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HAS 6385 July 23, 2012 Team 6- Sixers

Quality Improvement Project Electronic Medical Recording system at: Blue Horizon Eating Disorder Services, LLC. HAS 6385 July 23, 2012 Team 6- Sixers. Need for Improvement. Keeping of an accurate charting system affects the overall quality provided by a medical office

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HAS 6385 July 23, 2012 Team 6- Sixers

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  1. Quality Improvement ProjectElectronic Medical Recording system at:Blue Horizon Eating Disorder Services, LLC HAS 6385 July 23, 2012 Team 6- Sixers

  2. Need for Improvement Keeping of an accurate charting system affects the overall quality provided by a medical office Accurate patient charting will also aid in the increased accuracy of communication Hospitals within the United States are expected to adopt electronic medical records for use within the entirety of their organizations by 2014 The use of poor handwriting in patent charts resulted in over 7000 deaths each year

  3. Organizational Design Blue Horizon: small organization- 12 employees Not necessary for a total overhaul of current design Opportunity for management to make a significant impact • Lead from the top • Emphasize the need for all employees to take responsibility for quality As Blue Horizon grows, their organizational design will evolve with it

  4. Quality Theorists Influential quality theorists Blue Horizon should look to for their CQI process: W. Edwards Deming 14 points for management Walter Shewhart PDCA (Plan, Do, Check, Act) Cycle MalcomBaldrige Healthcare Specific Criteria with weighted scores

  5. Identifying the Scope of the Quality Problem Tools Flow Chart • Ability to see big picture • Shows how the quality problem affects each employee User Survey/ Interviews • Helps engage staff and encourage participation • Can identify specific issues users are experiencing Leadership/Staff Need to be prepared to train for the new process Realistic expectation of what the electronic documentation will solve Must keep staff highly motivated throughout the upgrade Provide positive criticism

  6. Recommendations for Changes in Process • Standard Project Management Principles Initiation Identifying parties involved Planning Details priorities and roles Implementation Training and “Go-Live” Close-out Monitoring system and listening to feedback

  7. Cost Indicators & Improvement EMR Long-term quality benefits outweigh high initial costs EMR potential cost savings are 81 billion annually How to determine: cost justification, cost-benefit ratio & quantifications How elaborate of a system is appropriate? Disadvantages: initial lost productivity, installation costs Cost reduction in: clerical, transcription, malpractice premium, storage space

  8. Implementation Plan Plan • Ensuring skills with computers by all members • Akin new system to align with benefits of old • Education of the staff Communication of Results • support from top management • Strong administrative involvement • creation of reports Maintaining Improvement • Focus on continued efficiency • Organizational leadership and encouragement • Offer staff all the resources needed to support the success of the new charting system

  9. Conclusion • Blue Horizon would greatly benefit from EMR • Growing company = more documentation • Effective system contributes to overall quality • Goal is to provide best care/maintain excellent communication • Current paper system has glitches EMR could fix • Organizational change & education required • Plan to implement EMR quickly with a smooth transition

  10. References Bigelow, J., Bower, A., Girosi, F., Hillestad, R., Meili, R., Scoville, R., Taylor, R. Can Electronic Medical Record Systems Transform Health Care? Potential Health Benefits, Savings, And Costs. September 2005 vol. 24 no. 5 1103-1117.Blaivas, M. (2012). Some charting methods put sued EPs in a tough spot. ED legal letter, 23(1), 1-2. Retrieved from CINAHL, EBSCO. Retrieved from http://web.ebscohost.com.Cao, B.Y., Chow, C., Elliott, P., MacPherson, R.D., Crane, J., & Bajorek, B.V. (2011). Implementing a pharmacist charting service in the pre-admission clinic.Journal ofPharmacy Practice & Research, 41(2), 102-7. Retrieved from CINAHL, EBSCO. Retrieved from http://web.ebscohost.com Curry, D.L., Gelowitz, T., Aldridge, G., & Kuncewicz, K. (2012). Transitioning to electronic medical records. Radiation Therapist, 21(1) 87-95. Retrieved from CINAHL,EBSCO. Retrieved from http://web.ebscohost.com..DeVore, D., Price, C., & Natzke, J. (2007). Preparing for electronic charting. Nursing homes: Long term care management, 56(1), 28-31, 85-6. Retrieved from CINAHL, EBSCO. Retrieved from http://web.ebscohost.com.Ehling, M., & Korner, T. (2007). Handbook on data quality assessments methods and tools. Retrieved from http://unstats.un.org/unsd/dnss/docs-nqaf/ Eurostat-HANDBOOK ON DATA QUALITY ASSESSMENT METHODS AND TOOLS I.pdf Harman, K., Bassett, R., Fenety, A., & Hoens, A. (2009). “I think it, but don’t often write it”: The barriers to charting in private practice. Psychotherapy Canada, 61(4), 252-8 (27 ref). Retrieved from CINAHL, EBSCO. Retrieved from http://web.ebscohost.com.Kelley, T.F., Brandon, D.H., & Docherty, S.L. (2011). Electronic nursing documentation as a strategy to improve quality of patient care. Journal of Nursing Scholarship, 43(2) 2nd Quarter, 154-62 (43 ref). Retrieved from CINAHL, EBSCO. Retrieved from http://web.ebscohost.com. Nicholson, S.K. (2011). Risk management. Electronic medical records and you: Issues related to accessing, editing, and standardizing documents. PT in motion, 3(8), 46-56. Retrieved from CINAHL, EBSCO. Retrieved from http://web.ebscohost.com.Ransom, E., Joshi, M., Nash, D., & Ransom, S. (2008) The healthcare quality book, 2nd. edition. Chicago: Health Administration Press. Renner, K. (1996). Cost-justifying electronic medical records. Hfm (Healthcare Financial Management), 50(10), 63.Salmela, S., Eriksson, K., & Fagerstrom, L. (2012). Leading change: A three-dimensional model of nurse leaders' main tasks and roles during a change process. Journal of Advanced Nursing, 68(2), 423-433.Scaletta, T. (2012). Charting methods: Each has legal pros and cons. ED Legal Letter, 23(1), 2-3. Retrieved from CINAHL, EBSCO. Retrieved from http://content.ebscohost.com.

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