Transforming Nursing and Healthcare Through Technology: The Use of Clinical Systems to Improve Outcomes and Efficiencies

Clinical systems make use of regulatory process and organization needs reviews to allows for specific operational and clinical performance areas to be targeted through technology interventions and mediations to ensure quality outcomes. From assessing the current position to implementing the clinical system, much insight can be gained to meet the care delivery goals. This is especially the case of the operational and clinical workflows can be aligned to streamline processes and technology, improve customer satisfaction, and improve outcomes. To be more precise, clinical systems can be applied to assess and monitor regulatory and quality measures in the rapidly changing health care industry that engages in strategic planning and implementation of a range of technologies and treatments. However, clinical systems have been significantly underutilized so that their use does not go beyond monitoring to provide a proactive, more hands-on approach in areas that are critical to financial and clinical performance. There is a gap, then in understanding how implementation of clinical systems, particularly electronic health records (EHR), can be customized to improve nursing outcomes and efficiencies.  Transforming Nursing and Healthcare Through Technology Essay Paper

Annotated Bibliography

Karp, E., Freeman, R., Simpson, K., & Simpson, A. (2019). Changes in Efficiency and Quality of Nursing Electronic Health Record Documentation After Implementation of an Admission Patient History Essential Data Set. CIN: Computers, Informatics, Nursing, 37(5), 260-265. https://doi.org/10.1097/CIN.0000000000000516

In this journal article, Karp et al. provide the results of a research study into the effects of personalizing a nursing electronic health record (EHR) documentation system. The study notes that including an admission patient history essential data set into the system helps to improve the efficiency and quality of nursing documentation. The study specifically reports that personalization reduces the active time that nurses spend on documenting patient history by 72%, from an average of 9.3 minutes reported before the nursing EHR documentation system was personalized to an average of 2.55 minutes reported after the personalization. Additionally, the results of the study indicate that the number of clicks reduced by 76%, from an average of 151.5 clicks before the personalization to an average of 35.93 clicks after the personalization. Besides that, the authors reported that the personalization resulted in the quality of documentation improving as only 6% of essential data elements was captured before the personalization to 24% of essential data elements being captured after the personalization. The study concludes that personalizing the EHR for the facility/organization is important for improving efficiency and quality of clinical workflow.  Transforming Nursing and Healthcare Through Technology Essay Paper

This journal article is relevant to the current research that focuses on how EHR, as a clinical system, can be customized to improve nursing outcomes and efficiencies. The explanation of aspects of clinical workflow that would be improved is useful for organizations that are seeking to customize the nursing EHR documentation system. However, more information is needed to understand how other aspects of nursing clinical workflow, outcomes and efficiencies would be affected.

De Benedictis, A., Lettieri, E., Gastaldi, L., Masella, C., Urgu, A., & Tartaglini, D. (2020). Electronic Medical Records implementation in hospital: An empirical investigation of individual and organizational determinants. PLoS ONE, 15(6), e0234108. https://doi.org/10.1371/journal.pone.0234108

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De Benedictis et al. presents the results of a research study that explores the factors that influence hospital-wide implementation of electronic medical records (EMR). The authors note that although EMR has long been considered as a significant factor for improve safety and quality in health care, improving clinical research, optimizing processes, reducing costs, decreasing adverse events, and obtaining the best clinical outcomes, EMR implementation is limited. The authors specifically note that implementation is limited by resistance to accept EMR. The results of the study reveals that medical personnel and health care organizations expect many benefits from EMR to include positive impact on effectiveness, efficiency and quality of care, greater control of the organization as a business, research and tutoring activities, and handover communication between health care workers. In addition, the study reported on factors that influence EMR implementation to include normative factors (perceived usefulness, ease of use and intention to use), and regulative factors (intention to use and perceived usefulness). The article concludes that the key factors to consider are peer influence and perceived usefulness, and that these factors can be leveraged on power users to motivate, generate and manage change.

De Benedictis et al. offers significant insight into factors that must be considered in the implementation of clinical systems to ensure that their full value is derived. Although the analysis is helpful in driving EMR implementation, more research is required to understand what value of EMR can be captured in terms of changes to nursing outcomes and efficiencies. Without this additional information, it would be difficult to this study as a basis for implementing EMR in other organizations. However, it does provide useful ideas and context that researchers can use to improve EMR implementation and acceptance.

Kleib, M., Jackman, D., Wisnesky, D. U., & Ali, S. (2021). Academic Electronic Health Records in Undergraduate Nursing Education: Mixed Methods Pilot Study. JMIR Nursing, 4(2), e26944. https://doi.org/10.2196/26944

Kleib et al. provide an analysis of the use of academic electronic health records (EHR) in undergraduate nursing education. It notes that while EHR has received significant attention and is increasingly being implemented, teaching EHR in nursing education programs presents a significant challenge. To address this concern, the study sought to apply simulated EHR education as an experiential, learner-centered strategy focused on enabling nurse learners to acquire and apply the knowledge need to professionally work with EHR. The results of the study revealed that prior to the program, about two-thirds of nursing students have inadequate or fair knowledge of EHR. The education program resulted in improved knowledge of EHR. In addition, there is high satisfaction with the education program.

Kleib et al. offers insight into knowledge deficiency as a limitation in EHR implementation. The study makes it clear that although EHR can improve nursing outcomes and efficiencies, the improvements would be limited by the knowledge deficiencies. With this information, we gain insight into the factors that influence the outcomes of using clinical systems. Thus, this study will provide useful context on factors that influence EHR use and outcomes.

Vehko, T., Hyppönen, H., Puttonen, S., Kujala, S., Ketola, E., Tuukkanen, J., Aalto, A-M., & Heponiemi, T. (2019). Experienced time pressure and stress: electronic health records usability and information technology competence play a role. BMC Medical Informatics and Decision Making, 19, Article number 160. https://doi.org/10.1186/s12911-019-0891-z

In this journal article, Vehko et al. present the results of a study into the usability factors of EHR and nurses’ informatics competence. The authors note that EHR has become an elementary part of the health care environment and that nurses are the single largest health care profession that uses EHR. Based on the results of a national survey conducted in Finland, the study reported that poor user friendliness and low EHR reliability are factors associated with high time pressure when using EHR. In addition, low informatics competence was associated with time pressure. Besides that, low informatics competence, low support for cooperation and low EHR reliability was associated with high psychological distress. The study concludes that unreliability and poor-user friendliness of EHR is a significant source of psychological distress and time pressure among nurses.

This journal article is relevant to the current research that focuses on how EHR can be customized to improve nursing outcomes and efficiencies. Its explanation on the factors that affect EHR use is helpful for designing a clinical system optimized for the best nursing outcomes and efficiencies.

Conclusion

One must accept that clinical systems help in improving operational and clinical performance through targeted technology interventions and mediations. In addition, one must acknowledge that clinical systems can offer significant value, but have been underutilized. This is because there is a gap in understanding how implementation of clinical systems, particularly EHR, can be customized to improve nursing outcomes and efficiencies. Karp et al. (2019) helps to fill the gap by explaining aspects of clinical workflow is useful for customizing EHR implementation as it explains the workflow areas that can be targeted. De Benedictis et al. (2020) offers significant insight into factors that must be considered in the implementation of clinical systems to ensure that their full value is derived, and this is useful for improving EHR implementation and acceptance. Kleib et al. (2021) offers insight into knowledge deficiency as a limitation in EHR implementation, and this is useful context on factors that influence EHR use and outcomes. Vehko et al. (2019) explains the factors that affect EHR use, and is helpful for designing a system optimized for the best nursing outcomes and efficiencies. The four identified journal articles provide background information to help explore the research interest on how EHR implementation can be customized to improve nursing outcomes and efficiencies.

References

De Benedictis, A., Lettieri, E., Gastaldi, L., Masella, C., Urgu, A., & Tartaglini, D. (2020). Electronic Medical Records implementation in hospital: An empirical investigation of individual and organizational determinants. PLoS ONE, 15(6), e0234108. https://doi.org/10.1371/journal.pone.0234108

Karp, E., Freeman, R., Simpson, K., & Simpson, A. (2019). Changes in Efficiency and Quality of Nursing Electronic Health Record Documentation After Implementation of an Admission Patient History Essential Data Set. CIN: Computers, Informatics, Nursing, 37(5), 260-265. https://doi.org/10.1097/CIN.0000000000000516

Kleib, M., Jackman, D., Wisnesky, D. U., & Ali, S. (2021). Academic Electronic Health Records in Undergraduate Nursing Education: Mixed Methods Pilot Study. JMIR Nursing, 4(2), e26944. https://doi.org/10.2196/26944

Vehko, T., Hyppönen, H., Puttonen, S., Kujala, S., Ketola, E., Tuukkanen, J., Aalto, A-M., & Heponiemi, T. (2019). Experienced time pressure and stress: electronic health records usability and information technology competence play a role. BMC Medical Informatics and Decision Making, 19, Article number 160. https://doi.org/10.1186/s12911-019-0891-z

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

New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.

Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.

In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.

To Prepare:

• Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
• Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
• Identify and select 4 peer-reviewed research articles from your research.
• For information about annotated bibliographies, visit https://academicguides.waldenu.edu/writingcenter/assignments/annotatedbibliographies

The Assignment: (4-5 pages not including the title and reference page)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:

• Identify the 4 peer-reviewed research articles you reviewed, citing each in APA format.
• Include an introduction explaining the purpose of the paper.
• Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.
• In your conclusion, synthesize the findings from the 4 peer-reviewed research articles.
• Use APA format and include a title page.

Transforming Nursing and Healthcare Through Technology Essay Paper