...Healthcare Ecosystems LLT Task 2 Jacqueline Sanders Western Governors University Healthcare facilities are required to maintain licensure, certification, and accreditation in order to receive payments from federal government programs such as Medicare. Healthcare facilities must meet the minimum standards in order to operate, such as sufficient staffing, personnel employed to provide services, the quality of equipment, buildings, and supplies, and services provided, including health records. (LaTour, 2013) Medicare has developed Conditions of Participation and Conditions for Coverage, which identifies specific criteria that must be met in order to receive reimbursement from Medicare. Medicare implements these guidelines in order to set a standard for improving quality of care and maintaining the health and safety of its beneficiaries. (CMS, 2013) State agencies conduct annual surveys of licensed facilties to ensure they are operating at or above the minimum standards set forth by the sate and CMS. It is imperative for licensed healthcare agencies to meet the guidelines of the Conditions of Participation in order to receive reimbursement, if they do not meet the minimum standards they could be unable to participate with Medicare, thus losing patients and revenue. Physician Quality Reporting System requires healthcare providers and hospitals to meet clinical quality standards and record them. Physician Quality Reporting System is a program implemented by Medicare that...
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...challenges and constant changes related to healthcare data. High-quality healthcare data is essential in order to create meaningful data. Electronic health records (EHRs) are a big part, and an increasingly important aspect of data quality. Data is analyzed and managed by the health professional, to be incorporated with new and changing technologies. Concerns have arisen with healthcare data, increasing the need for data integrity and reliability. Healthcare data will require constant improving to maintain quality. Healthcare leaders face many challenges related to data, such as the transition to the ICD-10-CM/PCS data system and producing meaningful use with data given. Other issues that occur for healthcare leaders, are maintaining compliance with clinical documentations and health data reporting requirements, whether by data entry or the software program itself. They must also ensure the health information exchange (HIEs) is worthwhile and that it will be sustainable. EHRs are used much more now than in the past and have become a staple in healthcare settings. EHRs have created options for healthcare organizations to choose from, in order to record documentation. Complaints and concerns have developed, in regards to electronic health records (EHRs). Since EHRs are being increasingly integrated into all aspects of healthcare settings, issues “regarding the integrity, reliability, and compliance capabilities of automated documentation processes,” have come to the surface...
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...Transforming Nursing and Healthcare Through Information Technology Instructor: Dr. Wagner March 27, 2016 Using the Data/Information/Knowledge/Wisdom Continuum Introduction Many organizations now have clinical documentation improvement programs (CDIs) designed to help an organization accurately reflect the quality of patient care, prove healthcare services, and make accurate reports of diagnosis and procedures (Cassano, 2014). A Clinical Documentation Specialist (CDS) is a registered nurse who manages, assesses, and reviews a patient’s medical records to ensure that all the information documented reflects the patient’s severity of illness, risk of mortality, clinical treatment, and the accuracy of documentation. Part of the role is to perform concurrent reviews of medical records, validate diagnosis codes, identify missing diagnosis, and query physicians and other healthcare providers for more specifics so documentation accurately reflects the patient’s severity of illness (Cassano, 2014). Health Information Management (HIM) professionals advocate for a strong commitment to accurate and timely clinical documentation as hospital initiatives push forward with programs such as ICD-10-CM/PCS implementation, Accountable Care Organizations reimbursement models, Fraud and Abuse compliance programs, and implementation of electronic health records (EHRs) (AMIHA, 2010). HIM professionals also impact CDI programs by providing education regarding compliant documentation to physicians, something...
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...University Nursing Assignment The technology necessary to meet the federally mandated requirements which will affect the merged healthcare organizations. Electronic health records with satellite facilities supported by remote technology. Electronic health records emerged as one of the most relevant topics in health care; EHRs are central in the strategy of federal government to transform health care providing in the U.S. (Henricks, 2011). Federal actions are promoting EHR in order to guarantee important implications for nursing practices. The technology implies also payment penalties for those providers who do not manage to meet the requirements of EHRs use. EHR technology has to be certified according to technical and functional criteria that are set forth by the government. The using of EHR technology is significantly important for laboratories (Henricks, 2011) since the certification criteria of EHR have to be related directly to laboratory testing or laboratory management. Federal government identified the goals for improving healthcare and EHRs are central for these goals. EHRs with satellite facilities aims at the following points, it should: * improve safety, efficiency, and quality of public healthcare and reduce people's health disparities; * engage the patients and their families in healthcare services; * improve healthcare coordination; * improve public health and population in general; * reduce costs; * maintain security and privacy...
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...system for better quality care D. Security standards of data and patient confidentiality, including the need for data storage integrity and data backup and recovery and the Health Insurance Portability and Accountability Act (HIPPA) requirements impact the use of the systems E. How the new system can affect healthcare cost F. The benefits these new systems can offer to patient care and nursing care delivery with a recommendation and justification of the system the hospital should put in place In today’s modern healthcare environment it is important to provide a variety of technology based resources to nurses and other providers to ensure productivity and efficiency are maximized. This requires an effective understanding of available computerized management systems and what resources are available to ensure continued effective, efficient, quality care to patients. Keeping that perspective in mind while creating a technologically advanced environment in which to deliver that care is critical and of vital importance to maximize resources while providing a solid technology platform. The utilization of electronic medical records and nursing documentation systems to ease the burden of paper based records, as well as the space required to store those records in a desirable manner is critical for an organization to sustain its capacity to provide high quality health care. This discussion will explore these systems...
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...2003). With that said documentation has been shown to take 13%- 28% of the nurses time, valuable time that can be used to interact and communicate effectively with patients (TIGER Initiative, 2007). However, as online documentation such as electronic health records are being introduced in certain health institutions across the globe , the nurse along with the healthcare team can save a lot of time by being provided the opportunity to have quicker...
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...condition and/or procedures, which includes but is not limited to, postoperative instructions, medications, follow-up appointments, wound care, and any questions they may have after going home, is considered to be patient compliance. As an Registered Medical Assistant (RMA), patient compliance starts with me. As a healthcare professional, it is my job to make sure that there is a positive relationship that is developed by helping patient's to feel more comfortable and educated, in which in the end, will help them to be more compliant. The role of a healthcare professional in patient compliance comes from what you can do as the patient's (client's) mentor, to make sure they understand all the information that is given to them. There are many ways that you as the healthcare professional can do that may actually contribute to noncompliance of your patient. For example, 1) not building that bond with your patient giving them the confidence to want to follow through with their treatment recommendations, 2) giving a lack of adequate information, with detailed explanations and pictures if needed to help them better understand, 3) lack of education on the healthcare professionals part to have the ability to answer any and all questions patients may have, so you as the professional can give the correct answers, to build that confidence in the patient even more. When you compare compliance and collaboration, you have to start with collaborating with your...
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...Relationship Between Nursing Documentation and Patients’ Mortality Emily Bosco Nursing 134 Mrs. Simmons/ Dr. Gusiti November 2, 2013 Relationship Between Nursing Documentation and Patients’ Mortality For the first time, the way a nurse documents have been linked to a patient’s mortality. The title of this article is called the Relationship Between Nursing Documentation and Patients’ Mortality. The focus of this study is to identity the association with nurse’s optional documentation and hospital mortality and how they are benefit each other for a set of risk- stratified acute care patients. Having an early recognition of a patients status followed with effective communication by the health care members has lead to a decrease in hospital mortality. It was found that nurses document optional data in the electronic health record (EHR) flow sheets. That is where they record any concerns they may have and to report abnormal data. The definition of optional documentation is recording vital signs more often than required, and entering in comments in the textbox that is associated with the data findings. The reason for optional documentation is the nurses concern for the patient’s current status deteriorating and leading to death. Optional documentation shows the nurses general concern and surveillance for a patient who may be dying. Then by documenting using the EHR it enables the patterns of documentation that are clinically significance to be detected and alerts the health...
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...Negligence Paper Unfortunately, it is not uncommon for mistakes to happen in the hospital setting. When policies and procedures are not followed, the opportunity for mistakes increases. The Neighborhood newspaper wrote an article regarding a 62-year old man who had the wrong leg amputated. This incident occurred at the same time that the hospital was enduring union issues and staffing problems. This paper will discuss the differences between negligence, gross negligence, and malpractice. It will also discuss why hospital staffing shortages play a role in negligence such as in the amputation mishap. In addition, the importance of documentation and its correlation to potential negligence will be discussed. Lastly, ethical principles that would guide my practice in this situation will be discussed. Negligence, gross negligence, and malpractice Negligence “equates with carelessness, a deviation from the standard of care that a reasonable person would use in a particular set of circumstances” (Guido, 2010, p. 92). An example of negligence is when a nurse places a nasal cannula on a patient who needs supplemental oxygen and does not check if the oxygen is flowing. This results in the patient not receiving oxygen and coding. Gross negligence is an extreme departure from the standard of practice. In respect to registered nurses, it is “the repeated failure to provide the required nursing care or failure to provide care or exercise precaution in a single situation which the nurse...
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...Standardized Simulation NR442 Asthma Management/Nabiha Meer Chamberlain College of Nursing: Nursing Students We want to thank you in advance for your active participation in this standardized simulation. Our purpose is to immerse you in a high quality clinical experience that will enhance critical thinking, decision-making, and prepare you as you move forward in the curriculum and transition into practice. The following material can be used in scenario preparation. You will find preparation documentation that includes course and student learning outcomes as well as general scenario information and resources. A brief patient history will be provided in addition to the most recent physician orders. Be prepared to document your assessment findings, administration of medication, and nursing notes. A medication administration record, laboratory results and patient education material will be provided for you during the simulated experience. One of the most important aspects of simulation is the assessment of performance and debriefing. Keep in mind that the purpose of participation is to enhance your learning and allow you to identify areas of needed remediation. There is no high-stakes testing. We are only asking that you engage in the learning experience and begin to use the feedback provided to enhance your practice. We want you to be able to self-reflect on your actions and interventions and remediate areas that you identify. An assessment matrix has been created...
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...Changing Healthcare Professional nursing practice models enable nurses to control the delivery of care and the environments in which that care occurs. Nurses have input into decision making and can design innovations specific to a particular care setting. (Professional Nursing, 2011) Today the nursing profession is increasingly in complexity and versatility. The current healthcare reform is adding a broader scope of practice for nurses. The current standards of practice continue to evolve allowing nurse to practice at higher functioning than what was previously expected. This has caused a shift to a higher complexity and more advanced level to the profession. Advancement in science and technology has added to the complexity in the nursing practice during the past 20 years. Technology savvy nurses are required to meet the standard of practice as we continue to advance into a paperless world. These issues are raising the bar on the practice of medical care for all healthcare workers across the board. There is a wide spectrum of nursing expertise, education, and credentialing that is now necessary for the ever changing profession. Differentiated models of practice are supported by a clinical "ladder" or defined steps for advancement within the organization based on experience in nursing, additional education, specialty certification, or other indicators of professional excellence. (Erickson, 1998) Much higher expectations are placed on registered nurse new graduate. ...
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... Monica Soto Grand Canyon University October 17, 2013 The IOM’s recommendation on improving the delivery of care begins with the transformation of the nursing profession. The Robert Wood Johnson Foundation (RWJF) along with the Institute of Medicine (IOM) established a two year Initiative on the Future of Nursing (Institute of Medicine [IOM], 2011, p. 2). In an unprecedented partnership to explore challenges central to the future of the nursing profession. The IOM and RWJF stated that accessible, high quality care cannot be achieved without exceptional nursing care and leadership (IOM, 2011, p. 2). This paper will discuss and explore how the IOM report impacts nursing education, nursing practice, and the nurse’s leadership role. The IOM recommends entering the field of Nursing prepared with a baccalaureate degree can provide a consistent foundation. Due to the complexities of managing patient care with chronic illnesses qualified nurses will need to possess the knowledge and training of a higher level of education. The IOM recommends that hospitals have a workforce of at least 80 percent of registered nurses with a minimum of a BSN degree by the year 2020 (IOM, 2011, p. 173). Although, there still exists various modalities to entering the nursing profession without having a BSN. The goal for nurses with a diploma and associate degree are encouraged to further their education by entering a baccalaureate nursing program. The future of nursing depends...
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...Registries are a category that use more detailed secondary data from patients’ medical records. Registries are usually clarified by health statuses of patients, diseases, conditions, or procedures. Registries inform healthcare professionals of availability and responses of patients on different methods of treatments. The information helps healthcare professionals in choosing the best treatment options to improve patients’ conditions. For example, cancer registries were developed with the need to collect information in studying the diseases to improve diagnoses and treatments of cancers. Hospital-based registries and population-based registries are two major types of registries for cancers. Hospital-based registries are developed for administrative...
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...NUT1 Task 1 Western Governor's University NUT1 Task 1 Importance of Information Access using Electronic Medical Record (EMR): Electronic Medical Record (EMR) is a computerized system of keeping patient information. Similar to paper charting, EMR can be used to chart important patient data to treat patients and document the related nursing care. EMR can be used to store important patient information like patient’s diagnoses, allergies, medication, patient’s demographics, lab and diagnostic test. EMR also includes patient’s medical record number and account number that is given to the patients and is also used as reference about patients for future admissions. EMR’s provide accurate information that is easily accessible than paper charting. It also provides easy health care access to providers, improves communication among patients and health care providers. With EMR, nurses have easier access to in depth and detailed charting of physical assessment, tallying input and output and easy comparison in the trends of labs and diagnostic test. EMR also prevents medication errors since patients bar codes are scanned and verified accurately prior to administering medication. Data about medication is available prior to administration, so nurses can monitor possible side effects of medication. Thus charting patient information in real time or the ability to access results improves quality of patient care and increase co-ordination among health care providers. Personal Health Information:...
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...Changing Paper Documentation to Electronic in Healthcare Name Institution Date Introduction Changing from paper documentation to electronic documentation is just like switching from analog to digital television. Rigidity in institutions may prevail but at the end all the institutions conform to one documentation method the electronic documentation. An electronic document is any media content other than computer system files or programs used in either soft copy form or paper as a print out (Yu, 2006). With technological advancement, the use of written documents has reduced because it has become easier to distribute and display documents in screens (AWARE, 2005). The method has an impact on reducing paperwork and space for storage of these materials. Documentation of activities involving purchases, sales, distribution, drug administration, patient health record, finance and other relevant activities of any organization is a primary issue in maintaining efficiency in operations (AHIMA, 2010). The use of paper documentation is somehow a far behind the method and rather tedious and inefficient. A more reliable and efficient way of keeping health records is thus a necessary change that may help reduce the demerits associated with the paper documentation method. Technologically advancement has brought with it more efficient and easy way to record and maintain a company or organization’s documents (AWARE, 2005). Changing from paper to electronic file documentation is thus a primary...
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