather outside information from a variety of sources, including colleagues, peers, experts, reference books, journal articles, and so on. Doing so not only provides you with a broader understanding of the issues at hand and the scope of the project but also can help you revise and refine your project and what you hope to accomplish. In gap analyses, workflow redesigns, and informatics implementations, nurse informaticists can gain valuable insights from the perceptions of others, both in and outside of their practice settings.

This week, you continue to develop and refine the workflow issue you plan to use for your Course Project. You share your workflow issue with your colleagues in this course to gain their perspectives on meaningful use objectives and how well the issue meets the requirements for the Course Project. This week, the Instructor also reviews your workflow issue and provides feedback on how it can be revised or refined.

Learning Objectives

Students will:

  • Analyze a specific workflow issue in a health care organization
  • Analyze the connection between workflow issues and meaningful use objectives

Have you ever carefully edited a paper you have written and then, when it is proofread by someone else, he or she finds a glaring typo? Sometimes we get so close to a project that we may fail to notice important details. The complexity of health care processes means that there can be a number of different gaps and varied areas of inefficiency in a single workflow. This is why it can be beneficial to get an outsider’s perspective on workflow issues you are investigating.

In this Discussion, you outline the workflow issue you plan to use for Part 1 of the Course Project in order for your colleagues to provide their perspectives and feedback. This Discussion serves as an opportunity for you to refine you workflow issue before submitting Part 1 of the Course Project in Week 5. It also builds on the Week 3 Discussion, which provided you with general information about meaningful use and its ties to common workflow issues in health care. You will apply that knowledge in this Discussion by critically analyzing your colleagues’ selected workflow issues, which will assist you in gaining a stronger grasp of the Course Project.

The Instructor in this course will also respond to your preliminary workflow issue and provide guidance for any necessary revisions or refinements you should make to better meet the requirements for the Course Project.

To prepare:

  • Reflect on the workflow issue that you are planning to use for Part 1 of your Course Project. Consider the inefficiencies and gaps based on your preliminary knowledge about the workflow.
  • Examine how the workflow issue relates to electronic health records (EHRs). How could the workflow issue be addressed through either the implementation or optimization of an EHR system?
  • Identify one or more specific meaningful use objectives that connect to your workflow issue. Refer to the Learning Resources in Week 3 for a review of the meaningful use objectives.
  • Review your initial thoughts on how you will conduct a gap analysis (your Gap Analysis Plan paper). What information will you need to obtain about the current-state workflow? How will you gather this information, and who will you consult in your organization?

With these thoughts in mind:

By Day 3

Post a description of the workflow issue you plan to use for your Course Project. Describe where the inefficiencies lie based on your current knowledge about the workflow, and identify the meaningful use objective(s) related to the workflow issue. Provide a brief overview of your plans for conducting a gap analysis, including your data-collection methods and who you will contact in the organization.

Note: As you write your initial posting, keep in mind that you will revisit this workflow issue throughout the Course Project, so you are not expected to have a perfectly structured and finalized workflow issue. It is understandable that your workflow issue may evolve throughout later weeks of this course as you gain new knowledge and gather more information about the workflow. This is the reality of the systems development life cycle (SDLC)—it is an iterative process in which later steps often help to inform and clarify earlier efforts in the process. Consider your workflow issue a living, developing element that has the potential for later growth and change.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days. Analyze the workflow issue your colleague selected and identify areas that are unclear or will need to be investigated as your colleague conducts the gap analysis. Analyze the workflow issue’s connection to meaningful use and whether or not it meets the requirements for the Course Project.

Note: You must obtain Instructor approval for your workflow issue and data-collection methods after completing this Discussion.

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NURS 6421 Week 5: Workflow Modeling

Maps, diagrams, and models are useful because they can capture the intricacies of complex systems and concepts in a simple, manageable way. For example, a road map illustrates the placement of streets and landmarks in relation to each other to allow drivers to better navigate unfamiliar territory. Similarly, workflow models can be used to show the interconnected steps that relate to a specific health care process or task and enable nurse informaticists to identify and analyze gaps.

This week you explore how workflow models are created and used in the health care field. You analyze the importance of accuracy and clarity in workflow modeling, and you consider strategies for creating more effective workflow models. Part 1 of the Course Project (Gap Analysis Plan) is due in this week. In addition, you may begin working on Part 2 of the Course Project.

Learning Objectives

Students will:

  • Evaluate a workflow model for accuracy and clarity
  • Analyze the importance of accuracy and clarity in workflow modeling
  • Formulate strategies for overcoming challenges to workflow modeling in health care
  • Develop a Gap Analysis Plan for a specific workflow issue
  • Develop a workflow model draft using Visio

Workflow modeling is widely used throughout many different types of businesses, including health care organizations, to visually summarize the steps of complex processes and systems. When constructing a workflow model, it is important to ensure that the model accurately reflects the actual steps in a process.

In this Discussion, you consider a case study of a health care clinic and its process for ordering medical supplies. You then examine a workflow model that is meant to reflect that process and analyze the model’s accuracy based on the information in the case study. You also analyze the importance of accurate workflow modeling and consider strategies for creating accurate workflow models for health care processes.

Case Study:

Deerborne Dialysis is a local dialysis clinic that is part of a larger health care network, Buckeye Health. Buckeye Health executives have recently been examining the processes by which organizations within the network manage their supplies. Deerborne Dialysis was identified as an exemplary model of efficient supply management, and Buckeye Health executives have requested a workflow model of how Deerborne Dialysis handles their supply management process.

Sharon is the nurse who oversees the process of ordering and stocking supplies for Deerborne Dialysis. She knows the process well and developed a description of the steps in the supply management process. First, Sharon conducts a daily check of the supplies in the storage room. If there is a supply that is running low, Sharon submits an order to the medical supplier. When the clinic receives the shipment, Sharon unpacks the shipment and cross-checks the supplies that were shipped with the supplies that were ordered. If there is a discrepancy, the entire shipment must be returned to the medical supplier, who then rushes a new shipment to the clinic to be received the next day. If there is no discrepancy, or once the new shipment is received, unpacked, and cross-checked, Sharon stocks the shelves in the storage room and gives the supply bill to the clinic’s accountant, who ensures that the medical supplier receives payment.

Sharon has created the following workflow model to reflect the steps she goes through to manage the clinic’s inventory of supplies:

 

To prepare:

  • Review the case study above and examine the workflow model that is meant to reflect the process described in the case study.
  • Identify problems with the workflow model. How could the model be revised to be more accurate, clear, and effective?
  • Reflect on the importance of creating an accurate workflow model of health care processes. What are the challenges involved in workflow modeling? What are the consequences of inaccurate workflow models?
  • Consider strategies that you can use to ensure that workflow models are effective and accurate.

With these thoughts in mind:

By Day 3

Post a summary of at least three specific problems you identified in the workflow model. Describe how the model could be revised to address those problems. Analyze the importance of accuracy and clarity in workflow modeling, and describe at least one strategy you plan to use to ensure that the workflow models you create are accurate and clear.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days. Provide any additional thoughts you have on the issues with the workflow model from the case study and the importance of accurate workflow modeling. Offer at least one additional strategy to your colleagues’ postings that could promote more accurate, effective workflow modeling for health care processes.

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NURS 6421: Supporting Workflow in Healthcare Systems

NURS 6421 Week 6: Examine the Current Workflow

As clarified last week, having an inaccurate workflow model can be worse than having no model at all. Can you image trying to follow a map that failed to include all of the streets in an area or even added a few that did not exist? If you use an inaccurate workflow model to determine workflow issues and their corresponding solutions, you may find yourself trying to implement solutions to problems that do not even exist! Because of the vital importance of clear and accurate workflow modeling, reviewing and critiquing that model is a crucial step that can prevent many unintended negative consequences.

This week, you complete a peer review of one another’s current-state workflow models and provide feedback on how the workflow model can be more effective in illustrating the current state. You also continue working on Part 2 of the Course Project, in which you conduct your gap analysis, summarize the results, and finalize your current-state workflow model in Visio.

Learning Objectives

Students will:

  • Evaluate current-state workflow models in health care settings

NURS 6421: Supporting Workflow in Healthcare Systems

In the Week 4 Discussion, you explored the benefits of gaining an outsider’s perspective on a workflow issue or gap you are investigating. It can be equally beneficial to request feedback from others on the accuracy and clarity of a workflow model.

In this Discussion, you and your colleagues critique one another’s Visio drafts of your workflow models that you created for Part 1 of the Course Project and provide feedback on how to make the workflow model more complete. You also receive feedback on your own workflow model and consider additional information that you may need to collect as you conduct your gap analysis.

To prepare:

  • By Day 1 of this week, your Instructor will have assigned you to review two colleagues’ Visio drafts. Locate these drafts in Doc Sharing.
  • Examine each workflow model using the basic requirements outlined in the Course Project. Consider the following:
    • Does each draft use standard Visio workflow shapes for start and end points, basic steps, and decision points?
    • Are all points connected with arrows flowing in the correct direction?
    • Are swimlanes present to identify who completes each task?
  • Carefully read through each workflow model.
    • Does it make sense?
    • What areas are unclear or confusing?
    • Are all decision points adequately explained?
    • What parts need additional detail?
  • Identify at least one additional gap in each workflow. For example, this may be a redundant task, an unnecessary task, an ineffective system or process, or an area where staff need support. What meaningful use objective or objectives are related to the identified gap?

Note: Before you submit your initial post, replace the subject line (“RE: Discussion – Week 6”) with “Peer Review of _________.” Fill in the blank with the first and last name of the colleague whose Visio draft you reviewed.

With these thoughts in mind:

By Day 3 and By Day 5

Post your reviews of your colleagues’ Visio drafts. Identify any basic requirements (standard workflow shapes, arrow directions, decision points, swimlanes, etc.) that are unmet or need revision. Also identify areas that lack information and what additional detail is necessary to clarify those areas. Describe the gap you identified in the workflow and explain how it is related to at least one meaningful use objective.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days.

In your response, reflect on the lessons learned from this Assignment. Explain what further understanding you have gained about modeling a workflow, the level of detail required, and how to accurately reflect workflow processes (e.g., decision points). How will you apply this understanding to your gap analysis and to revising your current-state workflow model?

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NURS 6421: Supporting Workflow in Healthcare Systems

NURS 6421 Week 7: Workflow Redesign

To this point in this course, you have focused on various considerations for analyzing a current-state workflow in a health care organization. You have identified and examined workflow issues and gaps, explored how to conduct a gap analysis, and created and critiqued workflow models. All of these initial processes have been building up to a critical stage in the systems development life cycle (SDLC): workflow redesign. Once all of the information about the current-state workflow has been gathered, nurse informaticists are faced with the challenge of brainstorming and selecting realistic solutions to workflow issues.

This week you begin to explore the process of redesigning workflow and examine how organizational constraints can impact the feasibility of possible solutions. You submit Part 2 of the Course Project and begin Part 3, in which you develop a specific solution to the workflow issue you identified and create a future-state workflow model using Visio.

Learning Objectives

Students will:

  • Evaluate workflow redesign measures
  • Apply consideration of organizational constraints to workflow redesign
  • Analyze data collected during a gap analysis
  • Create a finalized current-state workflow model in Vision

NURS 6421: Supporting Workflow in Healthcare Systems

After conducting a thorough gap analysis, the next step in the systems development life cycle (SDLC) is to target potential solutions to the gaps. There may be many potential solutions that can help to address workflow issues and inefficiencies, or there may be one seemingly obvious solution that could address almost all of the gaps in the current-state workflow. The challenge lies in selecting the most appropriate course of action from potential solutions that also works within organizational constraints.

In this Discussion, you revisit the scenarios from the Week 3 Discussion. You determine the possible avenues for workflow redesign and consider the constraints and factors that might impact your decision.

Scenario 1:

Stephanie is a nurse practitioner at Central Care Hospital who is often involved in administering prescribed medications for patients in the general care ward. When a physician sees a patient, he or she uses the hospital’s electronic health record (EHR) to document findings and recommendations for treatment but submits medication and drug orders by faxing prescriptions to the hospital’s pharmacy. Before Stephanie administers the medications from the pharmacy, she must cross-check the medication and dosage with the physician’s notes and patient information in the EHR. In doing so, Stephanie often identifies problems with the medication the physician prescribed; patients are sometimes prescribed a medication to which they have a known allergy or one that conflicts with another medication they are currently taking. In addition, the pharmacy sometimes sends the wrong medication or the wrong dosage. Furthermore, for patients who have been transferred from other parts of the hospital, such as the intensive care unit or the maternity ward, Stephanie often encounters duplicate drug orders or incorrect medications sent from the pharmacy.

Scenario 2:

General Health Hospital is implementing new outreach programs and preventative care support groups for patients with certain conditions or health risks, such as diabetes, smoking, and obesity. Philip, a nurse leader, is the manager of a team of nurses to organize these programs and groups and to identify patients who would be eligible and interested in being involved in these opportunities. However, Philip and his team have run into a variety of challenges and problems as they attempt to complete these tasks. In identifying patients to contact about the outreach programs and support groups, Philip’s team has had to browse the hospital’s entire electronic health record (EHR). The team has also run across significant holes in the EHR as they try to contact patients; many patients’ contact information is inaccurate or out of date. Furthermore, Philip’s team has partnered with the hospital’s Appointments Desk personnel in sending reminders about meeting dates and times to patients who express interest. However, the Appointments Desk often either neglects to send out these reminders or sends duplicate reminders to only a few patients because the personnel does not have a way of tracking who should be contacted and when.

Scenario 3:

Robert works in the medical records office at Garden View Hospital. Because the hospital does not have a policy of providing clinical summaries to patients after each visit, Robert frequently receives calls from patients requesting copies of their health information (such as test results, vital statistics, diagnostic information, and medication lists and dosages). For every request, Robert must retrieve the patient information from the hospital’s electronic health record (EHR), print out hard copies of the records, and then either mail the records or wait for the patient to retrieve them in person. Additionally, Robert’s hospital often receives lab test results for patients from certified third-party providers. These results are not automatically transferred from the provider’s EHR to the hospital’s EHR, so Robert often must contact the providers before responding to a patient’s request. Robert also finds that he and his colleagues in the office spend a considerable amount of time printing, mailing, and faxing immunization records to patients’ workplaces, schools, and volunteer organizations, which can be disruptive to the office’s other responsibilities.

To prepare:

    • Review this week’s Learning Resources on workflow redesign. Then select one of the scenarios listed above to consider for this Discussion.

Note: You may choose to examine the same scenario you were assigned for the Week 3 Discussion, or you may select a different scenario.

  • Identify one specific workflow issue (gap) in the scenario you selected. Formulate at least two distinct solutions for this workflow issue.
  • Of the two solutions you developed, which would you recommend for redesigning the current-state workflow in the scenario you selected? Why?
  • Reflect on the solution you would recommend. What two organizational constraints (budget, time, resources, personnel, IT expertise, resistance to change, lack of leadership, stakeholder buy-in, etc.) would most significantly impact the implementation of the solution? How would they impact the solution?

By Day 3

Post the scenario you selected and a description of the two solutions you developed for this workflow issue. Identify the solution you would recommend, and explain how this solution would address the workflow issue. Identify two organizational constraints that might impact the workflow redesign and explain their impact.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days. Respond to colleagues who selected different scenarios than you did. Critique your colleagues’ solutions and feasibility within a health care organization. Identify further problems or constraints that could impact the solution.

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NURS 6421: Supporting Workflow in Healthcare Systems

NURS 6421 Week 8: Implementation Planning

Would a school nurse converting vaccination records to a digital format use the same implementation strategy as a hospital integrating a multimillion dollar electronic health record (EHR) system? It is highly improbable. Implementing a workflow redesign project is not a one-size-fits-all process. There are many elements that nurse informaticists should consider when selecting an implementation strategy, from the nature, scope, and scale of the project to various organizational factors that affect implementation.

This week, you evaluate the appropriateness of workflow redesign implementation strategies within a health care setting. Additionally, you analyze the benefits and challenges of implementation strategies.

Learning Objectives

Students will:

  • Evaluate the appropriateness of workflow redesign implementation strategies within a health care setting

NURS 6421: Supporting Workflow in Healthcare Systems

Throughout this course, you have been developing a workflow redesign that could be applied in a health care practice setting. However, determining an appropriate workflow redesign is only part of the process. It is much easier to design something on paper than it is to actually make it work effectively within an organization. Nurse informaticists must consider how the workflow redesign can be implemented in a real-world organization. Attention needs to be focused on understanding organizational risks, organizational culture, and the needs of the end user. Implementing a new project may be disruptive. The key is to plan in such a way as to minimize this disruption as much as possible.

In this Discussion, you consider possible implementation strategies for the workflow redesign measure that you selected for your Course Project.

To prepare:

  • Review the articles in this week’s Learning Resources and reflect on the insights they provide on implementing a workflow redesign project within a health care setting. Also reflect on your past experience with workflow redesign and technology integration. What implementation strategies were applied?
  • Review pages 402–406 in the Dennis text. Identify a specific implementation or conversion strategy that would be appropriate for the workflow redesign you selected for your Course Project. For example, will it be a phased implementation? If so, which applications will be launched first, and why?
  • Consider why the strategy you selected would be appropriate for the scope of your workflow redesign project and your practice setting. Reflect on how it will support the needs of end users.
  • Consider the benefits and drawbacks of applying the implementation strategy you selected. What would the positive outcomes be? What potential challenges or barriers might you encounter?

With these thoughts in mind:

By Day 3

Post a summary of the workflow redesign measure you plan to use for Part 3 of your Course Project. Describe the implementation (or conversion) strategy you would recommend, and justify why it would be appropriate in your practice setting and for the scope of your workflow redesign. Explain the potential outcomes of this strategy, including benefits and potential obstacles.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days. Critique your colleagues’ implementation strategies as well as the benefits and obstacles they identified.

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NURS 6421: Supporting Workflow in Healthcare Systems

NURS 6421 Week 10: Implementing the System

Consider the average lifespan of a smartphone, a computer operating system, or another hardware device or software system. Often, it seems like only months after you purchase it, several new versions of the technology are released. One of the well-known realities of living in the “Information Age” is that technology evolves on an extremely rapid timeline. Changes and updates arise every day in response to innovations, new capabilities, emerging user needs, and other factors. Nurse informaticists should be aware of these possibilities and consider strategies for ensuring that the informatics systems they develop and implement are adaptable and upgradable to stay relevant in the fast-paced world of technological innovations.

In this week, you consider factors and possibilities that can influence the long-term success of a workflow redesign project. You also continue developing your Course Project Presentation.

Learning Objectives

Students will:

  • Analyze the impact of organizational factors on workflow implementation
  • Assess strategies for ensuring the long-term success of a workflow implementations

NURS 6421: Supporting Workflow in Healthcare Systems exam help

Adopting a workflow change requires consideration of many organization wide factors that span a much larger timescale and scope than the initial stages of implementation. The long-term success of a workflow redesign project depends not only on providing up-front support and training for end users but also on how well the project is maintained throughout its lifespan. Possible factors that influence the long-term, widespread effectiveness of a project include:

  • An organization’s culture, mission, vision, and values
  • End-user suggestions and feedback for improving the system
  • System glitches or bugs that were not identified in the design and implementation stages
  • Organizational restructuring or procedural changes that impact the basic functionality of the system
  • The rise of incorrect uses of the system or lack of end user accountability for correct system usage
  • New governmental or organizational requirements that have implications for the system
  • The emergence of innovations and new technologies that render the system obsolete

In this Discussion, you focus on how these possibilities affect the long-term and organizational success of a project.

To prepare:

  • Review this week’s Learning Resources for insights on the long-term, widespread success of health care informatics projects.
  • Consider how an organization can maintain a workflow’s efficiency and effectiveness once a change is implemented.
  • Examine the long-term and organizational factors and issues mentioned above. How do these factors impact the enduring, widespread success of a project in the health care setting?
  • What strategies could be used to address or accommodate these factors and issues? For example, help-desk support, regular training modules.

With this information in mind:

By Day 3

Post an explanation of how organizational considerations can affect the long-term success of a project implemented to improve workflow. Select 2–3 specific factors or issues and explain how they might impact the successful long-term implementation of a project. Identify at least one strategy for addressing each factor or issue you selected. Justify your response.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days. Provide additional insights on the factors and issues that might impact long-term success of a project. Critique the strategies your colleague proposed in terms of their feasibility within a real-world health care setting.

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NURS 6421: Supporting Workflow in Healthcare Systems

NURS 6421 Week 11: Project Management

When implementing any large-scale project in an organization, there are many important questions that must be addressed. For example, what are the goals of the project? What departments and individuals will be affected? How long will it take? How will it be funded? What are the risks involved? These and many other questions are essential to consider, especially in health care organizations undergoing workflow changes and informatics implementations. Projects often have constraints, whether related to scope, cost, or time. The role of the nurse informaticist is to ensure that the project is designed to best meet the informational needs of the health care organization while still remaining within project constraints.

This week you consider project management and triple constraints (scope, cost, and time) as they relate to the health care field. You explore how triple constraints and meaningful use objectives affect informatics projects in health care. You also turn in your Course Project Presentation.

Learning Objectives

Students will:

  • Analyze the impact of scope, time, and cost on project management in health care settings
  • Formulate strategies to accommodate meaningful use and triple constraints in health care settings
  • Develop a presentation for a proposed workflow redesign project

NURS 6421: Supporting Workflow in Healthcare Systems exam help

The term “triple constraints” refers to three universal restrictions that affect project management across virtually all fields, disciplines, and business sectors. These constraints are scope, time, and cost (or resources). In health care organizations, these constraints are especially relevant given the complex, interconnected nature of workflows; the urgent matter of improving care and outcomes; and the unfortunate realities of tight budgets and limited staffing. In addition, the Health Information Technology for Economic and Clinical Health (HITECH) Act and its meaningful use objectives have added even more requirements to projects undertaken in the health care field.

This Discussion focuses on project management in health care organizations. You explore how the requirements for meaningful use have complicated the implementation and conversion to a new informatics project. You also consider strategies for addressing and overcoming these challenges.

To prepare:

  • Review this week’s Learning Resources on triple constraints and project management. Consider how each of the three constraints relate to the implementation of workflow changes, technology innovations, and system upgrades in health care settings.
  • Reflect on the article, “EHR/EMR: ‘Meaningful Use,’ Stimulus Money, and the Serenity Prayer” in the Learning Resources, and consider its relevance to meaningful use objectives and the challenges they pose for the health care field. Also consider your experiences with meaningful use compliance in your health care setting. How does meaningful use contribute to additional stress for organizations?
  • Consider strategies and recommendations for organizations and nurse informaticists in accommodating meaningful use and triple constraints.

With these thoughts in mind:

By Day 3

Post an explanation of how each of the triple constraints (scope, time, and cost) relate to project management in health care settings. Describe how meaningful use adds additional complexity to project management planning. Propose at least one specific strategy that could be used to address meaningful use and triple constraints.

Read a selection of your colleagues’ responses.

by Day 6

Respond to at least two of your colleagues on two different days. Provide additional insights on the effect of triple constraints on health care informatics projects and meaningful use. Critique the strategy your colleague proposed on accommodating meaningful use and triple constraints.

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