CPSC 602 - Assignment 04 - Bruton, Erika

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Slippery Rock University of Pennsylvania *

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Health Science

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Oct 30, 2023

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Assignment 04 (50 points) Bruton, Erika Read Chapters 9 & 11 from “Health Informatics Practical Guide” textbook and answer the following questions. In addition to the information from the textbook, make sure to cite other resources in your answers if needed. 1. In your own words, describe the differences between quality, safety, and value, and how electronic health records is used to improve each one (Ch 9. 12 points) (350-400 words) Quality, safety, and value are interconnected concepts in healthcare, each representing a distinct aspect of patient care. While they are interrelated, they have distinct meanings and implications for healthcare delivery. ∙ Quality: Quality in healthcare refers to the effectiveness and efficiency of healthcare services in achieving positive patient outcomes. It encompasses aspects like the appropriateness of care, patient satisfaction, and adherence to clinical guidelines. EHRs contribute to improving quality in the following ways: o Decision Support: EHRs provide clinical decision support tools that help healthcare providers make evidence-based decisions, reducing errors and improving patient care. o Care Coordination: EHRs allow different healthcare providers to access a patient's complete medical history, ensuring seamless care coordination and reducing duplication of tests or treatments. o Performance Measurement: EHRs enable the collection of data on patient outcomes and processes, allowing healthcare organizations to measure and track performance to identify areas for improvement. ∙ Safety: Safety in healthcare focuses on minimizing harm to patients, including preventing medical errors and adverse events. EHRs promote safety through the following mechanisms: o Medication Management: EHRs help reduce medication errors by providing alerts for potential drug interactions, allergies, and dosage errors. This ensures that patients receive the correct medications and dosages. o Error Reduction: Electronic health records reduce the likelihood of transcription errors, misinterpretation of handwritten notes, and missing or lost medical records, all of which can lead to patient harm. o Patient Identification: EHRs include features to accurately identify patients, preventing mix-ups in diagnoses and treatments. ∙ Value: Value in healthcare refers to the balance between the quality of care provided and the cost of that care. EHRs contribute to improving value by: o Reducing Administrative Costs: EHRs streamline administrative processes, such as billing and claims management, leading to cost savings and increased efficiency. o Preventing Redundant Tests: By providing access to a patient's complete medical history, EHRs help avoid unnecessary duplicate tests and imaging, reducing healthcare costs. o Outcome Monitoring: EHRs allow for the tracking of patient outcomes, helping healthcare organizations identify which treatments and interventions are most cost- effective. 2. In your own words, discuss problems associated with electronic health records and their effect on safety and quality (Ch 9. 8 points) (250-300 words) One of the primary issues with EHRs is usability. Many EHR systems are complex and not user- friendly, leading to errors in data entry and retrieval. Clinicians often spend excessive time navigating

these systems, which can divert their attention away from patients, potentially leading to medical errors. ∙ Poorly designed interfaces and lack of interoperability between different EHR systems make data exchange difficult, hindering the timely sharing of critical patient information. Data accuracy is another concern. EHRs rely on accurate and up-to-date data to make informed clinical decisions. However, errors in data entry, such as typos or incorrect selections from drop-down menus, can lead to inaccuracies in patient records. ∙ These inaccuracies can propagate throughout the system, affecting the quality of care provided and potentially jeopardizing patient safety. Interoperability issues present a significant challenge. Different healthcare facilities often use different EHR systems that may not communicate effectively with each other. ∙ This can impede the seamless sharing of patient information between hospitals, clinics, and other providers. In emergency situations, the lack of access to a patient's complete medical history can lead to incomplete care and potential harm. Data security and privacy concerns are paramount. EHRs contain a treasure trove of sensitive patient information, making them attractive targets for cyberattacks. ∙ Breaches in EHR security can expose patients to identity theft and other privacy violations. Safeguarding EHRs from such threats is a constant challenge for healthcare organizations. Alert fatigue is a critical problem that can affect patient safety. EHRs generate numerous alerts and notifications for healthcare providers, often overwhelming them with non-critical information. ∙ Clinicians may become desensitized to these alerts, potentially ignoring important warnings, and negatively impacting patient outcomes. 3. In your own words, briefly discuss each of the following concepts (Ch 9. 8 points): a. Patient safety systems (30-35 words) 1. The goal is to offer healthcare organizations a proactive approach to designing or redesigning a patient-centered system to enhance care quality and safety. b. Root cause analysis (30-35 words) 1. A problem-solving approach encompasses various methods, tools, and techniques used to identify the root causes of issues. c. Computerized provider order entry systems (CPOEs) (30-35 words) 1. This refers to the process of providers entering and sending treatment instructions. d. Clinician alerts, reminders and checklists (30-35 words) 1. The effectiveness of prompts is evaluated individually, rather than in conjunction with existing prompts for other conditions. 4. Read the following article (attached) and discuss human factors in health care (Ch 9. 12 points) (250-300 words) a. Human factors, a scientific discipline, aims to help healthcare professionals do their best work, improve resilience, and minimize errors. Human factors-based solutions make it easier to do things right and harder to do things wrong, making errors less likely to lead to patient harm. By designing the healthcare environment with human limitations and abilities in mind, healthcare professionals can work more effectively and reduce the risk of errors. Examples: 1. Preventing Infusion Pump Errors  A Plexiglas guard was added to an infusion pump to prevent accidental changes in the pump's settings, enhancing clinicians' safety. 2. Improving Safety of Cardiac Surgery

 A team of human factors engineers, clinicians, outcomes researchers, psychologists, and sociologists conducted a comprehensive review of 22 cardiac surgery surgeries at five hospitals. They identified 58 hazards related to flawed devices, suboptimal layout design, processes, and organizational structures. Many of the team's recommendations were adopted, leading to improvements in infection prevention and care transitions. 3. Safe Medication Storage  A unit-based safety team has implemented clear plastic lockboxes in each patient's room to hold multidose insulin pens, addressing medication errors caused by nurses storing pens in their pockets due to interruptions.

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