Building A Safer Health System
Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That’s more than die from motor vehicle accidents, breast cancer, or AIDS–three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. NURS 6051 Essay Assignments
To Err Is Human breaks the silence that has surrounded medical errors and their consequence–but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agenda–with state and local implications–for reducing medical errors and improving patient safety through the design of a safer health system.
This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients’ expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes.
Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errors–which begs the question, “How can we learn from our mistakes?”
Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care.
To Err Is Human asserts that the problem is not bad people in health care–it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocates–as well as patients themselves.
First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine
WEEK 2: Adaptive Response
The Innate vs. Adaptive Immune Response
The first line of defense against non-self pathogens is the innate, or non-specific, immune response. The innate immune response consists of physical, chemical and cellular defenses against pathogens. The main purpose of the innate immune response is to immediately prevent the spread and movement of foreign pathogens throughout the body.
The second line of defense against non-self pathogens is called adaptive immune response. Adaptive immunity is also referred to as acquired immunity or specific immunity and is only found in vertebrates. The adaptive immune response is specific to the pathogen presented. The adaptive immune response is meant to attack non-self pathogens but can sometimes make errors and attack itself. When this happens, autoimmune diseases can develop (e.g., lupus, rheumatoid arthritis).
The hallmark of the adaptive immune system is clonal expansion of lymphocytes. Clonal expansion is the rapid increase of T and B lymphocytes from one or a few cells to millions. Each clone that originates from the original T or B lymphocyte has the same antigen receptor as the original and fights the same pathogen.
While the innate immune response is immediate, the adaptive immune response is not. However, the effect of the adaptive immune response is long-lasting, highly specific, and is sustained long-term by memory T cells. NURS 6051 Essay Assignments
“Change in all things is sweet” (Aristotle in Nicomachean Ethics, c. 350 BCE). Aristotle recognized that change in our world occurs naturally and can be both good and bad. Today, we recognize that adaptation is an essential physiological process by which our physiology changes in response to stressors of all sorts; some intrinsic and related to our natural life span, others environmental and related to the world in which we live, and still others that are self-inflicted and far too often destructive. Physiological adaptation can occur at different levels, from the molecular and subcellular level to whole cells, tissues, and organisms. It is now clear that many adaptive mechanisms evolved to enhance survival, but others provide no benefit or underlie disease conditions.
In this issue of Physiology, a clear example of physiological adaptation at the integrated whole organism level is evident by the response of some large mammals to climate change. Similarly, our adaptive responses to changing levels of oxygen, particularly hypoxia, are crucial for survival. In another review in this issue, the molecular mechanisms linking oxygen sensing and apoptotic cell death are discussed in the context of adaptive responses. As is evident by this review, the mechanisms underlying physiological adaptation are complex. In recent years, we have learned that physiological adaptation can involve epigenetic modifications that are heritable changes in gene activity without modifications of the DNA sequence itself. Another review within this issue explores epigenetic alterations involved in chronic lung diseases. As pointed out in this and other previous articles published in Physiology, adaptive responses can be triggered by our own lifestyles. For example, obesity is a major human problem that is linked to adaptive and maladaptive changes across a number of physiological systems. Similarly, as discussed in another review within this issue, alcohol abuse can lead to maladaptations triggering a variety of associated diseases. It is clear that physiological adaptations are important in both health and disease, so our interest in understanding underlying mechanisms is well justified. We are only scratching the surface, and, lucky for us as scientists, there is so much more to learn.
Global warming is a fact of life, and we all should be concerned about how we will adapt to this changing world. If large mammals are to survive the hotter, drier habitats in a climate-changed future, they will have to rely on their ability to alter their physiology. Genetic adaptation to climate change is unlikely because large mammals reproduce slowly and are long-lived. Human-made barriers also will prevent them from moving to more suitable environments, and their large body size limits microhabitats available for thermal refuge. In their review (2), Fuller et al. discuss how large arid-zone mammals, such as goats, oryx and kangaroos, alter their behavior and physiology to buffer hotter and drier environments. Traditionally, such studies investigating physiological adaptation have relied on measurements made from animals housed under artificial laboratory conditions. Although these investigations have yielded valuable insights, they do not accurately predict how animals function in their natural environment. Stress responses with human observers nearby also confound normal physiological and behavioral responses of the animals. In their studies, Fuller and colleagues use data obtained by biologging in free-living mammals. A detailed understanding of free-living mammalian physiology, such as thermoregulatory behavior, body temperature variability, and selective brain cooling, is required to accurately predict future ecological patterns and conserve biodiversity.
WEEK 3: Health Communication
Effects of Poor Communication in Healthcare
Effective communication between healthcare professionals influences the quality of working relationships, job satisfaction and has a profound impact on patient safety. As the healthcare system has become more complex and patient expectations are fast evolving, medical facilities are facing many challenges posed by the lack of effective communication among staff and patients.
Inefficient communication between a patient’s physicians can result in the sub-par quality of care and poor outcomes for the patient. They are even, according to a study, one of the leading causes of preventable deaths in hospitals.
Impact of Ineffective Communication in Healthcare
The industry works within an intricate network that comprises healthcare providers, patients, third-party service providers, and insurance carriers. At the core, there are many complex relationships between hospitals, researchers, EHR owners, internal tech leaders, and healthcare executives. Subpar communication in Healthcare can result in many adverse effects, including:
- Medical errors: Mistakes often occur when there’s a breakdown in information sharing among the medical staff involved in a patients’ treatment. Proper documentation is of course, important. Still, the data also needs to be distributed to the entire team on time, so errors can be identified and corrected before adverse medical events happen.
- Long waiting time: Waiting even for 10 minutes to access healthcare services or support is considered a deal-breaker. Patients are frustrated by long wait times and often leave before being seen by a physician and tend to correlate wait times with the quality of care received from the medical facility. These delays are usually the result of improper communication and diminish the overall patient experience.
- Wrong, delayed, or expensive treatment: As a healthcare provider, one of your topmost priorities is to eliminate liabilities. When your patients undergo improper treatment, face procedural delays, or receive an incorrect medication, you end up facing severe financial and reputational consequences. NURS 6051 Essay Assignments
- Incomplete follow-ups: The patient journey is not a one-time experience. Physicians and nurses need to ascertain if the patient is following the treatment protocol or is taking the prescribed medication correctly. You risk losing track of your patient inquiries and call statuses, by using cumbersome and inadequate follow-up mechanisms. This could result in poor outcomes for the patient.
- Lack of outreach to elderly patients: Effective communication is a vital driver of the healthcare experience, especially, when healthcare providers are dealing with isolated individuals who do not maintain consistent contact with family and friends. Lack of communication could result in neglecting health issues in these elderly individuals.
- Uninformed recommendations: Patient data is crucial information that needs to be managed carefully by healthcare providers. If inconsistently shared among your staff, patients may not receive the most appropriate treatment recommendations. In turn, it could prevent physicians from making the right decisions.
- Improper handling of private medical data: Incubating a culture of data privacy is a boardroom mandate for healthcare organizations. As healthcare technologies continue to evolve, the threat of security lapses grows too. Without effectively integrating the Electronic Health Records (EHR) into your systems, your patient data is at risk of getting exposed.
5 Major Communication Barriers in Healthcare
The healthcare industry consists of a web of providers, patients, third-party service providers, and insurance carriers. The high level of complexity of interactions between various stakeholders raises barriers to effective communication in healthcare:
- Complexity and volume of the service call: Healthcare providers handle hundreds of calls every single day. Without prioritizing & monitoring them, critical service requests can fall through the cracks.
- Inability to share information across departments: Healthcare staff across multiple departments often collaborate to improve the quality of care of the patient. Failure to coordinate these collaborative efforts could lead to miscommunication and duplicate work.
- Hurdles in upgrading to new communication systems: Many healthcare providers are stuck with outdated legacy tools due to their inability to change without experiencing downtime.
- Cost of hardware and infrastructure: While upgrading communication systems, the cost of infrastructure can be very high. In such cases, justifying the ROI of new investments can be hard.
- Difficulty in providing clear patient instructions via voice calls: While it has become quite common for doctors and nurses to provide patients with guidance over the phone, it’s often hard for patients to fully grasp complicated instructions verbally without the aid of visual demonstration. As a result, patient compliance with follow up care suffers.
Growing Importance of Communication in the Healthcare Industry
Poor communication in Healthcare impacts overall patient experience and harms medical reputation. In today’s healthcare market, since patients are paying for a more substantial portion of their medical bills through copays and deductibles, they demand more responsive services from their providers. NURS 6051 Essay Assignments
Also, patients generally interact with healthcare providers under crisis or high-stress conditions. It may be difficult to sustain a positive mindset while scheduling a doctor’s appointment, getting an X-ray or awaiting lab results. Poor services, at stressful times, will negatively impact patient retention and referrals.
There is a great deal of caution to be exercised because the business of taking care of the patient is always personal. It pays to improve levels of clarity, empathy, simplicity, and sophistication of the communication skills of healthcare staff with effective training.
Effective communication in healthcare is the need of the hour and holds the key to unlocking seamless patient experiences.
Benefits of Effective Communication in Healthcare
According to research, there are definite positive relationships between healthcare professional communication skills and a patient’s capacity to follow through with medical recommendations. Studies show that the doctor’s ability to explain, listen and empathize can have a profound effect on health outcomes as well as patient experience and satisfaction of care. The benefits of improved communication will show in a number of ways. Some of them are:
- Improved diagnostic accuracy: patient and provider interviews will be more accurate, useful, and helpful.
- Better patient follow-through: with effective communication practices in place, you’ll make it easier and more likely for patients to follow through with care protocols.
- Higher patient satisfaction: by reducing the risk of human and system errors, you increase the chances of patients having a positive experience.
- Greater team satisfaction:effective team communication will enhance relationships, improve job satisfaction, and reduce job turnover
WEEK 4: Data, Information, Knowledge And Wisdom Continuum
Information technology is transforming the health care field with a plethora of new tools, software, and devices. This transformation has especially affected nurses, which is why health care information technology is often referred to as “nursing informatics.” Nursing informatics is used in practice settings to help organize and apply data, information, knowledge, and wisdom. The continuum of data, information, knowledge, and wisdom shows how nurses use facts to make decisions and provide care. This continuum provides insight for how nursing informatics contribute to different levels of understanding, decision-making, and evidence-based practice. The lowest level on the continuum is data. The term “data” refers to discrete sets of details related to a specific situation, patient, or population. You can think of data as isolated islands of facts that any observer would be able to view and objectively identify. NURS 6051 Essay Assignments The next level on the continuum, directly above data, is information. Information is the result of processing and organizing data into more manageable structures, and interpreting the meanings of individual data points. Information systems, such as electronic health records (EHRs), compile data and support nurses at the information level of the continuum. After information, the next level up is knowledge. Knowledge arises when information is synthesized into formal relationships and interconnections. Knowledge involves recognizing patterns and abnormalities based on separate sets of information. Nursing informatics that operate at the knowledge level are called decision-support systems. Finally, the highest level of the continuum is wisdom. Wisdom is the application of knowledge to addressing clinical problems and complex patient health issues with compassion and regard for ethics and quality of life. Let’s explore a clinical example of how data, information, knowledge, and wisdom build on each other. Consider a 48-year-old male patient of average height who is slightly overweight. The patient’s recent blood test indicates that he has impaired glucose tolerance and slightly high cholesterol. All of these initial facts about the patient represent data. The nurse discusses the results of the blood test with the patient, and invites him to return for a follow-up visit. The second blood test indicates higher glucose levels and the same high cholesterol. These serialized blood test results represent information. The nurse then takes this information, refers to the patient’s electronic health record, and discovers that the patient has a family history of diabetes. This data, added to the information from the blood tests, allows the nurse to determine that the patient has type 2 diabetes. This diagnosis is knowledge. Finally, the nurse uses wisdom to determine the most appropriate strategy for addressing this patient’s diabetes. Because the patient does not have a personal history with diabetes and is relatively young, the nurse discusses lifestyle interventions to manage his glucose levels. If after six months, the patient’s glucose is not within the normal range, the nurse and the physician will consider medications and other treatment options.
WEEK 5: Implementation of New Electronic Health Records
Steps to Successful Electronic Health Record (EHR) Implementation
Implementing an Electronic Health Record (EHR) is a multi-step process that will impact all staff members. As with any new process, a learning curve is involved. Having a solid plan can save hours of stress for everyone on your team.
Here are ten essential steps to take for a successful EHR Implementation.
1) Build your electronic health record (EHR) implementation team
As you implement your EHR, you’ll need a strong team to help the process go as smoothly as possible. The team can include staff members such as physicians, nurses, medical assistants and administrative staff. Team members will assist the process by teaching colleagues EHR skills and serving as messengers to the implementation team to identify challenges along the way.
A lead superuser, lead physician, and project manager are three essential roles to consider while building your team. NURS 6051 Essay Assignments
Lead Super User
The lead superuser is the resident in-house EHR expert. A few duties may include template creation and developing workflows. This position may also be responsible for creating standard operating procedures to address problems users come across as they use the system.
The lead physician’s role is to guide the organization through EHR implementation by serving as a link between the front line users of the system and the technical staff. Consider utilizing a tech-savvy physician who welcomes the new process as the lead physician.
The project manager will become the main point of contact with the EHR vendor and staff. This position will also help everyone keep focused on implementation timelines, track progress and deal with user issues.
2) Prepare the software
When implementing your EHR, ensure security measures are met to not violate HIPPA. Your organization may need to conduct a HIPPA risk assessment. You can work with your health IT vendor to make sure the software is compliant.
3) Determine your hardware needs
Your hardware choices will have a significant impact on the time and money your practice uses. For example, having a printer in every room can save physicians up to 30 minutes a day. Some practices provide each staff member with their own tablet or laptop to save time logging in and out between each patient interaction.
If the idea of doing all this seems overwhelming, IT service companies can help practices with system hardware needs by helping find the correct equipment at the best price. Many companies will also install and troubleshoot the devices, taking the burden off your office staff.
4) Consider the patient treatment room layout
As the EHR program requires electronic data entry, the room layout can have a substantial impact on patient engagement and satisfaction. If the staff and physician face away from the patient while entering data, patients may feel like they are not being heard.
One way to solve this is by using the “triangle of trust.” This is a room configuration where the patient, physician, and computer form a virtual triangle, allowing the patient and physician to see each other. This layout helps because the staff member or physician only has to turn slightly while entering data, helping the patient feel they are being seen. Consider placing semi-circular shaped desks in patient rooms or use moveable carts to help the patient feel at ease during their appointment.
5) Transfer data
Once your hardware and software are ready to go, the next step in EHR implementation is to transfer the data. To begin, you’ll need to determine how to migrate data from your former record system to your new EHR.
There are a couple ways to do this step. You can assign existing staff, or hire additional or temporary staff to upload information into the new EHR.
To make this process as smooth as possible, you’ll want to prepare a checklist of information to be entered into the EHR. Having a process in place will help ensure no critical information is missed. NURS 6051 Essay Assignments
6) Create workflows
Speaking of process, now is the time to get solid workflows in place. It is vital to establish workflows prior to EHR implementation to decrease the amount of stress your team will face.
Having inefficient workflows, including an insufficient number of staff members who are trained and ready to use the EHR will exacerbate issues during the implementation process.
Consider these questions as you create workflows:
- Is this necessary?
- Does this add value for the patient?
- Does this increase efficiency for the staff?
- Is this the right order?
- Is the right person doing this step?
7) What to do when your EHR is down
As with any type of technology, you must be prepared for the occasional glitch. Start by brainstorming issues and come up with a solid game plan for how to handle potential problems.
For example, what will you do when the power goes out? What if there is a system-wide malfunction that requires the help of IT to fix? You will want to develop procedures that give clear instructions to physicians and staff on what to do when the EHR is unavailable.
Consider these questions when developing your procedures:
- How will physicians and staff be notified of downtime?
- How will the patient care flow continue?
- How will patient check-in occur?
- How will physicians and staff document the visit?
Having electronic and paper procedures available to staff will increase their confidence on how to handle EHR downtime. Some medical practices compile the instructions in three-ring binders and store copies both in-house and offsite. Also, consider storing PDF copies on a secure cloud, so staff members have multiple options to get the instructions quickly.
8) Have a training program in place
Extensive training is imperative to ensure success with EHR implementation. Create a training plan so that all physicians and staff, current and future, can gain the knowledge and skills to use the EHR successfully when you are ready to launch.
Here are a few principles to consider:
Provide physicians and staff with basic skills before launching. It can be difficult for users to fully understand the system until they are able to use the program. Once users are able to “drive” for at least a week, additional training can be introduced to increase skills, learn time-saving tricks and get more comfortable with the technology.
Let colleagues teach colleagues
Consider training super users in each specialty and for each role. For example, nurses teach nurses best and surgeons teach surgeons best. Besides, if you have a super user in each specialty, they can become an ongoing resource for their colleagues. NURS 6051 Essay Assignments
Map out ongoing training needs
Have a plan for ongoing training. As time passes, users will find shortcuts and new ways to use the tools, and will want to share these findings with their colleagues. In addition, the EHR will need to be updated with new and/or improved functionality that will require extra training.
Ways to effectively handle these situations include:
- Develop a system for users to submit EHR recommendations so changes can be made.
- Encourage active EHR users to share input and offer solutions for enhancing usability, either by a formal tracking system or through an online discussion that encourages the sharing of ideas.
- Create a system for continuous EHR customization. Once physicians and staff have a handle on the new EHR, they will identify modifications that can improve workflow.
- Preserve the EHR vendor relationship and utilize IT support to:
- Develop or customize data entry templates
- Revise EHR generated forms and letters
- Enable new clinical decision support rules (if available)
- Modify order sets
- Look for integration opportunities with other commonly used systems in the practice
- Plan group training in advance. Training will take time from seeing patients, so advanced planning decreases disruption to the practice workflow.
9) Decide on launch approach – “Big Bang” or Incremental?
Once your EHR implementation plan is ready to go, it’s time to decide how to launch. There are typically two ways to do this, all at once, the “Big Bang” or slowly, in an incremental approach.
Some practices use the “big bang” approach and roll out the EHR system for all patients and functions on the same day. This approach minimizes time spent managing paper records as well as the new EHR system at the same time. The disadvantage is it can be very disruptive and small problems can seem monumental.
Some practices take a slower approach and implement the EHR incrementally. By introducing EHR functions one at a time, such as e-prescribing to begin and then introducing other features later, some practices find the disruption easier to manage. Larger practices and organizations may implement slowly by rolling out the EHR in specific sites or departments first and introducing the program to the rest of the organization later.
Once the launch approach is decided, physicians and staff can get ready for the new EHR system.
On the actual “Go Live” day it is recommended to lower the patient volume which will ensure a smooth transition for both patients and staff. It is also recommended that the front desk staff informs the patients either pre-appointment or the day of that the practice is transitioning software and that the process may be slightly interrupted. They will appreciate the insight and have more patience should there be a delay during their visit. NURS 6051 Essay Assignments
10) Gather feedback for continual improvement
Now that you’ve successfully implemented the EHR, be sure to gather feedback from the users to continually improve the process. Be sure to keep the lines of communication open so staff members and physicians feel comfortable providing feedback. If everyone works together, the EHR system will be an improvement to your practice.
Implementing an EHR is a multi-step process that requires advanced planning. Use these steps to help make the transition as smooth as possible.
WEEK 6: Adoption of New Technology Systems
If users don’t adapt to and adopt the new technology, it is wasted money, effort, and time. Your ROI tanks. User adoption is not just achieved by training users on how to use the new technology, it is achieved by gaining buy-in and commitment. By implementing new technology you are disrupting the daily routine of users. This causes frustration and resistance. If this is not addressed it leads to delays, slows customer response time, and creates employee and customer satisfaction issues.
You’re in luck, though! Below are 7 tips for a successful technology adoption, that I have compiled after working too-many-to-count technology projects:
1. Align technology and strategy
Specific technology is often implemented because of the vendor and name recognition (i.e. SAP, Epic, Oracle), and not because it is necessarily the best solution to meet business needs, or achieve strategic goals. When choosing which technology to implement for your business, don’t just weigh the name of the vendor and the price. Take a look at your strategy. Think about how new technology will help you achieve your strategic goals.
The purpose of introducing new technology to a business is to improve performance. Start with the goals you want to achieve, and then plan backwards, finding a technology that best supports improved performance. People are more likely to adopt new technology if they can see how it helps them to achieve their goals and objectives.
2. Communicate for buy-in and engagement
Achieving user adoption for new technology requires communicating with stakeholders early and often. Before you can communicate with stakeholders you need to have all your stakeholder groups identified. The way each currently performs their work, processes, should be documented. The impacts the new technology will have on them needs to be identified and communicated. Ways in which your organization will mitigate any negative impacts for stakeholders also needs to be communicated. NURS 6051 Essay Assignments
You shouldn’t just be communicating cutover and go-live dates. Engagement requires communicating “with” and not “at” your stakeholders. Communicating for engagement requires audience segmentation. Not all stakeholders will need to hear the same message at the same time in the same way.
Informing stakeholders you are deploying new technology because “we need it” or because “leadership says so” or even because “it will help us compete” are not specific enough details to drive engagement – and engagement increases adoption.
- Perform a current systems analysis
Technology upgrades or introducing new technologies carries a huge compatibility risk – what if the new systems turn out not to be compatible with those you already have or integration requires more build time than was anticipated. To prevent system integration issues, make sure you review all your current technology systems thoroughly before you consider deploying something new. Don’t just conduct detailed requirements gathering for the new technology, make sure the functionality of your current systems can support and integrate effectively with your new technology. Performing this work upfront will prevent system redundancies, reduce costly build times, and help the budget from ballooning.
4. Develop training approach early
One of the biggest risks to user adoption is lack of sufficient and customized training. Many vendors offer training options as part of your technology purchase, however, most of this training is standardized off the shelf and not specific to your business processes or culture. Training should not just be screenshots and PowerPoint. People need to see and play in the system, prior to go-live, in the context of their specific work processes. NURS 6051 Essay Assignment
To increase adoption, make sure that training is specific to each stakeholder group and the way they perform their work. One quick way to increase resistance and decrease adoption is to make stakeholders feel they’ve wasted their time with training, and have them end up even more confused because they don’t see the connection to their work.
Additionally, not everyone will learn and adapt to new technology in the same way. Consider offering multiple training methods – electronic, classroom, smaller hands-on training labs – various options ensure users feel most prepared. NURS 6051 Essay Assignments
5. Integrate technology deployment with change management
Many organizations are so focused on deployment and conversion, schedules and criteria, that they fail to deploy and integrate a change management process for helping stakeholders adapt and adopt to technology. This is often one of the biggest reasons for rocky deployments, low adoption, and project failure. Technology only achieves desired goals if the people adopt it, if they don’t, technology is just wasted money.
To maximize adoption and minimize resistance, your deployment plan and team must be integrated with the change management plan and team. If you don’t have a change management plan and resources in place then you may want to get on that pronto.
WEEK 8 ; Patient Placement Flowchart
This study examined the predictive validity of the ASAM Patient Placement Criteria for matching alcoholism patients to recommended levels of care. A cohort of 248 patients newly admitted to inpatient rehabilitation, intensive outpatient, or regular outpatient care was evaluated using both a computerized algorithm and a clinical evaluation protocol to determine whether they were naturalistic ally matched or mismatched to care. Outcomes were assessed three months after intake. One common type of under treatment (ie, receiving regular outpatient care when intensive outpatient care was recommended) predicted poorer drinking outcomes as compared with matched treatment, independent of actual level of care received. Over treatment did not improve outcomes. There also was a trend for better outcomes with residential vs. intensive outpatient treatment, independent of matching. Results were robust for both methods of assessment. Corroboration by more research is needed, but the ASAM Criteria show promise for reducing both detrimental under treatment and cost-inefficient over treatment.
WEEK 11: Health Information Patient Handout
Health information management (HIM) is an empirical exercise that involves obtaining, evaluating, and safeguarding traditional and computerized clinical data with the objective of offering quality patient care. (McWay, 2013).
Acute care is a division of additional health care where a patient gets short-term albeit active treatment for a severe injury or an incident of illness, a critical medical ailment and so forth. In medical parlance, acute health care conditions contrast longer term care or chronic care. Non-cute care data refers to all scientific data used to analyze, evaluate and interpret acute health data. Such data is given then administrative and healthcare managers for decision and policy making interventions (Kahn, et.al, 2013). NURS 6051 Essay Assignments
The type of acute data collected can include; if the average length of stay (ALOS) for such diagnosis-related groups is considerably different from that of the national average length of stay for these diagnosis-related groups. The geographical area coverage the facility serves how charges compare with those of federal health facilities, which surgical/medical services admit the most number of patients among many others.
Data collection challenges that face health information managers are vast albeit, the most common ones include increasing and improving data analytical skills among HIM managers, analyzing data requires a high level of understanding, aptitude, and knowledge of health information and the tools needed to perform such tasks. Cultural barriers, this is with regards to disparities in ethnicity, language and culture; some cultures stigmatize some ailments while some patients are inherently difficult to obtain information from directly. Another challenge facing information management professionals is that collection and analysis of acute data might take too much time, and encroach on the budgetary limitations of the data collection exercise (Jordan, et.al, 2013).
A health information manager integrates medical skills, management skills, and information systems/technology skills in his/her daily responsibilities. He/she oversees all the medical information management at a given facility, designs and manages healthcare information systems, collect, analyze and generate reports on patient also institute procedures established to handle and safeguard patient data. NURS 6051 Essay Assignments
Non-Acute care is a part of ancillary health care where a patient gets short-term active treatment for less severe injuries. Non-cute care data refers to all empirical evidence used to analyze, assess and deduce non-acute health data. Equally, such data is then handed over to the administrative and healthcare managers for decision and policy making. Types of non-acute data can include how many patients got hospital-acquired infections, lengths of stay if any, diagnosis-related groups for inpatient discharge from the hospital among others (Audet, Squires & Doty, 2014).
Data collection challenges that face health information management professionals for non-acute healthcare include getting accurate data on senior citizens who frequently see several doctors and take various medications do not often give specific information between the different caregivers making analysis and interpretation of such data inaccurate. Equally, systems are now identifying, and research is similarly establishing, that the emergency section of a non-acute care hospital is not a suitable place for the senior citizens to obtain appropriate and efficient attention and diagnosis. The challenge is riddled with a further projection that asserts that by 2030 in the United States, for instance, there will be over 70 million senior citizens over the age of 65, which will be approximately three times as much as it was in the year 1980 (Audet, Squires & Doty, 2014).
Additionally, health information management personnel face the challenge of increasing and improving data analytical skills for analyzing data which typically requires high-level understanding, competence, and knowledge of health information systems, administration skills and the applications mandatory to accomplish such a momentous task.
Health information management professionals are charged with the authority of advancing quality medical care service delivery, by guaranteeing valuable information is accessible to relevant policy and healthcare decision makers. The personnel can oversee the services in collecting, planning, examining, and distributing individual patient and personal medical data. NURS 6051 Essay Assignments
An information system contains four interconnected modules namely, users, data, process and information technology. Health information management personnel’s’ general responsibilities equip them with the expertise in consolidating clinical information and procedures in a health management information system. Computerization of healthcare systems in caregiving establishments, the responsibilities of such management specialists have transcended beyond into information technology support, which typically is the duty of technology maintenance services (Appari, Eric & Anthony, 2013). Health Information Management experts’ experience and knowledge in the field of medical and administration over and above their training on managing clinical data; that equips them with the competence to uphold the authenticity and availability of e-medical data (Kahn et. al., 2013).
In conclusion, the healthcare sector is responsible for the structural quantum change in Health information Technology which enables involved parties to manage costs, espouse authenticity and advance the proficiency of the healthcare management technologies by streamlining services. This approach is set to instigate a broad health management framework that permits clinical data to be mutually utilized by clients, service providers and other related entities. NURS 6051 Essay Assignments