NURS 6051 The Use of Clinical Systems to Improve Outcomes and Efficiencies

Assignment Brief: NURS 6051 – The Use of Clinical Systems to Improve Outcomes and Efficiencies

Assignment Title: The Use of Clinical Systems to Improve Outcomes and Efficiencies

Course: NURS 6051 – Healthcare Systems and Quality Management

Assignment Overview

In this assignment, you will explore the impact of clinical systems on healthcare outcomes and efficiencies. You will focus on Electronic Health Records (EHRs) as a key clinical system. This assignment aims to enhance your understanding of how healthcare informatics and technology can shape the quality of care and operational efficiency within healthcare organizations.

Understanding NURS 6051: The Use of Clinical Systems to Improve Outcomes and Efficiencies

The NURS 6051 course delves into the critical role of clinical systems, such as Electronic Health Records (EHRs), in improving healthcare outcomes and operational efficiencies. It emphasizes the importance of leveraging technology to enhance the quality of care, streamline processes, and ultimately benefit both patients and healthcare providers.

The Student’s Role

As a student in NURS 6051, your role in this assignment is to conduct a literature review focusing on the application of clinical systems, particularly EHRs, and their impact on healthcare outcomes and efficiencies. You will analyze and synthesize peer-reviewed research articles to gain insights into the effectiveness of EHRs in various healthcare contexts.

NURS 6051 The Use of Clinical Systems to Improve Outcomes and Efficiencies Example Paper

Introduction

In the wake of the 21st-century digital revolution, governments, medical organizations, and institutions are increasingly embracing information and digital technology as the cornerstone of delivering high-quality healthcare to patients. With proven benefits in various significant industries such as retail, telecommunications, and manufacturing, investing in information technology offers a tangible return on investment, which can be quantified through improvements in patient outcomes and healthcare efficiencies (Mullins et al., 2020). Among the technologies garnering significant interest from healthcare organizations worldwide is the utilization of electronic health records (EHRs) to provide top-tier care. Researchers widely concur that EHRs have the potential to revolutionize healthcare delivery by enhancing care coordination, patient treatment, and adherence to evidence-based medical guidelines (Wani & Malhotra, 2018). Nonetheless, limited research exists on the efficacy of EHRs during their implementation. This paper aims to delve into articles that assess the impact of EHRs on the quality of care delivered to patients.

Annotated Bibliography

1. Mousa, M., Rankin, D., Mullins, A., O’Donnell, Rankin, Boyd-Skinner, C., Ben-Meir, M., & Skouteris, H. (2020). HEALTH OUTCOMES AND HEALTHCARE EFFICIENCIES ASSOCIATED WITH THE USE OF ELECTRONIC HEALTH RECORDS IN HOSPITAL EMERGENCY DEPARTMENTS: A SYSTEMATIC REVIEW. Journal of Medical Systems, 44(12). https://doi.org/10.1007/s10916-020-01660-0

This systematic review aimed to investigate the potential impact of EHRs on healthcare outcomes and efficiencies within hospital emergency departments. The authors conducted a systematic review of articles retrieved from databases like MEDLINE, EMBASE, and EMcare, spanning from 2009 to 2019. The selection criteria encompassed articles that assessed the functional impact of EHRs or health information exchanges, reported benefits in patient health outcomes and improved healthcare costs, were published in English, and underwent peer review. Out of 6635 publications, 23 articles met the inclusion criteria. The findings identified eight distinct categories of healthcare outcomes and three types of efficiency benefits associated with EHR usage in the emergency department. These benefits encompassed reductions in admission rates, improved diagnosis accuracy, decreased length of stay, and cost savings from reduced diagnostic testing and imaging. Notably, the study shed light on a previously unexplored phenomenon: moderate to large increases in admission rates linked with EHR adoption in the emergency department.

2. Shelden, D., Ateya, M., Jensen, A., Arnold, P., Bellomo, T., & Gianchandani, R. (2020). Improving Hospital Glucometrics, Workflow, and Outcomes with a Computerized Intravenous Insulin Dose Calculator Built into the Electronic Health Record. JOURNAL OF DIABETES SCIENCE AND TECHNOLOGY, 15(2), 271-278. https://doi.org/10.1177/1932296820974767

This study sought to investigate the impact of integrating a computerized intravenous insulin dose calculator into the EHR to enhance workflow, glucometrics, and outcomes within a hospital setting. The study employed a multidisciplinary approach, involving stakeholders from various departments such as nursing, pharmacy, clinical informatics, hospitalist service, critical care, and information technology. After the integration of the IV insulin calculator into the EHR, medical providers could conveniently order insulin using the linked infusion calculator through the physician order entry interface. The study assessed the outcomes of this intervention through a pre-and post-intervention framework. While the use of the insulin calculator led to a reduction in hypoglycemia incidence, particularly in severe cases, statistical significance for this parameter was not achieved. Nevertheless, the post-intervention group exhibited no instances of severe hypoglycemia. The study also noted a favorable trend in average blood glucose levels. In conclusion, the authors emphasized that the results of the study’s insulin calculator intervention yielded lower rates of hypoglycemia compared to previous empirical studies. Given these findings, the authors advocated for the continued adoption of EHR systems as the standard of care for patients.

3. Malhotra, M., & Wani, D. (2018). DOES THE MEANINGFUL USE OF ELECTRONIC HEALTH RECORDS IMPROVE PATIENT OUTCOMES? Journal of Operations Management, 60(1), 1-18. https://doi.org/10.1016/j.jom.2018.06.003

This paper aimed to investigate the impact of meaningful assimilation and integration of EHRs, as mandated by the Health Information Technology for Economic and Clinical Health Act, on patient health outcomes. The study design involved an examination of the effect of EHRs on patient length of stay (LOS) across three levels of healthcare institutions: those that fully implemented EHRs, those that partially adopted EHRs, and those that meaningfully integrated EHRs. Data were collected from the Office of Statewide Health Planning and Development (OSHPD) of California spanning from 2010 to 2013. The dataset included patient discharge records and demographic information. The results revealed that the average LOS decreased by 3% for patients receiving care at institutions meaningfully employing EHR technology compared to those treated at fully adopting EHR hospitals. The degree of reduction in LOS was more pronounced for patients with complex comorbidities and coordination issues. Additionally, a decrease in readmission rates by approximately 6.5% was observed over the same period. Such benefits were not observed among EHR complete adopters. Consequently, the study provided empirical evidence that, beyond mere adoption, hospital-wide EHR assimilation can significantly enhance patient care efficiency, particularly benefiting senior-aged patients.

4. Wilson, F., Martin, M., Yamamoto, Y., Partridge, C., Moreira, E., & Arora, T. et al. (2021). ELECTRONIC HEALTH RECORD ALERTS FOR ACUTE KIDNEY INJURY: MULTICENTER, RANDOMIZED CLINICAL TRIAL. BMJ, m4786. https://doi.org/10.1136/bmj.m4786

This paper set out to investigate the impact of electronic health record alerts on health outcomes for patients with acute kidney injury through a randomized clinical trial. The study encompassed six Yale-New Haven Health System institutions located in Rhode Island and Connecticut. Inclusion criteria required patients to be aged 18 or older and diagnosed with acute kidney injury. The randomized intervention involved the implementation of electronic automated pop-up alerts triggered when a patient’s electronic chart was accessed. Outcomes measured included dialysis receipt, progression of acute kidney injury, and interventions administered within 14 days of randomization. Secondary outcomes comprised the frequency of specific practices for acute kidney injury patients, including urine output and creatinine monitoring, documentation of acute kidney injury, urinalysis ordering, and kidney consultation ordering. The study included 6030 participants who met the inclusion criteria. The results indicated that the group receiving electronic health record alerts exhibited a higher likelihood (38.4%) of receiving intravenous fluid orders compared to the control group (34.8%). They were also more likely to undergo urinalysis (17.0% vs. 14.9%) and have serum creatinine measured (87.2% in the randomized group vs. 85.2% in the control group). Furthermore, the intervention groups exhibited a higher likelihood of documentation of acute kidney injury during hospital admission (70%) compared to the control group (63.0%). However, no significant differences were observed in recording urine output or the frequency of intravenous fluid administration at 24, 48, and 72 hours post-randomization. Ultimately, the study concluded that the implementation of automated electronic alerts for acute kidney injury patients had minimal impact on process measures and did not significantly affect the risk of progression, mortality, or dialysis. Therefore, the authors did not endorse the adoption of electronic alerts for acute kidney injury patients.

Conclusion

Electronic health records (EHRs) have emerged as pivotal tools in healthcare delivery, holding the potential to enhance the quality, efficiency, and cost-effectiveness of care. The reviewed studies collectively support the notion that strategic implementation of EHR systems can lead to improved healthcare outcomes and efficiencies within medical institutions. Nevertheless, it is essential to acknowledge that the impact of EHRs may vary depending on the specific clinical context. Consequently, ongoing research and evaluation are imperative to maximize the benefits of EHRs in diverse healthcare settings.

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