Nursing Research Utilization Project

Abstract

In a health care setting, effective communication is vital. It ensures the provision of high-quality healthcare, which promotes patient safety and outcomes. Consequently, nurse practitioners are trained to practice teamwork, relate well with physicians, and communicate appropriately with patients. In fact, nurses engage in continuous learning to improve their communication skills pre-licensure and post-licensure.

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This is aimed at helping them develop professional communication skills to use throughout their nursing practice (Woods, Thomas & Holl, 2005). Issues of poor communication in professional healthcare settings seem impossible to occur considering the emphasis communication is accorded. However, patients frequently raise numerous complaints resulting from the effects of poor communication between nurse-nurse, physician-nurse, and physician-physician practitioners (Wanzer, Booth-Butterfield, & Gruber, 2004).

For instance, patients often complain of poor health care, dissatisfaction, wrong prescriptions and medication, and harassment. Indeed, many healthcare consumers experience directly or indirectly the effects of poor communication between healthcare practitioners. Woods, Thomas, and Holl (2005) provide that approximately 70,000 children experience adverse conditions annually resulting from poor communication among healthcare practitioners. Sadly, these adverse conditions cause extended hospital stay and disability at discharge, and yet 60 percent of them can be prevented. Therefore, this nursing research proposal provides an effective solution to solve the issue of poor communication among healthcare practitioners to improve patient care.

This project proposal affirms that, indeed, poor communication between healthcare practitioners hinders effective healthcare delivery, exposes patients to healthcare risks, and causes job dissatisfaction. Therefore, poor communication is identified as a critical clinical issue that needs a concrete solution. Actually, appropriate intervention would result in overcoming the causes of poor communication in a professional healthcare setting. As a result, it is proposed that the adoption and implementation of an electronic medical record (EMR) would minimize or eliminate communication barriers between healthcare practitioners.

Moreover, the research proposal details a discussion of how EMR adoption and implementation would be conducted to realize a successful project. Information to support the solution is collected from relevant research studies to ascertain its feasibility before embarking on its implementation. Finally, the proposal provides a post-test tool to measure and assess the value the EMR solution would bring in health care.

Introduction

Frequent and effective nursing research is essential for healthcare practitioners and healthcare organizations because it encourages improved care. Through nursing research, nurse practitioners can identify work-related issues that jeopardize patient safety or subject nursing care to risks. This essay is a nursing research utilization project proposal that identifies a work-related clinical issue and proposes a viable solution to help address the problem effectively.

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Problem Identification

A work-related clinical issue identified that needs a solution is the issue of poor communication among healthcare practitioners in a professional healthcare setting. Healthcare facilities frequently report cases of medication errors and adverse effects resulting from poor communication between nurse-nurse and nurse-physician during practice. In fact, poor communication between healthcare professionals Jeopardizes the patient’s safety and care. This is could be the reason nurse practitioners learn communication skills right from the day they get admitted to college until they graduate. Communication is valued in the health care setting because it is the vehicle through which information flows from one department to another. Thus, lack of communication or poor communication may impair the functioning of a hospital or any health care facility.

Importance of the Problem

As earlier stated, communication plays a vital role in healthcare settings. It ensures the provision of high-quality healthcare, which enhances patient care and safety. Effective communication between nurse practitioners and physicians encourages teamwork resulting in the proper medical administration, improved patient care, and reduced medication errors that expose patients to adverse effects (Woods, Thomas & Holl, 2005).

According to Wanzer, Booth-Butterfield, & Gruber (2004), communication between healthcare practitioners affects patient outcomes and safety. This implies that effective communication is essential for healthcare professionals to offer quality patient care. On the contrary, poor communication leads to patient harm, malpractice suits, the occurrence of avoidable errors, and patient complaints that result in punitive measures. Indeed, poor communication is a threat to quality health care delivery as many scholars have discovered. For instance, Woods, Thomas, and Holl (2005) provide that approximately 70,000 children experience adverse conditions annually resulting from poor communication among healthcare practitioners.

Those adverse conditions cause extended hospital stay and disability at discharge, and yet 60 percent of them are preventable. This makes poor communication an important healthcare work-related issue that needs an immediate solution. However, achieving effective communication among the healthcare team is complex. This is due to relentless demands put on health care practitioners from the outside parties that threaten a culture of collegiality and effective communication.

Kirby (2010) provides that the impediments to effective communication within healthcare facilities exist at all levels of patient care. They are sometimes deliberate forcing health care practitioners to deal with exasperating communication problems frequently. The barriers include stress, exhaustion, professional dissatisfaction, and depression. At a glance, it seems difficult to eliminate them and achieve health care systems free from communication problems, but careful evaluation reveals that it is possible to eliminate them (The Victorian Quality Council, 2010). Implementation of electronic medical records would help healthcare practitioners to communicate effectively. This would solve the issue of poor communication among health care practitioners during practice.

The objective of the Study

The objective of this study is to encourage healthcare professionals to adopt electronic medical records (EMR) at their hospitals to improve patient care and safety.

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Brief Solution Description and Rationale

To solve the problem of communication among healthcare practitioners, an electronic solution is recommended. The use of electronic medical records (EMR) will ensure that all the patients’ clinical records are consolidated to form one source of truth. In addition, EMR will enhance the availability of patient information or shared patient information, increase teamwork, and simplify the integration of healthcare communication systems. In a healthcare setting, poor communication often arises from unconsolidated patient records, poor handwriting, health care practitioner’s stress and personal problems, and confusion of patients due to bulky paperwork the nurse practitioner must search to access the file of a specific patient.

Those barriers to effective communication can be eliminated by implementing electronic medical records in the hospital. Electronic medical records avail the patients’ medical information to the physician in real-time. This reduces face-to-face communication, thus, eliminating any chance for the occurrence of poor communication due to stress and personal problems among health care professionals. It also eliminates the issue of poor handwriting, which sometimes hinders effective communication between doctors and pharmacists.

Solution Description

Issues of poor communication resulting from bad communication channels within healthcare facilities are supposed to be a forgotten case in the 21st century. With technology, healthcare facilities can adopt and integrate electronic medical records into their systems. Electronic medical records enhance teamwork and efficiency by aligning daily patient care and organizational activities (Kirby, 2010).

This automatically improves communication between healthcare practitioners, which, in turn, improves patient safety, and care. In addition, EMR enhances the delivery of high-quality care because it ensures real-time information processing and collegiality between healthcare practitioners. This reduces incidences of medication errors or delayed medication, thus improving patient care. EMR promotes consolidation of workflow and data, visualization, and quality of care, which ensures the efficiency and safety of clinical care. With EMR, issues of stress, depression, poor coordination, and nonstandard terminologies, which hinder effective communication among healthcare professionals, are eliminated.

The consistence of the Proposed Solution with Current Research

The proposed solution is consistent with the current research and evidence-based nursing practice that values the use of technology to improve healthcare delivery. In fact, technology integration in healthcare facilities is a current health care reform many hospitals are striving to achieve. The reason for integrating information communication technology in health care is to improve patient care and reduce the burden of paperwork, which delays health care delivery.

Electronic medical records and health information systems ensure that the patient’s data is accurately handled and processed. Therefore, implementation or adoption of EMR in the hospital is consistent with the health care efforts various governments and health care organizations have put in place to ensure that patients receive quality health care. Successful implementation of EMR provides an answer to the question of how patient care and safety could be improved through technology integration in health care.

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Feasibility of Implementing EMR

It is, indeed, feasible to implement the proposed solution in the work setting because various health care facilities are committed to developing technology-enhanced medication systems to improve the quality of patient care, patient safety, and reduce medication costs. Implementing EMR will reduce the patients’ financial cost, increase health care credibility, and help healthcare practitioners to deliver faster and quality care.

Despite the benefits of EMR, management teams of many hospitals claim that the cost of implementing the solution is expensive and the returns on investments might take too long. This might be true because the initial cost of implementing an EMR might be very high. However, the benefits accompanying EMR adoption and integration in healthcare are more than the cost of maintaining paperwork and treating adverse effects resulting from poor communication. The EMR system is likely to register returns on investment if it is adequately implemented and used. Furthermore, there are plenty of certified EMR products in the market to enhance its adoption.

Consistency of EMR with the Organizational Culture and Resources

This solution is consistent with the facility’s organizational culture of creativity and innovation, and quality health care delivery. The facility is made up of professionals and visionary leaders who believe in using technological solutions to solve health care issues, and consequently improve patient care and satisfaction. The facility’s organizational culture is based on six fundamental values guiding the activities and operations of the health care workforce across the hospital.

The values include quality, teamwork, innovation, quality service, integrity, and compassion. Therefore, transforming manual medical records into electronic records to utilize the available opportunities technology brings improves health care quality, involves ICT innovation, encourages teamwork, promotes integrity by enhancing transparency, accountability, honesty, confidentiality, trust, and improves service delivery. Thus, EMR implementation is consistent with the ultimate goal of the hospital. Moreover, the facility has enough financial and human resources to support the adoption and integration of the EMR within its systems. The health care facility strives to be the best in clinical outcomes, research and education, and patient experience. Therefore, adopting and implementing an EMR in the hospital is consistent with the culture of research and education, and better patient experience.

In summary, sections A and B have provided a clinical issue and described in detail how the issues could be solved using a technology-based solution. Thus, the issue of poor communication between healthcare practitioners in a professional healthcare setting can be addressed sufficiently by adopting and implementing an electronic medical record system in the hospital.

Research Support for EMR Solution

Healthcare administrators and healthcare institutions acknowledge the importance of EMR in improving patient care. An EMR consolidates the patient’s medical records and improves information sharing among healthcare practitioners. Research provides that electronic medical records reduce the effects of human factors such as stress and fatigue, which cause medication errors when they are not carefully handled. Research conducted by various agencies and individuals supports the adoption and use of electronic medical records in healthcare facilities to encourage collaboration, teamwork, and improve communication among healthcare professionals. Electronic medical records foster effective communication in the healthcare setting by synchronizing the healthcare team, hospital organization, and individuals.

Research Study by O’Malley, Cohen, and Grossman

Research conducted by O’Malley, Cohen, and Grossman (2010) investigating the effectiveness of EMR in healthcare communication found that effective communication is hindered by human factors such as stress, fatigue, levels of staff, personality, distractions and interruptions, and memory failures. When those factors are not handled carefully, they pose a serious risk to patient safety. The researchers interviewed 26 healthcare practitioners with experience in both EMR and manual medical records. The practitioners included nurses, physicians, and nurse assistants.

Internal Threat to Validity

The health care practitioners who were interviewed might have been biased when giving their responses because there were no countermeasures in place to monitor bias.

External Threat to Validity

The participants included only those who had used an EMR in practice. This limits the generalization of the outcome. The sample size was small to guarantee the generalization of the results.

The reasons for including the study in support of this proposal

The study demonstrated that the use of EMRs can eliminate human factors that hinder effective communication among healthcare practitioners. The study also provided that it is rare for the physician to mistake medication or the patient records while using the EMR system. The researchers also noted that EMR can hinder face-to-face, patient-physician, conversation, which is crucial in healthcare. However, eliminating barriers to interpersonal communication would make EMRs effective.

Research Study Conducted by Shachak et al

Another research study conducted by Shachak et al (2009) found that electronic medical records (EMR) encourage interpersonal communication allowing healthcare professionals to get access to the real-time patient medical record. This improves health care coordination, which enhances patient outcomes. The study involved a sample of 25 primary care physicians who were interviewed using a semi-structured interview design. The researchers also used observation design to collect data for analysis. Upon consent, the physicians were interviewed. They were also observed for one week how they interacted and used electronic medical records. Sufficient data were collected and analyzed to generate important lessons about electronic medical records and patient safety.

Internal Threat to Validity

The Hawthorne effect may have affected the outcome of the observation results because the participants knew they were being observed.

External Threat to Validity

The sample size is a small limiting generalization of the results. In addition, the results may not apply to other physicians, not in the category of primary care physicians.

The reasons for including the study in support of this proposal

The study demonstrated that EMR potentially supports physician-physician communication through enhanced information sharing. In addition, the study found that electronic medical records (EMR) facilitate effective communication among healthcare practitioners. Observation results provided that the electronic medical record gave the physicians direct access to patients’ medical information. This enabled them to concentrate on the patient, rather than searching for the information from bulky paper files. This saved them time during patient visits (Shachak et al, 2009). However, the researchers concluded that only a few healthcare facilities have managed to adopt EMR because of financial constraints.

Research Study by DesRoches et al

According to DesRoches et al (2008), electronic medical record systems facilitate information sharing, which improves coordination and collaboration among healthcare professionals. In addition, healthcare facilities using EMR appear to have lower costs and better care services. The study involved a national survey of 2758 physicians. This number represented 62% of the response rate. The study surveyed physicians who were using the EHR in the office setting to identify their response to EMR adoption and their characteristics in practice.

Internal Threat to Validity

The participants may have exaggerated their responses concerning EMR adoption. This could occur because they knew they were being evaluated on their IT proficiency and responsibility. The pre-test results differed from the post-test results meaning that the change in post-test results might have been influenced by the pre-test experience.

External Threat to Validity

The sample size is small limiting the generalization of the results. Moreover, the study concentrated mainly on ambulatory care, so, it becomes ecologically impossible to generalize the result to other departments in the hospital.

The reasons for including the Study in Support of this Proposal

This research study demonstrated that hospitals utilizing EMR have improved patient care and controlled costs. Therefore, through electronic medical records, many costly medication errors, including prescription errors could be eliminated. The study also demonstrated that EMR eliminates paper-based healthcare transactions making it easier for healthcare professionals to offer efficient services. Moreover, EMR systems allow healthcare practitioners to access patient information in real-time to make timely decisions (DesRoches et al., 2008). The study pointed out some possible challenges that would be faced during EMR implementation. For instance, the physician reported that financial barriers greatly affected their decisions to adopt electronic medical records.

In summary, EMR systems improve the quality of care and generally make physicians and patients satisfied. Therefore, adopting and implementing an EMR is feasible and valuable in healthcare settings as supported by the three research studies analyzed above.

EMR Implementation Plan

Electronic medical records were identified in the previous section as the most viable solution to help reduce the problem of poor communication among healthcare professionals. This section provides a detailed EMR implementation proposal plan to guide the project team during the implementation and commissioning process.

Methods to be used to Implement the Proposed Solution

To implement the solution, the hospital will employ a process implementation planning methodology. This method is a customizable framework that would enable the implementation committee to establish a process and management program platform that influences the use of the 6D project channel. This method will ensure that the project management plans, expectations, and institutionalization of the project processes are managed effectively. It will involve the creation of an internal communication plan, setting up standards and policies, and project implementation procedures (Spector, 2010).

The Overall plan for implementing the Proposed Solution

The implementation process will begin with the selection of a committee of physicians, nurse practitioners, pharmacists, and IT experts. The project manager will make sure that at least every department in the hospital is represented on the committee. The implementation plan will follow the following procedure.

Assessment

The committee will conduct a thorough analysis of the hospital systems that require the incorporation of technology and EMR adoption. For instance, the hospital IT infrastructure will be evaluated as well as hardware requirements for the EMR system implementation (Brooks & Grotz, 2010).

Planning

Planning will involve reviewing the data collected during the assessment stage and developing EMR implementation goals. System improvement opportunities will be identified and targeted as well.

Selection

The type of the electronic health record system and the vendor will be selected during this stage. In addition, EMR system configuration and development goals will be identified and selected for replacement.

Implementation

The IT expert will initiate EMR system installation and configure the system hardware and software. The vendor will be given enough, but a scheduled timeline to carry out the implementation process. The staff will be trained on how to operate the EMR system. Finally, EMR system testing will be conducted to ascertain its workability (Spector, 2010).

Evaluation

The evaluation process will involve an audit of the whole project implementation process to identify possible challenges and develop measures to avoid them in the future. The committee will also use the review to generate an improved implementation plan.

Improvement

The implementation committee will modify the EMR to counter the problems identified during the evaluation phase.

Resources Needed for the Proposed Solution’s Implementation

Successful implementation of the EMR project requires qualified human resources, financial resources, and quality time. It also requires operational IT infrastructure within the hospital to enable hardware and software installation. The committee in charge of implementing the proposed solution will meet and discuss the actual cost of implementing the solution. However, a total cost of approximately $1000 will be used to carry out an intensive feasibility study before settling on a specific vendor who shall implement the solution.

Methods for Monitoring Solution Implementation

Survey and electronic data will be used to monitor the success of the EMR implementation. Survey tools will be used to monitor office medical processes such as doctors’ everyday jobs and administrative responsibilities after and before the implementation of the EMR system (Brooks & Grotz, 2010). This will enable the monitoring team to discover the weaknesses of the system and develop strategies to minimize them.

Using the Theory of Planned Change to develop the Implementation Plan

The development of this implementation plan utilized two planned change theories: Lewin’s change theory and the theory of reasoned change. Lewin’s change theory provides that change involves three distinct stages, which include unfreezing, change, and re-freezing. Unfreezing involves devising ways to have people forget their old patterns of behavior or operation. In this case, the hospital staff was to be mobilized against paperwork medical records, frequent face-to-face communication that is subject to confrontations, and the tradition of illegible physician handwriting. The unfreezing techniques provided by Lewin such as challenging the status quo were used accordingly.

The theory of reasoned action developed by Fishbein and Ajzen in 1975 was used to identify individual resistances and group conformity in this implementation plan. According to this theory, the realization of organizational change depends on the attitudes, intentions, beliefs, norms, and behavioral intentions of the organizing team. With this in mind, the committee responsible for developing this implantation plan realized that one’s decision to take an action depends on the intention, attitude towards change or reform, and the perception about the matter under consideration. As a result, this theory enabled the implementation committee to identify various intentions, attitudes, and perceptions the hospital staff had toward improving communication through the adoption of EMR. The second stage in Lewin’s change theory is changed.

The implementation committee, therefore, used the findings of the reasoned action theory to convince the healthcare team to accept the implementation of an EMR system. Lewin’s theory provides that for change to take effect, the organization must be prepared accordingly. Therefore, the hospital staff was prepared through continuous training, workshops, and seminars to change their attitudes, intentions, and perceptions towards technology adoption (Borkowski, 2005).

Moreover, the implementation committee organized a series of meetings with the top management to convince them about the importance of implementing an electronic solution to reduce medication errors, hospital operational costs, and paperwork. Lastly, re-freezing was conducted as provided by Lewin’s theory, whereby, technology adoption was taken as a new hospital culture to make it a standard operating procedure. This ensured that the hospital does not go back to its old ways.

Feasibility of the Implementation Plan

The hospital management is aware of the need to have a technology solution to deal with the issue of rampant medication errors and poor communication within the hospital. Therefore, the entire staff should be willing to accept necessary hospital reforms to improve patient care and safety. Implementation of this solution is viable because the hospital has an already established IT infrastructure. Moreover, the government is ready to offer financial support for the implementation of IT solutions to enhance patient care (Brooks & Grotz, 2010). The training conducted by the hospital change committee prepared the staff adequately on the importance of adopting EMR in the hospital. As a result, the implementation plan would not face resistance or group conformity problems. This makes the implementation plan feasible.

Outcome Measure

This section explains methods that were used to evaluate the process of electronic medical records implementation in the hospital. It also examines the outcome measure and shows how EMR discharge is reliable, sensitive to change, and appropriate for adoption. The major objective of this project was to implement an electronic medical record system that would help healthcare professionals solve communication problems within the hospital. Thus, they would avoid medication errors that jeopardize patient care and safety. Before-and-After the analysis outcome measure was used to evaluate the progress of this project. Improved communication between physician-physician, physician-nurse, and nurse-nurse, an overall reduction in medication errors in the hospital would indicate positive outcomes.

The project manager will collect data from health care professionals using a survey questionnaire three months after the implementation of an EMR system. The questionnaire will be based on the effectiveness and challenges of using an EMR in practice. In addition, the survey will measure satisfaction or dissatisfaction with technology use within the hospital. Some of the survey questions will be scale type to measure participant perceptions about the EMR project, while others will require the participants to give either true or false answers (Brooks & Grotz, 2010). The outcome measurement tool is provided in the appendix.

How the Selected Outcome Measure is Credible

The committee in charge of implementation, evaluation, and monitoring of the electronic medical records consisted of IT experts and healthcare professionals. Therefore, the criteria they used to develop the outcome measure survey were based on experience. This confirms the validity of the outcome measure in determining the effectiveness of EMR in improving communication between healthcare professionals and reducing medication errors. Moreover, the use of a survey instrument to collect information on EMR use and staff compliance with EMR standards enhanced the validity of this outcome measure.

The measure is reliable because it gathers information directly from the participants while evaluating their perceptions, interest, and willingness to use technology in practice. Furthermore, the measure is sensitive to health care reform and change because technology solutions are believed to improve patient safety and care. Therefore, the use of the survey was the most appropriate method to gather information on improved communication between healthcare professionals and reduced medication errors due to the successful adoption of EMR. The measure allowed the EMR implementation team to gather information before and after the execution of the EMR project to develop a better outcome.

Methods Used to Collect Outcome Measure Data and their Rationale

Behavioral and work-site observation method was used to collect outcome measurement data. This method is known to measure the effect of the behavior-based intervention. A checklist of communication behaviors between healthcare professionals and patients was developed and adjustments were made depending on the feedback. This method was chosen because it is a “leading indicator”, implying that intervention or safety measures are developed before an incident takes place. In addition, observations could occur regularly to generate information sensitive to changes caused by the adoption of electronic medical records.

Another method that was employed included employee surveys. The surveys were used to measure what could not be observed (World Health Organization, 2000). This method examined the knowledge, attitudes, beliefs, and perceptions healthcare professionals held about EMR incorporation in the hospital systems.

Resources Needed for Outcome measure Evaluation

Resources needed for evaluating the outcome measure include information and materials that were collected during a pilot project. The committee would need to spend quality time analyzing the post-test EMR implementation results to determine the effects of EMR in the entire hospital. The establishment of appropriate communication channels is also a vital resource needed for outcome evaluation. This would ensure that there is a precise and clear presentation of data and results to enable the management to make decisions for improvement. Other resources needed include qualified personnel, finances, and quality time. In addition, hardware and software resources will be required to ensure the successful installation and functioning of the EMR system (EMR Evaluation Toolkit, 2009).

The Feasibility of the Evaluation Plan

The evaluation plan is feasible because it depends on the participants’ willingness to embrace change efforts initiated by the committee in charge of EMR adoption. Change of behaviors, attitudes, and beliefs towards technology will enable healthcare professionals to use EMR effectively and improve patient care. EMR post-implementation evaluation results will help the committee to identify areas that need improvement to enhance the effective use of an electronic medical record system to improve communication and reduce medication errors (Brooks & Grotz, 2010). Thus, the evaluation plan is feasible.

Two Grant Funding Sources

The funding sources include federal funding through the HITECH Act that allows healthcare facilities to receive approximately $19 billion to adopt EHR. The proposal is good for this funding because it corresponds with the government’s efforts to promote patient care (EMR Evaluation Toolkit, 2009). Another funding source targeted is the $36 billion incentive payments made to physicians and hospitals. This funding is appropriate for this proposal because hospitals and physicians who demonstrate a desire to incorporate technology in practice and adopt EHR qualify for this fund.

Decision-Making Strategies

Maintaining the Solution

The committee in charge of implementing the electronic medical records will monitor staff compliance with technology for six months. Successful transition from paperwork records to technology records will reflect full compliance. However, any difficulties discovered with EMR use will be countered by continuous training. The outcome of successful implementation will also be monitored. Feedback from the patient, nurse practitioners, and physicians concerning EMR usage will be used to evaluate the progress of the solution. Positive feedback will mean the transition from the old ways is successful. On the other hand, negative feedback would imply that measures need to be taken to bring the change process to the truck.

Methods and Plans to Extend the Solution

Many healthcare facilities are committed to improving patient care through technology solutions. EMR reduces incidences of medication errors and patient dissatisfaction resulting from poor communication channels within the hospitals. To extend this solution, the hospital management is ready to organize seminars for physicians and senior healthcare professionals to teach them about the importance of using EMR. Moreover, the hospital will use the successful solution to encourage other healthcare facilities to adopt the solution. This would enable easy access to patients’ medical records in case a patient is referred to a different hospital for further medication.

Methods and Plans to Revise a Successful Solution

Six months after EMR implementation, the committee will evaluate the incidence of medication errors and the quality of communication among healthcare professionals. If the rate of technology adoption and proficiency is slow, training schedules will be revised, and a more simplified procedure will be adopted to enhance quick EMR adoption and use. EMR system experts will meet with the physician and the nurses to discuss possible challenges they faced for the last six months they had used EMR so that appropriate revision will be initiated. Revision on the solution will involve addressing all the challenges the hospital staff met while using the system.

Methods and Plans to Terminate an Unsuccessful Solution

To terminate an unsuccessful solution requires one to evaluate the solution from the beginning to identify the root cause of failure. The committee in charge will discuss the impact of terminating the solution. If the reasons for terminating the solutions include lack of information technology in the facility, lack of finances, or employees’ reluctance to change and reform, then the committee may decide to communicate the termination request to the project coordinator to facilitate termination.

Plans for Work Setting and Professional Feedback

Communication or feedback on the work setting is crucial. The supervisors will inform the project coordinator about the progress of the project weekly. Moreover, public announcements will be made available on the hospital notice board to inform stakeholders about the progress of EMR project adoption. In addition, the project coordinator will publish the project results in the hospital’s quarterly newsletter and email them to the external stakeholders to update them on the progress of the project. Lastly, the committee may inform stakeholders, both internal and external, about the benefits of implementing EMR during annual general meetings (World Health Organization, 2000).

Conclusion

This research proposal has provided that poor communication within healthcare facilities results in medication errors, which threaten patient care and safety. However, it has been proposed that successful implementation of EMR can improve communication between healthcare professionals as well as reduce the incidences of medication errors. Implementation of an EMR system is feasible because of guaranteed support from the government (O’Malley, Cohen, & Grossman, 2010).

References

Brooks, R., & Grotz, C. (2010). Implementation of electronic medical records: How healthcare providers are managing the challenges of going digital. Journal of Business & Economics Research, 8 (6), 73-84.

DesRoches et al., (2008). Electronic health records in ambulatory care: A national survey of physicians. New England Journal of Medicine, 359 (1), 50-60.

EMR Evaluation Toolkit. (2009). EMR evaluation and planning toolkit. Web.

Kirby, S. G. (2010). Communication among healthcare professionals: An essential component of quality care. Web.

O’Malley, A. S., et al., (2010). Are electronic medical records helpful for care coordination? Experiences of physician practices. Journal of General Internal Medicine, 25 (3), 177-185.

O’Malley, S, Cohen, R., & Grossman, J. (2010). Electronic Medical Records and Communication with Patients and Other Clinicians: Are We Talking Less? Web.

Shachak, A., Hadas-Dayagi, M., Ziv, A., & Reis, S. (2009). Primary care physicians’ use of an electronic medical record system: A cognitive task analysis. Journal of General Internal Medicine, 24 (3), 341-348.

Borkowski, N. (2005). Organizational Behavior in Health Care. Sudbury, MA: Jones and Bartlett Publishers.

Spector, B. (2010). Implementing Organizational Change (2nded.). Upper Saddle River, NJ: Pearson Prentice Hall.

The Victorian quality council (2010). Promoting effective communication among healthcare professionals to improve patient safety and quality of care. Web.

Wanzer, M. B., Booth-Butterfield, M. & Gruber, K. (2004). Perceptions of health care providers’ communication: Relationships between patient-centered communication and satisfaction. Health Care Communication, 16 (3), 363-384.

Woods, D.M., Thomas, E.J., & Holl, J. (2005). Adverse events and preventable adverse events in children. Pediatrics, 115, 155-160.

World Health Organization. (2000). Workbook7: Outcome Evaluation. Web.

Appendix

Before-and-after Analysis Outcome Measurement Tool

This outcome measurement tool helps to determine the amount of progress that has been achieved. Questions that healthcare professionals were asked pre-EMR implementation were slightly changed and then asked post-EMR implementation to determine how much has been achieved since implementation. The major focus is on the reduction of medication errors and improving patient safety.

Pre-EMR Implementation Questionnaire

  1. Do you encounter communication problems with colleagues when on duty? Yes or no
  2. How many times a week do you experience communication failure with nurses?
  3. How many medication error incidences do you report every week? How many of those incidences result from poor communication?

Post EMR Implementation Questionnaire

  1. Which of the two systems is easier to use, manual patient records, or electronic medical records?
  2. Do you still experience problems with communication after successful EMR implementation in your hospital?
  3. What is the frequency of communication problems post-EMR implementation?
  4. Have you ever encountered problems with EMR use?
  5. Have you ever recorded any medication errors resulting from communication breakdown post-EMR implementation?
  6. What future improvements do you propose?

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