Week 2 Assignment
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Christopher White
Week 2 Assignment
HIM 301: Introduction to Health Informatics
November 6
th
, 2023
Chapter 7 | Michael H. Kennedy, Kim Crickmore, and Lynne Mile
How are patients prioritized for bed assignment?
The case study does not go into detail about how patients are prioritized when it comes to
bed assignment at Zed Medical Center; however, it does mention that the Patient Placement
Facilitators in the Patient Care Coordinator Department decide which nursing unit patients
should be assigned to based on the level of care needed, physician preferences, and the scope of
care supported by the nursing units. The Bed Control Division uses this data to place new
patients in available beds. The severity of a patient's illness, the availability of adequate
treatment resources, and the urgency of the situation are probably all factors in determining the
order in which patients are seen.
Patient care and hospital efficiency are both negatively impacted when the work of
assigning beds is inadequately handled. Assigning beds requires thoughtful planning and
execution for effective capacity management. Essential guidelines include centralizing bed
assignment power, using non-clinical personnel, providing an escalation mechanism, and setting
priorities. Priorities for bed assignment need to be connected to the requirements of the sickest
patients in the organization, wherever they may be, with those needing ICU-level care having the
greatest priority.
(Dick, 2019).
Describe some of the advantages and disadvantages of this new software; include the stated
organizational goals in your answer.
TeleTracking software is used to coordinate patient transfers and bed allocations at Zed
Medical Center. Some of the benefits include enhanced patient safety, real-time insight into bed
availability, and streamlined communication and processes thanks to a centralized system. It also
fits nicely with the hospital's plans to enhance patient flow and better manage bed capacity.
However, some of the drawbacks include pricey setup and ongoing upkeep, extensive training
for all staff members, the risk of a decline in staff decision-making ability, and the inability to
account for all factors influencing patient bed allocations. Benefiting from EHR systems requires
a shift toward evidence-based medicine, system and team-based care, and quality improvement
approaches. Although the EHR cares about quality, safety, and efficiency, it cannot guarantee
these qualities on its own (2021b).
Discuss how this software might share data with other institutional applications to provide a
dashboard view of census-type activity.
Data from Zed Medical Center's TeleTracking program, used for managing patient
transfers and bed allocations, may be shared with other institutional systems, creating a "census
view." This is possible with the use of data integrations and APIs, which facilitate
communication between various programs. According to Dr. Nicholas Marko, chief data officer
at Geisinger Health, "There is no such thing as one set of data that gives you everything you need
in one single format." This means that there will always be a need to work with systems that can
process information from a wide variety of sources. (2021)
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TeleTracking, for instance, may communicate with the hospital's EHR system, which
stores both demographic and clinical data on each patient. Patient volume, bed availability,
duration of stay, and acuity levels are just a few of the major parameters that may be shown in a
unified dashboard view made possible by the hospital's integration of this data. This may aid
hospital management and staff in making educated choices about patient care, resource
allocation, and personnel levels.
The financial management, supply chain, and personnel management systems may all
benefit from the information-sharing capabilities of the TeleTracking software. Patient admission
and transfer data, for instance, may be shared with the accounting software. To prepare for new
patients, it might communicate relevant information to the supply chain management system.
Last but not least, it can communicate with the HR software to help with staffing needs
depending on patient volume and severity.
The TeleTracking program may assist hospital managers and staff in making data-driven
choices to enhance patient care and operational efficiency by exchanging data with other
institutional systems.
Conclusion
In conclusion, Zed Medical Center employs the TeleTracking software to solve the
difficulties it has in controlling patient flow and bed capacity. There are benefits and drawbacks
to the program, and the hospital should weigh them well before deciding to deploy it. Patient
volume, bed availability, duration of stay, and acuity levels are just a few of the main indicators
that can be monitored with the help of the aggregated data shared by the TeleTracking software
with other institutional programs. Improved patient care and streamlined hospital operations may
result from hospital managers and staff using this information to make educated choices about
patient care, staffing levels, and resource allocation.
References
Dick, R. (2019, September 23). Capacity Management | Observation Care. The Shift - US Acute
Care Solutions Blog.
https://theshift.usacs.com/four-rules-for-bed-assignment-in-an-
efficienthospital/#:~:text=Priorities%20for%20bed%20assignment%20need,would
%20have%20the%20highest%20priority
.
H. (2021a, November 30). Why Application Programming Interfaces Are Key for Healthcare.
HIT Infrastructure. Retrieved March 19, 2023, from
https://hitinfrastructure.com/features/why-
application-programming-interfaces-are-key-for-healthcare
W. (2021b, June 8). Advantages and Disadvantages of EHRs. Wheel. Retrieved March 18, 2023,
from
https://www.wheel.com/companies-blog/advantages-and-disadvantages-of-ehrs
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Chapter 10 | Newly Appointed Director of Clinical Decision Support
This case study discusses the hiring of a new Director of Clinical Decision Support in a
healthcare delivery system comprising numerous hospitals and clinics. The company doesn't do
much in the way of Clinical Decision Support (CDS). False-positive alerts are a common source
of frustration for clinicians using the existing CDS system, which focuses mostly on medication
interactions and allergies. The government uses IT and CDS to improve the quality and
efficiency of care. by three months, the Director is expected to develop a strategic plan for CDS,
and by 12-18 months, tangible "wins" are expected to have been achieved. In this article, the
Director's strategy for creating a holistic CDS system, setting priorities, balancing short-term and
long-term objectives, pinpointing quality and value improvement opportunities, and gauging the
results of CDS interventions will be laid forth.
Describe the approaches you would use to ensure that all aspects of patient care were
considered when developing a CDS system.
There are several ways to make sure a CDS system covers all bases when it comes to patient
care. The use of evidence-based recommendations, incorporation of patient choices, ongoing
feedback collection, and involvement of physicians and end-users are all examples. Involving
clinicians and end-users in the design process allows for the collection of valuable feedback and
the validation that the resulting system will be useful in actual clinical settings. Care
coordination, transitions between care venues, and other related activities are all part of what is
meant by "considering the entire care continuum."
Data-based recommendations aim to connect the system with the most recent clinical data
and promote the greatest quality of patient care possible by embracing best practices and clinical
evidence. Patient preferences must be taken into account while developing patient-centered
clinical decision-support treatments. encourage group decision-making and patient autonomy.
Involving doctors and end-users in the development and implementation processes, as well as
maintaining two-way communication with them, is an example of actively seeking ongoing input
that can be used to refine the system and better meet the requirements of both clinicians and
patients.
As was said earlier, there are a few different ways to go about developing a CDS system
that takes into account every facet of patient care. Using these methods, healthcare providers
may design CDS systems that improve clinical decision-making and provide better treatment for
patients.
How would you prioritize the efforts of your CDS team?
The work of a CDS team might be prioritized in many ways. The first stage in
implementing CDS is to determine the healthcare organization's overarching objectives and then
tailor your efforts to meet those objectives. This guarantees that the CDS system helps the
company achieve its goals. The second stage is to undertake a needs assessment to determine
which aspects of patient care may benefit most from CDS implementation, giving special
attention to those aspects that have the most bearing on patient outcomes, safety, and quality of
care.
The next step is to evaluate the data sources, technical capability, and resources needed to
put CDS interventions into action in the priority regions. It is also important to hear from
physicians, patients, and healthcare administrators to set priorities that serve their needs and
interests.
After deciding what CDS interventions are most important, an implementation strategy
should be drafted to guide their rollout; this plan should give priority to those that can be put into
action rapidly and have the most effect.
Last but not least, it's crucial to keep an eye on the results of CDS interventions to make
sure they're having the desired impact and that the team's work is in line with the business's top
objectives.
By adhering to these guidelines, a CDS team may better prioritize its efforts, ensuring
they are in line with the organization's goals and objectives, enhance patient care, and undergo
constant evaluation and adjustment.
How would you balance the need to deliver desired CDS capabilities quickly against the
benefits of establishing robust infrastructure to enable future deliverables to be implemented
more quickly?
Adopting an Agile development process is one way to strike a balance between the time
constraints imposed by the requirement for rapid delivery of CDS capabilities and the advantages
of building a solid foundation. The agile technique places an emphasis on development that is
iterative, collaborative, and adaptable to meet the needs of stakeholders and adapt to changing
requirements. The agile approach helps offer initial capabilities rapidly while providing a strong
basis for future expansion by breaking down the narrative into smaller, more manageable
components.
Pay attention to what the users want: Clinicians and patients should be at the center of
CDS development.
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It is recommended to create CDS in stages, with each stage supplying a certain feature or
function.
Third, features should be prioritized, with the most important CDS elements being
developed first and less crucial components being delayed to subsequent iterations.
Work together with key stakeholders Clinicians, IT professionals, and business
executives should all have input into the creation of clinical decision support (CDS).
During development, CDS capabilities should be rigorously tested to guarantee their
reliability and effectiveness.
Keep an open mind: The Agile development process is malleable enough to
accommodate last-minute changes in requirements, user input, and newfound knowledge.
The advantages of having a solid infrastructure should not be sacrificed in favor of the
urgency with which CDS capabilities must be delivered. Healthcare companies may provide a
solid groundwork for future CDS development while providing initial capabilities rapidly by
concentrating on user requirements, building progressively, prioritizing features, cooperating
with stakeholders, putting an emphasis on testing, and being adaptable.
Identify one quality and value improvement area and define CDS interventions that you would
implement to address this area of need.
Medication management is an area for quality and value improvement that may benefit
considerably from CDS interventions. Some CDS interventions that might be used to fill this
need are as follows:
The first possible remedy is to create drug-drug interaction notifications. By alerting
doctors of the potential for negative interactions between drugs, this helps cut down on
both prescription mistakes and adverse drug events.
The use of allergy notifications is a second possible strategy. Notifying doctors of any
known allergies patients may have to certain drugs may assist in minimizing dosing
mistakes and lowering the likelihood of adverse drug events.
Dose-checking alerts are a third possible intervention. Verifying that a patient's
prescription dosage falls within safe and effective limits, may help minimize the
likelihood of adverse drug events and avoid dosing mistakes.
The use of order sets is the fourth possible corrective action. This may assist in
decreasing the risk of medication mistakes and enhance the speed of medication ordering
and administration by providing doctors with pre-populated prescription orders based on
the patient's condition or diagnosis.
Clinical recommendations are the sixth possible intervention. This may boost patient
outcomes, lessen the likelihood of pharmaceutical mistakes, and guarantee that drugs are
given and delivered correctly depending on the patient's condition or diagnosis.
These CDS interventions have the potential to enhance the quality and effectiveness of
medication management, decrease the likelihood of medication mistakes and adverse drug
events, and save time and money.
Medication Management is a crucial area where CDS interventions may increase quality and
value. prescription safety, efficiency, and patient outcomes may all be enhanced by putting into
practice the possible CDS interventions listed above, all while decreasing the likelihood of
prescription mistakes and adverse drug events.
Describe how your approach aligns with the best practices discussed in this chapter.
CDS's medication management initiatives are consistent with research-backed best
practices. Stakeholder involvement with CEOs of healthcare systems, nursing informatics
officers, and the chief medical informatics officer are examples of these best practices.
Medication mistakes and adverse drug events may be avoided by using evidence-based
recommendations, alerts and reminders, order sets, and monitoring and assessment. These CDS
interventions have the potential to improve healthcare delivery's efficacy, quality, and efficiency,
thereby benefiting patients.
How would you systematically measure the impact of these CDS interventions?
The effect of CDS interventions on drug management and patient outcomes may be
evaluated using a variety of indicators. Medication errors (including dosing errors, drug-drug
interactions, and drug-allergy interactions), adverse drug events (including adverse drug
reactions, medication-related falls, and medication-related hospital readmissions), and
medication-related costs (including the number of prescriptions written, the cost per prescription,
and the total cost of medications) are all examples of relevant metrics.
To systematically evaluate the results of CDS treatments, it is necessary to collect and
analyze data on these variables across time. To assess the importance of the changes seen, the
data must be statistically examined. This may feed continuing attempts to optimize the CDS
system and assist in identifying places where improvement is needed.
Conclusion
In conclusion, several CDS interventions might enhance the quality and utility of drug
management. Drug-drug interaction notifications are one such intervention. This may assist in
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discovering pharmaceutical interactions that potentially lead to adverse drug events (ADEs) and
warn doctors of possible hazards before prescribing drugs. CDS may keep tabs on how often and
how much a patient takes their medications, notify doctors of potential problems like overdosing
or underdosing, and recommend dosage schedules based on patient characteristics. Patient-
specific factors, such as age, weight, and comorbidities, may be taken into account when using
CDS to guide the selection of the most suitable drugs. By applying these CDS strategies,
healthcare organizations may lower the risk of ADEs, enhance patient safety and quality of care,
and optimize drug management procedures.
References
McDonald, K. (2021, August 14). Using Agile in Clinical Decision Support Development | Agile
Alliance.
Agile
Alliance.
Retrieved
March
19,
2023,
from
https://www.agilealliance.org/resources/experience-reports/agile-clinical-decision-
support-developments/
Measure Effects and Refine CDS Interventions. (n.d.). HealthIT. Retrieved March 18, 2023, from
https://www.healthit.gov/sites/default/files/3-4-5-measure-effects-and-refine-cds-
interv.pdf
Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I.
(2020). An overview of clinical decision support systems: benefits, risks, and strategies
for success. Npj Digital Medicine, 3(1).
https://doi.org/10.1038/s41746-020-0221-y