Case Study Questions

CASE STUDY DISCUSSION QUESTIONS

1.       What diversity issues are present in the case?

2.        2. How would you define diversity? What makes an organization diverse?

3.        3. How should Ralph open up the diversity conversation to the Corporate Leadership Team (CLT) as a whole?

4.        4. What conflict management tools should Ralph use to address the perceived cultural bias issues with the Corporate Leadership Team (CLT)?

5.        5. What effect did promoting Roosevelt to Senior Vice President (SVP) have on the organization? Why?

6.        6. Why did Ralph promote Roosevelt to Senior Vice President (SVP)? What did that signal to the organization and CLT?

7.        7. Which team is more important to have as high performers, the Corporate Leadership Team (CLT) or the Corporate Diversity Department (COD)? Why?

8.        8. What impact will increasing diversity have on team performance? Why?

9.        9. What leadership traits will be important for Mikayla to develop for the Chief Diversity Officer (COO) position?

10.   10. Is the current workforce diverse? In all professions?

11.    11. How much does the composition of the Board of Directors contribute to Ralph’s decision-making?

 

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NURS WK 6 ASSGN

Week Six – Correlations Exercises

Correlations are used to describe the strength and direction of a relationship between two variables. A correlation between two variables is known as a bivariate correlation. In this module the Pearson Product-Moment Correlation will be used when running a correlation matrix. The Pearson correlation coefficient ranges from a value of -1.0 to 1.0. A correlation coefficient is never above 1.0 or below -1.0. A perfect positive correlation is 1.0 and a perfect negative correlation is -1.0. The size of the coefficient determines the strength of the relationship and the sign (i.e., + or -) determines the direction of the relationship. The closer the value is to zero the weaker the relationship and the closer the value is to 1.0 or -1.0 the stronger the relationship. A correlation coefficient of zero indicates no relationship between the variables.

A scatterplot is used to depict the relationship between two variables. The general shape of the collection of points indicates whether the correlation is positive or negative. A positive relationship will have the data points group into a cluster from the lower left hand corner to the upper right hand corner of the graph. A negative relationship will be depicted by points clustering in the lower right hand corner to the upper left hand corner of the graph. When the two variables are not related the points on the scatterplot will be scattered in a random fashion.

Using Polit2SetB dataset, create a correlation matrix using the following variables: Number of visits to the doctor in the past 12 months (docvisit), body mass index (bmi), Physical Health component subscale (sf12phys) and Mental Health component subscale (sf12ment). Run means and descriptives for each variable as well as the correlation matrix.

Follow these steps using SPSS:

1.Click Analyze, then correlate, then bivariate.

2.Select each variable and move them into the box labeled “Variables.”

3.Be sure the Pearson and two-tailed box is checked.

4.Click on the options tab (upper right corner) and check “means and standard deviations.” The exclude cases pairwise should also be checked. Click continue.

5.Click OK

To run descriptives for docvisit, bmi, sf12phys and sf12ment do the following in SPSS: 

1.Click Analyze then click Descriptives Statistics, then Descriptives.

2.Click the first continuous variable you wish to obtain descriptives for (docvisit) and then click on the arrow button and move it into the Variables box. Then click bmi and then click on the arrow button and move it into the Variables box. Then click sf12phys and then click on the arrow button and move it into the Variables box. Then click sf12ment and then click on the arrow button and move it into the Variables box.

3.Click the Options button in the upper right corner. Click mean and standard deviation.

4.Click continue and then click OK.

Assignment: Answer the following questions about the correlation matrix.

1.What is the strongest correlation in the matrix? (Provide correlation value and names of variables)

2.What is the weakest correlation in the matrix? (Provide correlation value and names of variables)

3.How many original correlations are present on the matrix?

4.What does the entry of 1.00 indicate on the diagonal of the matrix?

5.Indicate the strength and direction of the relationship between body mass index and physical health component subscale?

6.Which variable is most strongly correlated with body mass index? What is the correlational coefficient? What is the sample size for this relationship?

7.What is the mean and standard deviation for bmi and doctor visits?

Part II

Using Polit2SetB dataset, create a scatterplot using the following variables: x-axis = body mass index (bmi) and the y-axis = weight-pounds (weight).

Follow these steps in SPSS:

1.Click Graphs, then click on Legacy Dialogs, then click “Scatter/Dot”.

2.Click “Simple Scatter” and then click “Define.”

3.Click on weight-pounds and move it to the Y-axis box and then click on body mass index and move it to the x-axis box.

4.Click OK.

To run descriptives for bmi and weight do the following in SPSS:

5.Click Analyze then click Descriptives Statistics, then Descriptives.

6.Click the first continuous variable you wish to obtain descriptives for (body mass index) and then click on the arrow button and move it into the Variables box. Then click weight-pounds and then click on the arrow button and move it into the Variables box.

7.Click the Options button in the upper right corner. Click mean and standard deviation.

8.Click continue and then click OK.

Assignment:

1.What is the mean and standard deviation for weight and bmi?

2.Describe the strength and direction of the relationship between weight and bmi?

3.Describe the scatterplot? What information does it provide to a researcher?

References 3 references required

 

Required Media

Walden University. (n.d.). Correlations. Retrieved August 1, 2011, from http://streaming.waldenu.edu/hdp/researchtutorials/educ8106_player/educ8106_correlations.html

Required Readings

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

Chapter 23, “Using Statistics to Examine Relationships”

Statistics and Data Analysis for Nursing Research

Chapter 4, “Bivariate Description: Crosstabulation, Risk Indexes, and Correlation” (pp. 59–61 and 68–78)

Chapter 9, “Correlation and Simple Regression” (pp. 197–209)

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Assessment

S. T., a 24-year-old graduate student, visits the clinic to report “bad headaches.” She says that her headaches occur two to three times a month and last at least an entire day. The headache centers above and behind her eyes, throbs, and is not relieved by any over-the-counter medications. She says that they get worse when exams are near and she spends time in the library to study. She is worried that the headaches will cause her to fail graduate school.

Discuss the:

developmental,

age,

socioeconomic,

and cultural considerations

that should be considered during the gathering of subjective and objective data.

(Please be sure to cite in APA format and use the weekly readings and other sources to support your post)

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Nursing care

There are many videos on the Web that demonstrate culturally competent nursing care. Explore your favorite video archive, such as YouTube, and watch some of these videos (you can use the keywords “cultural care nursing”).
Identify the videos you watched. Provide a list of the titles and the URL. In a 1-2 page Word document, answer the following questions about the video(s) you viewed.

  1. What was the most surprising thing you learned about culturally competent nursing care from watching the videos?
  2. What was the most interesting thing you learned about culturally competent nursing from watching the videos?
  3. What are some challenges and/or barriers in being culturally competent in nursing practice?
  4. In what ways did the videos provide you with an understanding about the relationship between cultural competence and client quality and safety?
  5. After watching the videos, describe two areas of awareness you gained about being more open to cultural diversity in clients and populations?

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Determining Workflow Issues

Discussion: Determining Workflow Issues

 

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 (McGonigle & Mastrian, 2012, p. 226). 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

 

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.

 

 

 

To prepare

 

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?

 

 

 

Post by tomorrow Tuesday 9/13/16, 550 words essay in APA format with a minimum of 3 references from the list provided below. Include the level 1 headings as numbered below:

 

1) 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.

 

2) Identify the meaningful use objective to which the gap relates, citing specific points in the Brown article. (See Attached File)

 

3) Explain how you would conduct a gap analysis to gather further information and determine strategies for addressing the gap.

 

 

 

Required Readings

 

Dennis, A., Wixom, B. H., & Roth, R. M. (2015). Systems analysis and design (6th ed.). Hoboken, NJ: Wiley.

 

  • Chapter 2, “Project Selection and Management” (pp. 35–80)

 

This chapter describes the organizational steps involved in selecting an appropriate IT project, creating a viable project plan, and finally, managing and controlling the project once it is implemented.

 

 

 

McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.

 

  • Chapter 14, “Nursing Informatics: Improving Workflow and meaningful Use”

 

 

 

Better clinical outcomes, increased efficiency and improved care coordination are a few of the benefits afforded by the use of electronic medical records. In this chapter, the authors illustrate how nurses are actively supporting, developing and utilizing informatics to improve patient care and fulfill meaningful use standards by improving workflow in their respective health care organizations.

 

 

 

Brown, B. (2010). 25 steps to meaningful use. Journal of Health Care Compliance, 12(3), 33–34, 68–69.

 

Retrieved from the Walden Library databases.

 

As part of the implementation of the HITECH initiative, three different stages of implementation have been outlined. This article dissects the first phase and describes the different steps health care organizations must achieve to be in compliant with the meaningful use standards.

 

 

 

Blumenthal, D., & Tavenner, M. (2010). The “meaningful use” regulation for electronic health records. The New England Journal of Medicine, 363(6), 501–504.

 

Retrieved from the Walden Library databases.

 

The authors explain HITECH’s objective in creating the meaningful use policies in order to help create a consistently high quality nationwide system of EHRs. The article reviews the key regulations that are tied to meaningful use and what they mean to health care organizations.

 

 

 

Centers for Disease Control and Prevention. (2011). Meaningful use: Introduction. Retrieved from http://www.cdc.gov/ehrmeaningfuluse/introduction.html

 

This page offers an overview of meaningful use as outlined in the HITECH initiative. It highlights the rationale behind the meaningful use standards and how they relate to health outcomes policy priorities.

 

 

 

 

 

Healthcare Financial Management Association. (2008). Gap analysis helps nurses become better leaders. Retrieved from http://www.hfma.org/Content.aspx?id=3398

 

This article presents how gap analysis aids in optimizing unit performance and management. By examining a real-life example of how gap analysis was employed in this study, the authors demonstrate its real-world applications and benefits.

 

 

 

 

 

HealthIT.gov. (n.d.). Meaningful use. Retrieved January 2, 2014, from http://www.healthit.gov/policy-researchers-implementers/meaningful-use

 

The meaningful use initiative is part of the governmental agenda to further advance the use of electronic health records in the health care community. This article outlines the conditions and projected timeline of meaningful use’s national implementation.

 

 

 

Required Media

 

Laureate Education, Inc. (Executive Producer). (2012a). A discussion on meaningful use. Baltimore, MD: Author.

 

Note: The approximate length of this media piece is 7 minutes.

 

This audio interview provides an overview of the meaningful use component of the HITECH law and how it affects the use of electronic health records.

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Which of the following behaviors may be…

1. Which of the following behaviors may be: (1) ethical but illegal, (2) legal but unethical, (3) illegal and unethical, and (4) legal and ethical.

a) Working in a clinic that performs abortions.

b) Respecting the wishes of a client suffering from ALS that he be permitted to die with dignity and not placed on “breathing machines”

c) Respecting the health surrogate’s wishes regarding termination of life support of her friend.

d) Observing a coworker take out two tablets of oxycodone as ordered for pain management for his patient but keeping one for himself, administering only one tablet to the patient.

2. Differentiate among the following: deontological theories, utilitarianism, and principlism.

3. What do you think about health-care professionals disclosing information to clients about a poor prognosis, even though the information may cause severe distress.

4. What do they think about health-care professionals disclosing information to clients against family wishes?

5. You see a colleague use another nurse’s password to access the medication administration system and take out a narcotic. What would you do?

6. Your colleague’s child fell and was brought to the emergency department. She comes back up to the unit and tells you that they cleaned and debrided the wound, and she needs to change the dressings twice a day using a wet to dry method. You see her go into the supply system and remove the dressings and saline using a patient’s identification number. What would you do?

7. You are caring for a patient who has a terminal disease. He asks you if he is dying. Would you tell him? If yes, how? If no, what might you say? .

8. You are administering hydromorphone to a patient. The patient asks you what you are administering. Would you tell the patient about the medication?

Essentials of Nursing Leadership & Management 6th Edition  Sally A. Weiss  MSN, EdD, RN, CNE, ANEF   Ruth M. Tappen  EdD, RN, FAAN    ISBN-13: 978-0-8036-3663-7

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Communication in the Planning Process

Explore the functions of communication in the strategic and program planning processes for a health care organization. Consider the topics discussed thus far and clearly integrate at least five key concepts related to an effective and efficient strategic plan for organizational communication dissemination. Identify three challenges with organization-wide strategic plan communication dissemination and recommend communication strategies to ameliorate these challenges. Your paper must be three to five double-spaced pages (excluding title and reference pages) and formatted according to APA style as outlined in the Ashford Writing Center. Utilize a minimum of two scholarly sources that were published within the last five years. One source must be obtained from the Ashford University Library. All sources must be documented in APA style as outlined in the Ashford Writing Center.

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Root Cause Using Five Whys

Read the news report “Maryland Health Care Provider Sentenced to 10 Years in Federal Prison for Health Care Fraud Resulting in Patient Deaths.”

Use the Five Whys to conduct a root cause analysis to determine why the Medicare fraud occurred and Timothy Emeigh’s participation in the case.

Write a 525- to 700-word paper that identifies and evaluates the root cause for Medicare fraud in this case.

Include the following:

  1. List each of the Five Whys and your response.
  2. Speculate as to why Mr. Emeigh participated in the scheme.
  3. Explain what you might have done to prevent this from happening.

This is the link to the web site for this assignment

https://www.justice.gov/usao-md/pr/maryland-health-care-provider-sentenced-10-years-federal-prison-health-care-fraud

Cite 3 reputable references to support your assignment (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality).

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Discussion response2

Improving Quality

Improving the quality of health care delivery and patient safety continues to be a political concern and has been at the heart of reform issues for many years. The American Nurses Association (ANA) and the Institute of Medicine (IOM) have increased awareness of health care quality and safety issues, as well as advocated for health care reform. The documents featured at the ANA and IOM websites listed in this week’s Learning Resources focus on many of the current issues surrounding quality and safety in the health care industry.

To prepare:

  • Review this week’s Learning Resources, focusing on the Six Aims for Improvement presented in the landmark report “Crossing the Quality Chasm: The IOM Health Care Quality Initiative.”
  • Consider these six aims with regard to your current organization, or one with which you are familiar. In what areas have you seen improvement? What areas still present challenges? As a nurse leader, how can you contribute to improving the organization’s achievement of these aims?
  • Select one specific quality or safety issue that is presenting a challenge in the organization. Consider at least one quality improvement strategy that could be used to address the issue, as well as which of the six aims for improvement would then be addressed.
  • Reflect on your professional practice and your experiences with inter-professional collaboration to improve quality and safety. How has inter-professional collaboration contributed to your organization’s efforts to realize the IOM’s six aims for improving health care? Where has inter-professional collaboration been lacking?

 

Post a description of the quality or safety issue you selected and a brief summary of the impact that this issue has on health care delivery. Describe at least one quality improvement strategy used to address this issue. Then explain which of the six “aims for improvement” are addressed by the strategy. Finally, explain how inter-professional collaboration helps improve quality in this area.

Read a selection of your colleagues’ responses.

 

Respond  in one or more of the following ways:

  • Ask a probing question, substantiated with additional background information, evidence, or research using an in-text citation in APA format.
  • 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.

 

Discussion 1

Improving Quality: Patient Center Care

Patient-centered care (PCC) is increasingly being highlighted as an important model to improve quality of health care having been linked to improved patient satisfaction, better health outcomes, and cost-effective care (Bauchat, Seropian & Jeffries, 2016).  Lack of communication with patients and providers can affect patient compliance, hospital stays, and overall patient outcomes. Poor communication has been well documented as one of the top three contributors to sentinel events by the Joint Commission (Bauchat, Seropian & Jeffries, 2016).  The Institute of Medicine (2012), states that if a health care system can achieve major gains in the six areas of safe, effective, patient-centered, timely, efficient, and equitable care, it would be far better at meeting patient needs. The challenge is to find an effective means of training non-technical skills, such as empathy, to promote a patient-centric model of care; empathy is arguably an important cornerstone to effective PCC (Bauchat, Seropian & Jeffries, 2016).

Impact on Healthcare Delivery

According to Reuben and Tinetti (2012), major efforts have been launched to make care more patient-centered, defined as respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions. Attention to patient-centered measures and outcomes will be particularly important as the Centers for Medicare and Medicaid Services (CMS) moves increasingly to link health care providers’ reimbursement to their performance on selected measures (Reuben & Tinetti, 2012). Assessments of quality of care and health outcomes have not incorporated patient-centeredness. Measurement of quality has addressed preventive care while outcomes focuses on condition-specific processes. An alternative approach to providing better care would be to focus on a patient’s individual health goals within or across a variety of dimensions (Reuben & Tinetti, 2012).

Quality Improvement Strategy

The VA looked at developing a better relationship between patients, families and health care teams. Beginning in 2010, the VA adopted the Patient Aligned Care Team (PACT) model of care, which is adapted from the patient-centered medical home (Burkhart & et al., 2016). At the same time, the VA also established the Office of Patient-Centered Care and Cultural Transformation to guide transformation toward patient-centered care (PCC) (Burkhart & et al., 2016). This transformation to care for patients involved health coaching, decision-making initiatives, alternative medicine and pet therapy. Access to care improvements included same-day appointments, after hours availability, expanded visitor policy for inpatients, and valet parking (Burkhart & et al., 2016). The aim for improvement was focused directly on patient-centered care.

Aim for Improvement: Patient-Centered Care

Providing patient-centered care means giving patients the information they need to participate actively in decision making about their care with goals of obtaining the most desirable outcome (Knickman & Kovner, 2015). The individual’s culture, social context and specific needs should be addressed and the patient should have input in their own care. The achievement of a truly patient-centered health system will require the participation of patients, family members, physicians, nurses, and other health care providers involved in the provision of care (Knickman & Kovner, 2015). It is this team collaboration that makes the process more effective in patient care. Families should be more involved in the care process and goals should be discussed with the patient to obtain a more realistic approach.

Inter-professional Collaboration

Collaboration in health care has been shown to improve patient outcomes such as reducing preventable adverse drug reactions, decreasing morbidity and mortality rates and optimizing medication dosages (Bosch, Mansell, 2015). Trust must be established to build health care team. One way is consistency in care. Developing trust takes time and a lot of personal contact (Bosch, Mansell, 2015). This may be a challenge in some health care settings due to things such as rotating staff schedules, which contributes to constantly changing teams. Developing a personal relationship with a patient take time and adds to the patient centered approach to individual care.

Conclusion

In conclusion, the Institute of Medicine of the National Academies (2012) defines patient-centered as providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions. Patient care should reflect individual and safe care as part of achieving quality health care.

 

References

Bauchat, J. R., Seropian, M., & Jeffries, P. R. (2016). Communication and Empathy in the Patient-Centered Care Model—Why Simulation-Based Training Is Not Optional. Clinical Simulation in Nursing12(8), 356-359. doi:10.1016/j.ecns.2016.04.003

Bosch, B., & Mansell, H. (2015). Interprofessional collaboration in health care. Canadian Pharmacists Journal (Sage Publications Inc.),148(4), 176-179. doi:10.1177/1715163515588106

Burkhart, L., Min-Woong, S., Jordan, N., Tarlov, E., Gampetro, P., & LaVela, S. L. (2016). Impact of Patient-Centered Care Innovations on Access to Providers, Ambulatory Care Utilization, and Patient Clinical Indicators in the Veterans Health Administration. Quality Management in Health Care25(2), 102-110. doi:10.1097/QMH.0000000000000093

Institute of Medicine of the National Academies. (2012). Crossing the quality chasm: The IOM Health Care Quality Initiative. Retrieved from http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%202001%20%20report%20brief.pdf

Knickman, J. R., & Kovner, A. R. (Eds.). (2015). Health care delivery in the united states (11th ed.). New York, NY: Springer Publishing.

Reuben, D. B., & Tinetti, M. E. (2012). Goal-oriented patient care—an alternative health outcomes paradigm. New England Journal of Medicine366(9), 777-779.

 

 

 

Discussion 2

Quality of care issue: Electronic Health Records.

Today Electronic Health Records (EHRs) are at the center of health care uniting health care professionals, working as one team to improve the quality of care to all patients (Center for Medicare & Medicaid Services, 2012). However, quality of health care throughout the US varies among states, individual providers and even inter-departmental within hospitals (Knickman & Kovner, 2016). Additionally, even with advances in science and technology, 40% of the population is made up of chronic diseases; we need to bridge this gap between acute and chronic care, to ensure patients are receiving what they deserve in a more consistent way (Institute of Medicine, 2001). Providing safe and quality health care is paramount, and the Institute of Medicine (IOM) identified six issues, improving the overall health of the nation: Health care should be safe, effective, patient-centered, timely, efficient, and equitable (2001).

Impact of Delivery

EHRs are a digital version of the patient’s medical records and are an important part of today’s health care. EHRs are real-time, providing up to date information about both medical history and treatment of the individual patients. As nurses, we spend a lot of our time with our patients, so the EHRs provides an up to date record of the nurse-patient interaction.  EHRs are an invaluable tool for the day to day events of the patient. By using EHRs, communication improves which allows information to be readily and instantly available to authorized personnel (HealthIT.gov, 2013). Also they have a significant impact on patient-centered care, providing one particular place for all the pertinent information about the patient such as medical history, treatment plans, and laboratory results. Another benefit of EHRs is the instant access to evidence-based practice, allowing incorporation into the treatment of the patient, making treatment more efficient and effective (HealthIT.gov, 2013). Lastly, by having all this information stored digitally and in one place, information can flow across all providers; data can flow from primary care to specialist physician to pharmacy, radiology, emergency room, etc. (HealthIT.gov, 2013).

Strategy for improvement.

When I first started nursing, if someone would have told me I would be charting at computers at the bedside, I would have been very skeptical. In fact, when I was introduced to the idea of EHRs, I thought this was going to take me away from the bedside and put me in front of a computer screen. However, now having used EHRs for many years in different countries, I can see the benefits. It gave me more time with the patient rather than less. Now I find it an integral part of everyday life and communication with all members of the health care team. One strategy for improvement is by working with student nurses, incorporating EHRs into their curriculum. By combining this within their program, it provides a greater knowledge and understanding of the benefits for both the user, the patient and their family (Kowitlawakul, Chan, Pulcini & Wang, 2015).  By encouraging acceptance of EHRs, we promote a united front and a positive attitude towards our patient’s overall care.  Also we can aim to bridge the gap between the care that the patient is receiving and what they desire for the best outcome for their health (IOM, 2001).

When looking at combining EHRs into nurse education, this allows for the improvement of patient care from many different angles. Mostly I feel this looks at the patient as a whole, promoting a patient-centered approach to care. By looking at the patients holistically, it allows for the patient to be at the forefront of treatment, taking into consideration, their preferences and needs, benefiting and involving them in their medical decision (IOM, 2011).

Inter-professional collaboration

EHRs ensure a safer practice, uniting all medical personnel, so preventing medical errors and benefiting the patient. This effective teamwork and pooling of computerized evidence-based information promotes new and more efficient ways of treatment for patient care but always having the patient in the center of their medical plan.

Conclusion

In conclusion, EHRs are invaluable in the care and treatment of our patients and their families. EHRs are patient-centered, providing a unique way to tell the individual’s story, utilizing teamwork, excellence and evidence-based practice into an individualized package.

References

Center for Medicare and Medicaid Services. (2012) Electronic Health Records. Retrieved from https://www.cms.gov/Medicare/E-Health/EHealthRecords/index.html

HealthIT.gov. (2013). What is an electronic health record (EHR)? Retrieved from https://www.healthit.gov/providers-professionals/faqs/what-electronic-health-record-ehr

Institute of Medicine of the National Academics. (2001). Crossing the quality chasm: a new health system for the 21st century. Retrieved from http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%202001%20%20report%20brief.pdf

Knickman, J. R., & Kovner, A. R. (2015). Health care delivery in the United States (11th ed.). New York, NY: Springer Publishing.

 

Kowitlawakul, Y., Chan, S. W. C., Pulcini, J., Wang, W. R. (2015). Factors influencing nursing students’ acceptance of electronic health records for nursing education (EHRNE) software program Nurse Education Today. Retrieved from http://www.sciencedirect.com.ezp.waldenulibrary.org/science/article/pii/S0260691714001944

 

Discussion 3

 

Improving Quality: Patient -Centered Care.

According to the Institute of Medicine (2012), in order to improve health care, the goal should be to provide safe, effective, patient-centered, timely, efficient and equitable care. Health care needs to be patient-centered and all though most places claim to base their practice around patient’s, it does not always happen that way. As providers feel pressured to see more patients in less time, care has shifted to the needs of the system rather than the patient. According to Knickman and Kovner (2015), even though many tools, techniques, and measure have been implemented to evaluate and improve quality in the U.S, patient-centered treatment is still an ongoing problem in the US.

Quality Improvement Strategy

According to The Institute for Health Care Improvement, 2016 “care that is truly patient-centered considers patients’ cultural traditions, their personal preferences and values, their family situations, and their lifestyles. It makes the patient an integral part of the care team who collaborates with care providers in making clinical decisions. Patient-centered care puts responsibility for important aspects of self-care and monitoring in patients’ hands long with the tools and support they need to carry out that responsibility”.

Aims for Improvement

Knickman

 

Improving Quality with Interpersonal Communication

“Communication is an integral part of life; without it, we would not survive. Verbal and non-verbal communication begins at birth and ends at death. We need communication not only to transmit information and knowledge to one another, but more importantly, to relate to one another as human beings around the world in the context of relationships, families, organizations, and nations” (American Nurses Association,2012). Bedside reporting is a great example of implementing interpersonal communication, it allows the patient to meet the on coming nurse and it allows the patient to be part of their care. Also the doctor setting up a follow up appointment for the patient before they discharge is a way to keep an open line of communication between patient and doctor and it provides patient center care. I see both of these examples done at my place of employment.

 

Summary

 

Although there has been much improvement to patient-centered health care, there is still much more work to be done. I have heard the expression, we are guests in our patients lives, instead of hosts in our health care organization. This is a great motto to live by  and to use as we grow to be the kind of health care organization that patients do not mind revisiting as their health needs permit.

 

 

 

Reference:

American Nurses Association. (2012). Improving health care in your state. Retrieved from

http://nursingworld.org/MainMenuCategories/ Policy- Advocacy/Advocacy Resources Tools/ Looking-for-Solutions.pdf

Institute of Medicine of the National Academies.  (2012). Crossing the quality chasm:  The IOM Health Care Quality Initiative.  Retrieved from http://www.nationalacademies.org/hmdl/~/media media/Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%202001%20%20report%20brief.pdf

Institute for Health Care Improvement. (2016). Across the Chasm Aim #3: Health Care must be Patient centered. Retrieved from:  http://www.ihi.org/resources/Pages/ImprovementStories/AcrosstheChasmAim3HealthCareMustBePatientCentered.aspx

Knickman, J. R., & Kovner, A. R. (Eds.). (2015). Health care delivery in the united states (11th ed.). New York, NY: Springer Publishing.

 

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Discussion Topic

Discussion Topic/ The Patient Protection and Affordable Care Act (PPACA) was passed…

This is a discussion post, ABOUT 250 WORDS, tittle page not require In- text citation is required original work please,  scholarly references are required for this assignment, website source strongly preferred.

 

QUESTION 1

The Patient Protection and Affordable Care Act (PPACA) was passed into legislation in March of 2010. Identify the impact of this legislation on your nursing practice by choosing two key nursing provisions outlined in the topic material “Nursing and Health Reform.” Discuss how these two provisions have impacted, or will impact, your current practice of nursing.

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