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HIT: Key to Quality Improvement
Information technology (IT) has reached a point of maturation, with ubiquitous broadband, mobile devices, more options for data input, advanced analytic, and applications in the cloud. So that well-designed software can improve clinical workflow. Health Technology does make things better. It provides instantaneous access to information where, and when, it is needed. It can help facilitate communication and collaboration. It can sort through huge amounts of data and help someone make sense of it. It can free up space in a health provider office that was previously dedicated to health paper records. Properly applied, and with appropriate training in its use, health information technology will help transform clinical workflow and practices for the better. Nurse leaders played a crucial role in achieving quality improvement and medication safety through technology. When nursing leaders guided the implementation process by working with teams to integrate the technology to redesign and improve existing medication processes, organization-wide improvement occurred. To achieve improvement with large-scale change, nurse leaders must work alongside staff to interdependently improve processes, challenge existing rules that impede open communication, and collectively work to achieve a common goal. These characteristics exemplify a transformational leadership style, where leaders and staff work together toward a greater good. Transformational leaders strive to raise their followers up by working interdependently as a team. Nurse leaders who create an environment conducive to open communication and information sharing will ultimately lead to a cohesive, goal-directed team environment. Importantly, when nurse leaders facilitate teamwork and goal achievement by empowering the team through seeking ongoing team member input and feedback, improvement can occur.
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In a healthcare setting, when the unit is full, and when it takes 12 hours or more for a room to be clean and ready for the next patient. In an emergency room , as one nurse prepares to go off shift, and the head nurse ask her, could you remind a housekeeping that room 4 still need to be cleaned while you are passing by them?. It’s not a problem to remind housekeeping to come up, but the problem is these small adjustments are sometimes forgotten, in due time the regular hospital schedule will bring the right people to clean the room. That impact of the slower progress is felt throughout the organization that leads to lower job satisfaction, and potentially lower quality of care.
Health IT promises many benefits for improving efficiency and quality. Health IT systems often assume a workflow structure in the way their steps are organized. Organizations that studied workflow design are more likely to be successful in adapting to health IT. Healthcare industry depends heavily on good and valuable information. These valuable information can be lost when poor workflows impede communication and coordination or increase interruptions. Characteristics of a poorly functioning work process include unnecessary pauses, delays, and rework. Health organizations adapt workflows to suit the evolving environment. Over time, organizational workflows may show that some processes are no longer necessary, or can be updated and optimized. Workflows are the set of tasks, grouped chronologically into processes, and the set of people or resources needed for those tasks, which are important to accomplish a given goal. Efficiency in the workflow can be improved by carrying out processes in parallel, rather than improving the efficiency of existing steps. Workflow processes are mapped that direct the care team how to accomplish a goal. A good workflow will help accomplish those goals promptly; leading to care that is delivered in a safe manner, more consistently, reliably, and in compliance with standards of practice. Nowadays, developing a supportive, proactive care environment that ensures patient safety and satisfies nurses requires outstanding leadership. It takes a strong nurse leader to Lead continuous quality improvement initiatives, ensure collaboration, foster lifelong learning strategically manage resources and facilitate empowering care delivery models that increase the level of nursing practice within the organization. Nurse leaders striving for every opportunity to support nursing excellence can take advantage of information technology to analyze outcomes, identify issues, and access hard data to support programs for change. Nurse leaders regularly review and use data drawn from the decision support system, including information on staffing, patient satisfaction, patient accounting. Nurse leaders use these information to identify areas for improvement, recognize successes, and help plan nursing programs at the strategic level. Health care is a nurse leader business and, as such, nurse leaders must seamlessly respond to patient clinical changes that will be created, enabled and supported by technology. Therefore, to ensure readership of nurse managers, executives, and faculty stay knowledgeable and informed about health information technology(IT) and the fundamental informatics competencies that are required to function within the patient-care environment. Nursing leaders have a double responsibility to develop systems in the world of IT to first, to provide a safe patient care and second, to support the work of leaders and managers leveraging IT. Competency in clinical IT is a fundamental tool for the leadership practice of managers and leaders. Thus, it will become more important in the future as we develop more sophisticated clinical IT. A nurse leader needs technologies in her/ his administrative platform and clinical settings to make healthcare safer, more effective, efficient, patient-centered, timely and equitable by interweaving evidence and technology seamlessly into practice, education and research fostering a learning healthcare system.As technologies leverage and improve the workplace by providing data about the impact of nursing care, nurse leaders can translate, synthesize, interpret, and manage the data into measurable outcomes. The innovative nurse leader integrates people, processes, and technology for transforming and moving beyond past simple problem-solving approaches of overcoming complexity by utilizing information and technology to focus on managing the benefits of both technology and practice. Because data technology tools give a nurse leader the opportunity to track individual patient input in real time, so s/he can implement effective strategies to address clinical issues and problems before these needs advance to a critical and costly level. Moreover, it allows a nurse leader to leverage reports that provide evidence of individual and aggregate patient trends over time. So, a nurse leader can evaluate and measure the effectiveness of interventions. Thus, s/he has an opportunity to discover gaps in the both the care delivery processes and systems can be identified quickly. References Retrieved from http://www.medscape.com/viewarticle/473683_2 Retrieved from https://www.nursingeconomics.net/necfiles/news/MJ_10_Nickitas.pdf The development of a perioperative nursing language; Perioperative Nursing Data Set (PNDS); established an evidence-based practice model (PNDS) for preoperative professional nurses. The Perioperative Nursing Data Set was created in the 1990s by AORN members. PNDS is a clear, precise nursing language that offers standardized terminology to support a perioperative nursing practice. Justifying perioperative nursing care can be performed with a national database both quantitatively and qualitatively. The purpose of this language is to allow for sharing of reliable, retrievable, and reportable clinical data for analysis and decision-making purposes.
The third edition of PNDS was published in 2010. The goal of the most recent edition of PNDS is to make the perioperative nurse use the PNDS in a meaningful way. Moreover, the goal is to promote the implementation of the standardized PNDS in health practice, both in written documentation and the electronic health record. PNDS Components 64 nursing diagnoses. 127 nursing interventions. 29 nurse-sensitive patient outcomes. PNDS Benefits Describes: Patient problems that nurses identify. Interventions that nurses provide. Resources required to administer the care. The achieved outcomes. Allows: A structure of documentation and evaluation of nursing care. Precise and complete data analysis. Benchmarking activities among healthcare organizations. Costing based on activity. PNDS Implications for Clinicians • Supports standardized nursing documentation. • Provides language for clinical pathways and replication of outcomes. • Guides developing policies and procedures. • Provides language for quality indicators and improvement initiatives. • Facilitates clinical based research activities. • Assists measuring and evaluating of patient care outcomes. • Enhances patient care continuity. PNDS Implications for Managers • Develops databases that help supporting resource utilization review. • Supports practicing in a professional model. • Provides for consistent communication and documentation. • Assists with clinical data comparison from large patient populations. • Supports databases to help in measuring clinical outcomes and in monitoring level of effectiveness. • Permits cost evaluating in relationship to quality and effectiveness . • Offers valid clinical data for decision making and health care policy development. • Supports cost calculation, management and reimbursement in clinical and administrative activities at the perioperative setting. PNDS creation allows for the concept of a complete computerized patient record to be realized. When PNDS is inserted in the information systems, it makes it possible to extract information that is consistent and comparable across perioperative settings and institutions. The documentation of the nursing impact being made on patient outcomes becomes apparent. References Petersen, C. & Kleiner, C. (2011). Evolution and revision of the Perioperative Nursing Data Set. Europe PupMed Central. 93(1):127-132. DOI: 10.1016/j.aorn.2010.07.015. Retrieved from http://europepmc.org/abstract/MED/21193085 Preoperative Nursing Data set. (2003). Retrieved from http://people.duke.edu/~newki001/ Researchers design and use of computer technology, focusing especially on the interfaces between users and computers. Throughout the past two centuries, technologies have made rapid progress, revolutionization, and refining many aspects of human life. Such as electricity, steam engine, printing machine, automobiles, airplanes, telephones, radio, television.., etc. In health care settings, highly quality patient care relies on careful documentation of every patient’s health status, family history, current medical conditions and treatment plans. Thus, much attention has been focused on applying computer technology to facilitate the delivery of health care in a fast and safe manner. Human-Technology Interface (HTI): is the understanding of how humans comprehend, interact, and use the world around them by interacting with any technology (e.g., computers, patient monitors, robots, telephone, etc.). The increasing use of computers, robotics, and virtual reality depend upon technology to make a "user-friendly" environment. It also can realize a large amount of data and images and to "naturally" interact with computers and machines. HIT has opportunities to improve nurse productivity and satisfaction, operational efficiency, patient satisfaction, safety, and quality. The HTI is everywhere in health care and takes many forms and may present information using numbers, texts, icons, pictures, or sound. Wearable Intelligence's compliant platform is one example of human-technology interfaces. Wearable Intelligence's compliant platform wirelessly enables nurses, physicians, and surgeons, to achieve greater efficiency, collaboration, and patient satisfaction. References Satava R. M & Ellis, S. R. (1994). Human interface technology. An essential tool for the modern surgeon. PubMed. (7):817-20. Huston, C . (2015). The Impact of Emerging Technology on Nursing Care: Warp Speed Ahead. The Online Journal of Issues in Nursing Retrieved from http://wearableintelligence.com/industries/healthcare. |
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