...of Electronic Health Records on Pediatric Patient Flow Elizabeth Dutton September 24, 2014 HCM-500 Healthcare Informatics 4-1 Case Study: EMR Implementation and Patient Flow The goal of integrating to the use of electronic health records (EHRs) is to improve quality and reduce costs, however, these systems experience a number of challenges. Electronic health records are computerized paper charts that allow hospitals and medical facilities to compile patient information into one system. This case assesses the effect of employing EHR on “overall patient length of stay, time to medical provider, and provider productivity during implementation of the EHR” (Kennebeck, 2011, p. 443). While the focal point of these systems is to improve the quality and timeliness of patient care, there are a number of challenges facilities face throughout the implementation phase. The implementation of EHRs faces an assortment of trials within the medical industry. The largest concern regarding electronic systems is the protection of patient information, which is required by law through HIPAA. In addition, Stephanie Spellman Kennebeck (2011) describes the potential difficulties involved with the evolution of electronic medical records, stating, “as EHR systems evolve from first generation computerized physician order entry or simple niche system to large hospital-wide EHR integrated records, the risks of the implementation on impacting patient safety, efficiency, and financial recovery...
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...capacity. BWH can also evaluate making some of underutilized wards can converted to ICU as demand arises and converted back to regular wards as demand reduces. Yield Management of BWH: Based on case, a comprehensive yield management system incorporating all strategies relating to demand for and supply of services was not incorporated to. Its not clear that how far their existing Yield management system has the ability to segment patient requirements into different service classes and helps for an efficient yield management. They should have implemented Yield management software applications which can be customized do this for them, which will same the time and energy. What strategies can be used to manage BWH capacity? Need for adjusting service capacity to match demand. BWH can use part time employees when peaks of activities are persistent and predictable. BWH can also follow “Chase Demand” approach, which adjusting capacity to meet demand. They should consider elective & emergent/urgent flows as need arises rather following single patient inflow model. Exhibit 1 ICU Access Management Plan, states that ICU bed manager knows the ICU bed availability....
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...impacting the quality of patient care and the effectiveness of its operations. Previous studies have highlighted the impact of workplace culture and pay disparities in influencing nurse retention and burnout. Studies show that up to 57 percent of recently employed nurses leave their positions within two years, and at least 17.5% leave within the first year. This paper outlines some key performance indicators (KPIs) to evaluate the efficacy of interventions to enhance workplace culture and augment financial incentives for nurses. This analysis outlines proposed solutions that can help alleviate the current nursing crisis. The selected KPIs will reflect the...
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...delivery, quality, and outcomes of care. Conversely, delayed or limited access contributes to patient/provider frustration, poorly coordinated care, unnecessary emergency room visits, and potential increases in the burden and cost of disease. A recent high-profile crisis in health care focused on prolonged and unfair wait times at Veterans Health Administration (VHA) facilities that led to potentially preventable morbidity and mortality. In response to this, the Institute of Medicine (IOM) was commissioned by the VA to understand experiences and opportunities throughout the nation related to the scheduling of and access to health care. In a very recent publication from October 2015, the IOM summarized their findings and established that inappropriate scheduling practices are a systemic problem across the entire nation and called for an end to arbitrary scheduling standards, for more transparency, more accountability, and for more attention to be paid to the “corrosive culture” that led to the manipulation of data in the system (1). The report also concludes that opportunities exist to implement enhanced practices and strategies. Appropriate Access To Care Within 48 Hours has been identified as one of the top priorities of the Spectrum Health System. To measure access, Spectrum Health uses ‘third next available appointment’ which is the average length of time in days between the day a patient makes a request for an appointment and the third available appointment. Many service lines...
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...health record implementation on patient flow metrics in a pediatric emergency department (Kennebeck, Timm, Farrell, Sooner, 2012) attempted to quantify the effects of offloading low acuity patients and its impact on length of stay. Length of stay and volume of patients in an emergency department are correlated. The study was conducted in a pediatric emergency department (ER) in Cincinnati, Ohio. Prior to implementation, a plan was utilized to off load patients to a different area in the ER due to a surge from the H1N1 flu virus. This was successful in decreasing patient numbers and length of stay. The organization decided to use the same template for the EHR implementation. Despite its prior success, offloading patients did not improve efficiency or length of stay (LOS) during EHR implementation. The primary issue identified was the failure of offloading patients. The study stated, “During implementation only 5% of patients were diverted. During the H1N1 surge, 10-20% of patients were diverted.” (Kennebeck, Timm, Farrell, Spooner, 2012). The organization used the same criteria for both scenarios. Changing the criteria could be a simple solution. The organization could have added to the flu symptom criteria. For example: lacerations, simple orthopedic injuries, or anything that could be seen in an urgent care setting. This would decrease visits to the main ER and improve efficiency based on decreased number of patients seen....
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...Flowchart for Inpatient Medication Administration Name: Institutional Affiliation: Flowchart for Inpatient Medication Administration Introduction The medication administration process has a direct impact on the patient’s health and well-being. The evaluation of the medication administration workflow is crucial to ensure that the right procedure is utilized to offer quality care. The proper design of the process makes sure that there is provision of safe, efficient, prompt, and patient-centered care. Also, there is the elimination of cases of medication administration errors in hospitals through the appropriate workflow design. The application of technological elements in the process with proper integration serves to enhance...
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...members to construct a new long-term acute care (LTAC) facility. An LTAC is designed for patients whom require hospital stays of 25 days or more. Recently the U. Va. had been facing capacity issues with an inadequate number of beds. The hospital would gain an additional 25 bed days per patient transferred to the LTAC, thus increasing revenues from patient’s insurance and increasing patient care. Fitzgerald’s previous proposal for the LTAC facility in 1999 was declined by the board. Although recent regulation put a halt to new construction of LTAC facilities beginning in January 2007, Fitzgerald was determined to convince the board of the value the investment would provide. The board required certain restrictions with new capital investments. First, a 5.0% profit margin as the minimum on new investments,...
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...November 2011- Present * Performing cardiac screenings of 2-D echocardiograms, Carotid arteries, and abdominal aorta * Color flow, echo Doppler diastolic function, and measurements for echocardiogram * Color flow, Doppler, and measurement of CCA, ICA and ECA * Measurements of abdominal aorta Mid Distal and Prox. Sagittal and Transverse views | | Dr. Alaa Abdel-Meguid Echocardiography Trainee May 2007Dec2007/Present * Performing echocardiograms 2-D echocardiography, color flow, echo Doppler, Diastolic Function, M mode and Stress Echo exams for diagnostic purpose alongside lead echo tech Lisa Quick (13 Year experienced technician) * Orientate and prepare patients on procedures, complete all paperwork pertaining to scans performed Med 3000, Tinley Park, Il Collection Specialist/AR Team Lead June 2010-Present * Constantly adapt to changes in a fast-paced work environment while supervising a staff of 16 in Accounts Receivable and Collections * Evaluate patient’s financial status and establishes payment plan payments * Provided immediate supervisor with production reports of all specialist on team and feedback on quality * Maintain strictest confidentiality and adhere to all HIPAA guidelines and regulations * Advise patients of balances, insurance payments and adjustments on accounts * Review explanation of...
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...the consummate translator of the vernacular of the Toyota Production System into the everyday parlance of healthcare. With each concept and its application, the reader is challenged to consider what is truly possible in the delivery of healthcare if standardized systems borrowed from reliable industries were implemented. Graban provides those trade secrets in an understandable and transparent fashion.” — Richard P. Shannon, MD, Frank Wister Thomas Professor of Medicine, Chairman, Department of Medicine, University of Pennsylvania School of Medicine “There is an enormous shortfall between the healthcare we are promised and what we actually get. Mark Graban explains how those in the system can make care delivery better for everyone –patients, providers, and payers.” — Steven Spear, Senior Lecturer, MIT, Senior Fellow, IHI “Mark Graban’s work has been a steady companion in the three years I have been studying and applying lean in healthcare. He...
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...credit to resolve internal or external obligations. As a result, Campello Graham & Harvey (2010) found that during the financial crisis, 86% of constrained United States firms said that they bypassed attractive investments due to difficulties in raising external finance. In contrast, only 44% of unconstrained firms avoided such investments. Creditworthiness The organization develops creditworthiness based on debts paid and minimum credit established with the lenders. Organizations take advantage of the credit’s contribution to financial stability. The creditworthiness aspect of the organization provides a wealth of additional benefits. The borrower has the opportunity to receive a credit rating by the credit agency, and the credit rating flows across the organization’s performance throughout the life of the business, reflecting the internal and external aspects that might affect the overall credit score. Consequently, the credit agency rates the organization “A” or “BBB –”; these assigned ratings can vary depending upon the credit agency, essentially within the market-oriented setting (Kaufman, 2006). Obviously, the “A” rating offers better financial opportunities to the organization, such as low interest cost, which provides...
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...2006). The daily process identified in Week One, was the Collection and Invoices of paid and unpaid invoices within a hospital billing department. Through the monitoring of the process for two weeks, a bottleneck was identified. This paper will focus on the bottleneck process and how the Goldratt’s theory of constraints may be applied to alleviate process bottlenecks. Process Bottleneck The ability to identify the bottleneck is important in the analysis to increase capacity as well as to determine the process capacity. Based on the analysis of the flowchart and metric system, the main bottleneck detected was 120 days invoices remained within the facility with no further updates. Since inpatient admissions originate through the emergency room, patients often times provide incorrect contact information or incoherent at time of admission. Once the task of contacting patients was completed, the next task is easier. Patients with accurate contact information, their cases were settled within 60 days, resulting in revenue for the hospital. Goldratt’s Theory The underlying premise of theory of constraints is that organizations can be measured and controlled by variations on three measures: throughput, operational expense, and inventory (Wikipedia). The Goldratt’s Theory uses a process to eliminate the constraints though five steps which are identifying the constraints, decide the method to exploit the constraint, subordinate all other processes to the above decision, elevate the constraint...
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...found that only half of all joint ventures yield returns to each partner above the cost of capital. That’s worrying, given that partnerships and alliances are central to many companies’ business models. Originally used to outsource noncore parts of supply chains, alliances today are expected to generate a competitive advantage. So it is necessary to dramatically improve their odds of success. Why do alliances fail so often? The prime culprit is the way they are traditionally organized and managed. Most alliances are defined by service level agreements (SLAs) that identify what each side commits to delivering rather than what each hopes to gain from the partnership. The SLAs emphasize operational performance metrics rather than strategic objectives, and all too often those metrics become outdated as the business environment changes. Alliance managers don’t know whether to stick to the original conditions or renegotiate. By that time, the companies’ leaders have returned to run their own organizations and haven’t followed up to ensure that their vision for...
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...methods, competition with a large group of employed physician practices, and changes in patients’ insurance coverage, a practice can be at risk for decreased revenue and increased financial instability. Fortunately, having an efficient Revenue Cycle Management (RCM) process and integrated electronic health records (EHRs) can help mitigate financial risk. Whether we like it or not, reimbursement policies for physicians and their practices are changing. To stay relevant, independent healthcare providers must keep up or get left behind. A recent article in Healthcare Dive touches upon today's ever-changing regulations...
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...CLINICAL CLARIFICATION • Normal pressure hydrocephalus (NPH) is caused by decrease uptake of cerebrospinal fluid leading to a dilatation of the ventricular system and eventual damage to the adjacent parenchyma causing neurological deficiency 1 CLASSIFICATION • Primary (idiopathic) 12 • Secondary to other diseases such infection,trauma to the brain or brain tumors • Absence of an obstruction of cerebrospinal fluid outflow inside the ventricular system of the brain is a common feature of both idiopathic and secondary normal pressure hydrocephalis 2 • Idiopathic normal pressure hydrocephalus 7 o Affect the elderly • Secondary normal pressure hydrocephalus 7 o Affects all ages DIAGNOSIS CLINICAL PRESENTATION • History o Patients...
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...The Immediate Benefits Realized by Humanity in the Pursuit of Space Exploration Bradley D. Fluharty COM/156 September 30th, 2012 Dr. Nguyen Thinh The Immediate Benefits Realized by Humanity in the Pursuit of Space Exploration Research has indicated that technological developments associated with the exploration of space are far more reaching than previously imagined. Developments and innovations in the fields of health and medicine, public safety, transportation, and many other unassociated categories, are the direct result of man’s quest to inhabit celestial bodies other than the earth. Critics suggest that the economics involved in the research necessary to facilitate planetary colonization are profoundly wasteful, but developed technologies have immediate benefits for humanity. Technologies developed by NASA are currently used in our doctors’ offices, operating rooms, and rehabilitation clinics, helping individuals, and professionals alike achieve a higher degree of health and wellness. “Olympians and professional and collegiate athletes can now avoid dangerous heat related illnesses during intense workouts” (spinoff.nasa.gov, 2009). This is the result of an indigestible thermometer pill that was designed by NASA to keep tabs on the core temperatures of astronauts during space flights. Since their inception, these pills can now also contain micro cameras which can assist doctors in the inspection of individuals’ digestive tracts. LED chips (light emitting diodes)...
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