(Solved) NURS-FPX6218 Assessment 1: Proposing Evidence Based Change | Homework Solution

Assessment 1 – Proposing Evidence Based Change

Propose a change to one aspect of your local or regional healthcare system or program that would improve outcomes. Then, conduct a comparative analysis of other, non-U.S. healthcare systems, focusing on the proposed change. Summarize the proposed change and your comparative analysis in a 4-page report.

Introduction

Note: Complete the assessments in the order in which they are presented.

Health care systems around the world provide useful models for analysis. Familiarity with different models and approaches to health care enables leaders to identify what works and what does not, as the basis for proposing a change. As we continue to evaluate the complex and fragmented system in the United States, it is important for nurse leaders to become familiar with the programs and systems that provide evidence-based quality care that is affordable and focused on continual improvement. Proposing Evidence Based Change

This assessment provides an opportunity to examine a local or regional health care issue from a global perspective.

Preparation

Your organization, in collaboration with the key stakeholders from the community, is funding an initiative to investigate potential improvements in the local or regional health care system. As a nurse leader attuned to the effects of health care policy and finance on the provision of affordable, high-quality care, you have been asked to join the task force conducting the study.

You know that an examination of other countries’ health care systems can provide a solid, evidence-based foundation for evaluating outcomes and identifying benchmarks. Consequently, you have decided to undertake an analysis of selected, non-U.S. health care systems and compare them to each other and to the existing local or regional U.S. system to help inform decision making as the task force considers proposed changes. Proposing Evidence Based Change

In this assessment, you will propose a change to one aspect of your local or regional health care system or program. Conduct a comparative analysis of different health care systems and summarize your proposed change and findings from your analysis in a report to executive leaders. Proposing Evidence Based Change To prepare for your assessment, you are encouraged to begin thinking about the non-U.S. health care systems you might like to examine.

Requirements

Complete this assessment in three steps:

1. Propose a change to one aspect of your local or regional health care system or program that would improve outcomes.
2. Conduct a comparative analysis of different health care systems, focusing on one aspect of the system you are proposing to change. Proposing Evidence Based Change
3. Summarize your proposed change and the results of your comparative analysis in a report to executive leaders.

The summary report requirements outlined below, correspond to the grading criteria in the scoring guide for Proposing Evidence-Based Change, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed. The Guiding Questions: Proposing Evidence-Based Change document provides additional considerations that may be helpful in completing your assessment. In addition, be sure to note the requirements below for document format and length and for citing supporting evidence.

• Identify an aspect of a local or regional health care system or program that should be a focus for change.
• Define desirable outcomes, including who will pay for care and factors limiting achievement of those outcomes.
• Analyze two non-U.S. health care systems or programs that offer insight into a proposed change for a health care system or program in the United States. Get SMART Goals Assignment Help!! Proposing Evidence Based Change
  

• • Choose one of the following options for selecting the two systems or programs:

• • • Option 1: Select two systems at opposite ends of the scale in terms of desirable outcomes for the issue reflected in your proposed change.
    • Option 2: Select two systems that both produce positive outcomes but take unique or innovative approaches to the problem. Proposing Evidence Based Change
  • Compare the outcomes in each non-U.S. system with each other and with present outcomes in your local or regional health care system.
• Explain why specific changes will lead to improved outcomes.
• Determine the financial and health implications associated with the proposed changes.

• • Address the implications of making the changes.
  • Address the implications of not making the changes. Proposing Evidence Based Change
• Write clearly and concisely in a logically coherent and appropriate form and style.
• Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.

Document Format and Length

• Your summary report should be 4 pages in length, not including the title page and references page.
• Be sure to apply correct APA formatting to all source citations and references.

• Cite 3–5 credible sources from peer-reviewed journals or professional industry publications to support your comparative analysis.

Assessment 1: Proposing Evidence-Based Change

Kathy Ergle Capella University

NURS-FPX 6218: Leading the Future of Health Care Prof. Donna Ryan

November 09, 2022

Proposing Evidence-Based Change

A healthcare system is crucial to improve health, enhance the quality of life, and prevent diseases. A good health system ensures timely access to effective care delivery. It integrates clarity in roles, better information transfer, and best care collaboration for better health outcomes (Kruk et al., 2018). Proposing Evidence Based Change In this assessment, I will propose a change in the local healthcare system to improve care quality for people struggling with mental health issues. Moreover, the change will be compared with two non-U.S. healthcare systems.

Executive Summary

Proposed Change

After heart and cancer problems, medication errors are the most common cause of high death rates in the United States. Most errors occur due to faulty or ineffective processes in a healthcare system (Carver & Hipskind, 2019). For example, the local health facility where I work depends on paper records for patient medical information, rising the chances of medical errors. Proposing Evidence Based Change Two other challenges that the healthcare system is facing due to paper records are related to the security of the medical records, poor decision-making, and ineffective information storage (Honavar, 2020). All these challenges make up care process for patients unsafe.

According to the World Health Organization (WHO), unsafe care is one of the ten worldwide leading causes of disability and mortality (World Health Organization, 2019). Proposing Evidence Based Change Therefore, the aspect of the local healthcare system related to paper records should be changed. The focus for change in the local and regional healthcare system is the utilization of an electronic medical record (EMR) system instead of paper records.

The expectation from the EMR system is to reduce medication errors, reduce time spent on data recording, and improve information storage, decision-making, and security of medical records through effective methods of data management (Vaidotas et al., 2019). Proposing Evidence Based Change According to the expectations, the EMR system will reduce medical errors occurring due to manual medical records. Also, the system will help providers store information in one place, and access the complete medical history of patients without dual tests and waste of time, leading to effective information and decision-making (Honavar, 2020).

Moreover, the EMR system is encrypted and provides access to only authorized stakeholders like relevant health providers and patients which results in a secure medical record (Hodgson et al., 2021). Proposing Evidence Based Change Study shows that the use of EMR reduced data recording time by 24.5% and 23.5% with equipment at the bedside and central location, respectively (Vaidotas et al., 2019).

Desired Outcomes

The desired outcomes of the EMR system will be:

1. Decline in medical errors

 

2. Lesser time spent on data recording

 

3. Effective information storage and decision-making

 

4. Secure medical records

These outcomes are defined as the desired consequences of using the EMR system in the local healthcare system. The rationale behind this definition is the evidence-based results of the EMR system that are associated with a reduction in medical errors, effective information storage, decision-making, and security of the medical record. Proposing Evidence Based Change The reduction in medical errors by using EMR is supported by a comparative study conducted by Vaidotas et al. (2019).

They compared the occurrence of medication errors in two emergency departments and two other units of a health setting. Two were using electronic records while the other was dependent on handwritten records. The results showed lesser medication errors and improved patient safety in the departments using electronic records. Proposing Evidence Based Change

The evidence by Hodgson et al. (2021) supports the enhancement of clinical factors and patient outcomes, including the integration of patient information in one place and improved decision-making regarding patient health by using an EMR system. Proposing Evidence Based Change Likewise, the research by Chen et al. (2020) supports the effective information storage and security of medical records with the implementation of EMR.

According to the authors, cloud computing technology used in EMR can store a large amount of health data in one place which makes it easier for providers to store and access the information effectively. Moreover, the research asserts that the system is secured with certain encryptions; its software is HIPAA compliant, and avoids access to unauthorized personnel, leading to the security of patient medical records.

To implement the EMR system, eligible providers and healthcare systems are provided with incentives by Medicaid and Medicare Services. Moreover, the Office of the National Coordinator for Health Information Technology (ONC) pays local and regional systems of the country to use the EMR system (HealthIT, n.d.). Proposing Evidence Based Change

Limiting Factors

There can be some factors that can limit the achievement of the desired outcomes. 

1. Training issues for the technological use of EMR exist in some health. For instance, lack of adequate training hinders the proper use of EMR by physicians. They do not know how to use the advanced features of EMR due to poor vendor training. Thus, better outcomes are not achieved properly. (Rahal et al., 2021).
2. Resistance to the use of EMR at the providers’ level. Physicians sometimes find the use of new technology complex and challenging which makes them avoid the technology (Singh et , 2020).

Healthcare System Comparative Analysis

The two non-U.S. systems selected for the comparative analysis are the Australian and United Kingdom (UK) healthcare systems.

The Australian healthcare system (acute and primary health settings) uses an electronic health record system to reduce medication errors, and improve information storage, decision- making, and record security (Schofield et al., 2019). Proposing Evidence Based Change The usability of the system depends upon the health sector and the features being used. For example, the positive experience of health providers in decision-making is more positive in hospitals while in the primary care sector the providers have positive EMR experience regarding easy storage of information and reduction in errors (Lloyd et al., 2021).

Studies show that medication errors after the implementation of the EMR system in an Australian healthcare system rose to the highest level (44.6%) initially due to lack of technology use. But after 1.5 years, the percentage of errors reduced below 7.3%. The type of errors varies as per job role. The healthcare system can use the study to promote providers’ training to effectively use the EHR system for the reduction in errors right after the implementation of the system (Qian et al., 2020).

In the UK, the healthcare system uses the electronic patient record system to improve the storage and access of patient information (McMillan et al., 2018). Study shows that the information is securely gathered in a digital form by using the EHR system. Also, it reduces the time for documentation. Proposing Evidence Based Change The healthcare system encourages the engagement of health providers in improving usability processes to improve the system use (Tapuria et al., 2021). The use of electronic medical records (known as NHS care records) in the healthcare system of the UK reduces some types of medication errors. The study suggests system optimization to reduce medication errors to a larger percentage (Slight et al., 2019).

Lessons from Both Systems

The lessons that I learned from studying both systems provide indicators for the US healthcare system. First, the system should organize training of health providers and increase their involvement in the usability of the EMR system to reduce difficulty in using the system. Proposing Evidence Based Change Second, the system should be optimized according to departmental needs to reduce medication errors of all kinds.

The Rationale for the Proposed Change Proposed Change leading to Positive Outcomes

The use of the EMR system in the U.S. healthcare system will improve medication errors, information storage, and security of records because it helps providers manage patient data using online technology (Adane et al., 2019). Proposing Evidence Based Change The process of data management through EMR is much easier than manual data recording (paperwork). In paper documentation, keeping patient records in one place is difficult and can cause human errors. In the case of online data recording chances of documentation errors are, reduce and providers can easily access the medical history of patients to know about his\her allergies.

Thus, the possible errors related to patient data and health information can be reduced, improving outcomes (Vaidotas et al., 2019). Second, the use of EMR reduces the time for paper documentation, gathers all patient medical history in one place, and provides easy and timely access to health information. It makes the storage of information effective and helps providers in decision-making regarding continuity of care (Honavar, 2020). Moreover, the researchers showed that encryption methods in EMR make the data of patients secure and safe from unauthorized access Proposing Evidence Based Change (Chen et al., 2020).

The evidence discussed above supports the rationale behind the proposed change and its contribution to improved outcomes. The expectations related to the use of EMR in the existing healthcare system are reasonable as they are supported by credible evidence. Proposing Evidence Based Change The associated benefits of using EMR are also evidence-based which is why the change within the system will be completely practical.

Financial and Health Implications

The use of EMR will reduce the financial burden on hospitals in certain areas such as administrative, nursing, and documentation costs. One study also showed an increase in reimbursement by using the EMR system (Tsai et al., 2020). Another study showed the short- term and long-term effects of implementing EMR. The effects include an increase in the cost of software updates and maintenance.

But the cost related to paper documentation and staff in data records decreased. Moreover, billing revenue increased with the use of the implementation of EMR. According to the study, other health implications of using EMR were a reduction in medication errors, increased confidentiality of data, better storage of information, increased adherence to guidelines, and improved health outcomes Proposing Evidence Based Change (Gopidasan et al., 2022).

The implications of not making the proposed change may include the risk of medication errors, lesser efficient decision-making regarding patient care, and risks associated with the security of patient data. Poor care quality can increase readmissions and cost implications for individuals and communities (Schopf et al., 2019). The United States government has to spend more than $40 billion on patients affected by medication errors each year Proposing Evidence Based Change (Tariq et al., 2022).

Cost-Benefit Analysis

The overall spent cost of the implementation of EMR was $31 billion till 2018. It is now considered a necessity for better patient outcomes. In 2019, the cost went to $27 billion which highlights the benefits of EMR usage in the settings (Nguyen et al., 2022). Proposing Evidence Based Change The cost-benefit analysis in different health settings showed a positive impact of EMR implementation on hospital revenue, positive net financial benefit after 3 years, and benefits for the pharmaceutical market. Other advantages included improvement in population health and patient experience (Nguyen et al., 2022).

Conclusion

 The use of the EMR system in the U.S. healthcare systems can reduce medication errors and improve information storage, decision-making, and security of medical records. The comparative analysis of two non-U.S, healthcare systems provide lessons related to EMR use in U.S. health settings. Also, the financial and health implications of making and not making the proposed change are discussed in the research work. Proposing Evidence Based Change

Appendix

Table 1: Health Care System Comparative Analysis

  Outcomes	Health Care   System of Australia	Health Care   System of Norway	Health Care   System of U. S
Reduction in medical errors	Long-term reduction in medication errors with the use of EMR Proposing Evidence Based Change	Reduced come kinds of medical errors	Increased chances of medical errors due to paper documentation
Effective information storage and decision-making	Positive experience with EMR regarding easy storage of information and decision-making	Improved information storage and decision-making with the use of EMR	Ineffective way of information storage and poor decision- making while using paper documentation
Secure medical records	The positive experience of keeping records safe with EMR	Secure information collection with EMR Proposing Evidence Based Change	Patient data on papers is not secure and anyone can access the information

 

References

Adane, K., Gizachew, M., & Kendie, S. (2019). The role of medical data in efficient patient care delivery: A review. Risk Management and Healthcare Policy, Volume 12(12), 67–73. https://doi.org/10.2147/rmhp.s179259

Carver, N., & Hipskind, J. E. (2019, April 28). Medical error. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430763/

Chen, C.-L., Huang, P.-T., Deng, Y.-Y., Chen, H.-C., & Wang, Y.-C. (2020). A secure electronic medical record authorization system for smart device application in cloud computing environments. Human-Centric Computing and Information Sciences, 10(1). https://doi.org/10.1186/s13673-020-00221-1/Proposing Evidence Based Change

Gopidasan, B., Amanullah, S., & Adebowale, A. (2022). Electronic medical records – A review of cost-effectiveness, efficiency, quality of care, and usability. Journal of Psychiatry Spectrum, 1(2), 76. https://doi.org/10.4103/jopsys.jopsys_17_22

HealthIT. (n.d.). Is federal financial support available for implementing electronic health records (EHRs)? | HealthIT.gov. Www.healthit.gov. Retrieved April 12, 2021, from https://www.healthit.gov/faq/federal-financial-support-available-implementing-electronic-health-records-ehrs

Hodgson, T., Burton-Jones, A., Donovan, R., & Sullivan, C. (2021). The role of electronic medical records in reducing unwarranted clinical variation in acute health care: Systematic review. JMIR Medical Informatics, 9(11), e30432. https://doi.org/10.2196/30432/Proposing Evidence Based Change

Honavar, S. G. (2020). Electronic medical records – The good, the bad and the ugly. Indian Journal of Ophthalmology, 68(3), 417. https://doi.org/10.4103/ijo.ijo_278_20

Kruk, M. E., Gage, A. D., Arsenault, C., Jordan, K., Leslie, H. H., Roder-DeWan, S., Adeyi, O., Barker, P., Daelmans, B., Doubova, S. V., English, M., Elorrio, E. G., Guanais, F., Gureje, O., Hirschhorn, L. R., Jiang, L., Kelley, E., Lemango, E. T., Liljestrand, J., & Malata, A. (2018). High-quality health systems in the Sustainable Development Goals era: Time for a revolution. The Lancet Global Health, 6(11), e1196–e1252. https://doi.org/10.1016/s2214-109x(18)30386-3

Lloyd, S., Long, K., Oshni Alvandi, A., Di Donato, J., Probst, Y., Roach, J., & Bain, C. (2021). A National Survey of EMR Usability: Comparisons between medical and nursing professions in the hospital and primary care sectors in Australia and Finland.

International Journal of Medical Informatics, 154(104535), 104535. https://doi.org/10.1016/j.ijmedinf.2021.104535

McMillan, B., Eastham, R., Brown, B., Fitton, R., & Dickinson, D. (2018). Primary care patient records in the United Kingdom: Past, present, and future research priorities. Journal of Medical Internet Research, 20(12), e11293. https://doi.org/10.2196/11293/Proposing Evidence Based Change

Nguyen, K.-H., Wright, C., Simpson, D., Woods, L., Comans, T., & Sullivan, C. (2022).

Economic evaluation and analyses of hospital-based electronic medical records (EMRs): A scoping review of international literature. Npj Digital Medicine, 5(1). https://doi.org/10.1038/s41746-022-00565-1

Qian, S., Munyisia, E., Reid, D., Hailey, D., Pados, J., & Yu, P. (2020). Trend in data errors after the implementation of an electronic medical record system: A longitudinal study in an Australian regional drug and alcohol service. International Journal of Medical Informatics, 144(104292), 104292. https://doi.org/10.1016/j.ijmedinf.2020.104292

Rahal, R. M., Mercer, J., Kuziemsky, C., & Yaya, S. (2021). Factors affecting the mature use of electronic medical records by primary care physicians: a systematic review. BMC Medical Informatics and Decision Making, 21(1). https://doi.org/10.1186/s12911-021-01434-9/Proposing Evidence Based Change

Schofield, P., Shaw, T., & Pascoe, M. (2019). Toward comprehensive patient-centric care by integrating digital health technology with direct clinical contact in Australia. Journal of Medical Internet Research, 21(6), e12382. https://doi.org/10.2196/12382

Schopf, T. R., Nedrebø, B., Hufthammer, K. O., Daphu, I. K., & Lærum, H. (2019). How well is the electronic health record supporting the clinical tasks of hospital physicians? A survey of physicians at three Norwegian hospitals. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-4763-0

Singh, A., Jadhav, S., & Roopashree, M. (2020). Factors to overcoming barriers affecting electronic medical record usage by physicians. Indian Journal of Community Medicine, 45(2), 168. https://doi.org/10.4103/ijcm.ijcm_478_19

Slight, S. P., Tolley, C. L., Bates, D. W., Fraser, R., Bigirumurame, T., Kasim, A., Balaskonis, K., Narrie, S., Heed, A., Orav, E. J., & Watson, N. W. (2019). Medication errors and adverse drug events in a UK hospital during the optimisation of electronic prescriptions: A prospective observational study. The Lancet Digital Health, 1(8), e403–e412. https://doi.org/10.1016/s2589-7500(19)30158-x/Proposing Evidence Based Change

Tapuria, A., Porat, T., Kalra, D., Dsouza, G., Xiaohui, S., & Curcin, V. (2021). Impact of patient access to their electronic health record: Systematic review. Informatics for Health and Social Care, 46(2), 194–206. https://doi.org/10.1080/17538157.2021.1879810

Tariq, R. A., Vashisht, R., Sinha, A., & Scherbak, Y. (2022). Medication dispensing errors and prevention. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519065/#:~:text=The%20total%20cost%20of%20looking

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Vaidotas, M., Yokota, P. K. O., Negrini, N. M. M., Leiderman, D. B. D., Souza, V. P. de, Santos, F. P. dos, & Wolosker, N. (2019). Medication errors in emergency departments: Is electronic medical record an effective barrier? Einstein (São Paulo), 17(4). https://doi.org/10.31744/einstein_journal/2019gs4282

World Health Organization. (2019). Patient safety. Who.int; World Health Organization: Proposing Evidence Based Change WHO. https://www.who.int/news-room/fact-sheets/detail/patient-safety