Thursday, July 30, 2015

WorkFlow

Workflow is defined as any task performed in series or parallel by two or more members of a work group to reach a common goal. At a regular level, workflow would allow users to deliver information to the appropriate people; organize information to be immediately used; ensure that the information is acted upon; and finally file information and record action taken.
Due the complexity of the procedure of healthcare that involves both clinical and administrative tasks, workflow concept is an ideal match with the specific need of the healthcare industry (Chaiken, n.d.). A common problem that I used to see in my work place is the use of both Electronic Health Record’s (EHR’s) and paper documentation. The use of EHR’s in Saudi Arabia is in its infancy stage; therefore, it is not being fully utilized. Nurses are still documenting on paper, but have to enter Doctor’s orders in the system such as blood tests and x-ray requests. Additionally, there are only two computers in the unit for the nurses to use which delay the work of some nurses since they have to wait before entering the orders.
 Nursing documentation is important to patient care since caring for one patient can involve many providers and information sources. Thus, there should be complete and accurate information related to patient care. Using both, EHR’s and paper documentation can increase the work load on nurses leading to missing some of the information or performed procedure to be documented which affect the quality of patient care. Even more, it can lead to many errors at hand off or transition points in addition to degradation of information.  Paper-based documentation cannot keep healthcare providers completely informed because it can be only in one place at a time. Thus, it cannot be shared between two providers or more health specialist at different locations simultaneously. This has a negative impact on optimization of information management in healthcare and leading to reducing productivity and quality of care provided (Altuwaijri, 2008).

My proposed solution for improving this workflow is to fully utilize the EHR’s and install a software system that replaces the paper work. Each staff nurse will have a computer with access to the EHR’s and it is the only place where nurses and other healthcare professionals do their documentation. The EHR's will save time and ease the documentation process for nursing staff in addition to its benefit in reducing medical errors caused by unclear hand writing. The electronic format will provide healthcare providers with easy access to the patient medical records at the same time in different geographical areas. Furthermore, EHR will enable information sharing across the organization and between different organizations, enhance services to the patients, and ensure security and privacy of patient information. Here is an article showing Saudi Physician’s perspective regarding EHR’s      


In a systematic review done by Hasanain, Vallmuur, & Clark, 2014 it has been shown that due to some technical, social, and resources barrier, there has been low uptake of HER’s implementation in Saudi Arabia hospitals. Leaders must manage, plan, and evaluate the new integrated technology and its effectiveness in the setting. They also should educate and train the staff about the new embraced technology to increase the staff buy-in and empower them to engage and utilize the integrated technology efficiently and effectively (Volgelsmeier, Scott-Cawiezell, 2009). Leaders should performed constant review and evaluation of the implemented new technology to evaluate its effectiveness (Gamble, 2009). Leaders should be involved in the selection, planning, implementation, and evaluation of the new technology.
Here is a video explaining how to optimize your clinical workflow in four steps

References
Altuwaijri, M. M. (2008). Electronic-health in Saudi Arabia. Saudi Medical Journal. 29(2). 171-178.
Chaiken, B. P. (n.d.). Workflow in Healthcare. Retrieved on 27 July 2015 from http://www.docsnetwork.com/articles/BPC97112.pdf
Gamble, K. (2009). Administrative. All systems down: as more applications go live, the pressure on CIOs to ensure server reliability is growing.Healthcare Informatics26(11), 20.
Hasanain, R., Vallmuur, K. & Clark, M. (2014). Prograss and challenges in the implementation of Electronic Medical Record in Saudi Arabia: A Systematic Review.Health-informatics- An international Journal. 3(2). 1-14.
Marley, K., Reck, D. (2006). The Role of Nursing Leadership in Clinical Transformation. Nurse Leader, 29-33.

Volgelsmeier, A., Scott-Cawiezell, J. (2009). The Role of Nursing Leadership in Successful Technology Implementation. JONA, 39(7/8), 313-314.

Wednesday, July 22, 2015

Nursing Leadership and Technology Integration in Healthcare Setting

Technology had already transformed the healthcare system; therefore, the integration of technology would significantly and positively impact the quality of the provided services. Nurse leaders and nurses are key frontrunners in developing the infrastructure for effective and efficient health information technology that transforms the delivery of care. Therefore, nurse leaders should have a deep understanding of health information technology in order to first incorporate it in their own administrative platform and then provide effective leadership for their hospital, health system, or clinic. The basic understanding of technology integration will enable nurse leaders to manage, educate, and engage all the staff. The engagement is not limited on specific individuals; however, all levels of leadership must be engaged to embrace and manage the challenge of this change which is new technology integration in the setting.
There are some initiatives such as the Technology Informatics Guiding Education Reform (TIGER ) that would help nursing leadership to integrate technology in their own administrative platform and in the clinical setting. The Technology Informatics Guiding Education Reform ( TIGER ) Initiative represents a comprehensive, interdisciplinary effort that is well suited to the integration of informatics into education, practice, administration, and research environments. One of the highest priorities of TIGER summit was to develop revolutionary leadership that drives, empowers and executes the transformation of healthcare through the use and integration of technology in addition to engaging more nurses in the development of a national healthcare information technology (NHIT) infrastructure.
Leveraging programs such as Leadership Strategies for Information Technology in Health Care that enable nurse leaders and nurses to develop the organization health IT strategic vision, proactively addressing challenges posed by the changing health care landscape is significant because it will support the evolving role of health informatics in healthcare. In addition, Nurse Leaders should ensure that all practicing nurses adopt and adhere to all policies and principles of the TIGER initiative while they are “Nurse Leaders” are adhering to it. Leaders need to promote the new vision and mission of technology integration among their staff to help them take ownership of the process. In addition, Nurse Leaders are responsible to communicate with the staff and provide them with the proper training for any new implemented technology in order to use it properly and efficiently. Education and communication will help in fostering an environment that is receptive to the technology changes being integrated in healthcare setting.

  
References
Marley, K., Reck, D. (2006). The Role of Nursing Leadership in Clinical Transformation. Nurse Leader, 29-33.

Vogelsmeier, A., Scott-Cawiezell, J. (2009). The Role of Nursing Leadership in Successful Technology Implementation. JONA, 39(7/8), 313-314.

Friday, July 10, 2015


HUMAN/TECHNOLOGY INTERFACE


Healthcare is emerging into the new era of informatics technology. In today’s healthcare, healthcare professionals are encountering a wide variety of human-technology interfaces which increases the interaction between human and technology.
Human/Technology Interfaces is define as the hardware and/or software through which the user interacts with any technology such as computers, patient monitors, defibrillators, electronic thermometers, telephones and pagers. The availability of both, the principles and techniques for developing human/technology interfaces allowed the people to use the provided technology with minimal stress and maximum efficiency.



Patient care technology has become increasingly complex even though it has the potential to improve patient care. Furthermore, technology has transformed the way nursing care is conceptualized and delivered. Therefore, human technology interface is significant, as well as essential to nursing practice within healthcare today. The integration of technology within the nursing practice and patient care will ensure efficiency, accuracy, quality and safety for patients. Nurses effective use of the technology has the potential to produce a positive impact on nursing-sensitive patient outcomes with the support of nursing leadership. Effective nursing leadership can positively influence the effective development, dissemination, and use of technology. The interface of human with technology can make the lives of the people benefiting form it more efficient and easier; however, the new medical technologies could poses safety problems to the patient and healthcare providers if the users are not trained properly.
Caring and technology can be integrated in competent nursing care. The nurse is responsible to document nursing care and complete the electronic health record (EHR) while having the obligation to interact with the patient in the moment. To be able to complete the EHR, the nurse has to establish a caring and trustful relationship between self and the patient in order to perform a meaningful assessment and data collection process. 
 
References

Hill, T. (2013). Invited Editorial: Caring and Technology. Online Journal of Nursing Informatics, 17 (3). 2857.
Powell-Cope, G., Nelson, A. L. & Patterson, E. S. (2008). Patient safety and Quality: An evidence-based handbook for nurses. Rockville, MD. Agency for Healthcare Research and Quality.