Nursing Assignment: Quality Improvement with EHR Implementation

This nursing assignment proposes a quality improvement initiative focused on implementing Electronic Health Records (EHR) within a healthcare setting. The paper begins by outlining the problems associated with paper-based documentation, such as inefficiencies in accessibility, increased costs, and potential for errors. It argues for EHR implementation as a solution to improve documentation, patient care, and overall healthcare quality. The assignment provides an overview of the significance of EHRs, citing research that supports their effectiveness in enhancing care processes, increasing accountability, and improving communication among healthcare professionals. The report details the steps required for successful EHR implementation, including staff awareness, training, and evaluation of the process. The evaluation methods include audits, questionnaires, and statistical analysis to determine the impact of the initiative. In conclusion, the paper emphasizes the benefits of EHRs in fostering quality and sustainability within the healthcare environment. The report also references several peer-reviewed sources to support the proposed quality improvement initiative.

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of the student
Name of the university
Author note

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Introduction
Quality improvement (QI) is inclusive of the systematic processes and continuous actions
so that the loopholes and limitations present in the healthcare processes could be measured and
improvement could be implemented (Sittig & Singh, 2015). As per Durbin et al. (2016), QI is the
process which helps in enhancement of the care process and obtain positive outcome for the
patients involved. Documentation and patient records are among the critical aspects that should
be protected and performed in any healthcare facility. As per Krousel-Wood et al. (2017), proper
documentation and record of patient serves primary purpose of healthcare by fostering quality
care and maintains continuity of care. With paper medical records, healthcare facilities require
additional staff so that handling and maintenance of the documents could be done effectively
however, due to the application of this process, documents become hard to up to date and access
in emergency.
Hence the primary aim of this paper is to propose the application of electronic healthcare
record or EHR in my organisation so that quick access and documentation handing becomes
easier.
Significance of this quality improvement
As per Wager, Lee and Glaser (2017), Electronic Health Record system or EHR is an
electronic system that is accessible through computers, laptops and mobile phones and is
shareable among the healthcare professionals and the patients. This system includes patient’s
information about allergies, family history, list of medications, previous healthcare records and
surgeries so that while receiving care from a new healthcare facility, all these records help to

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provide the patient with effective care (Palvia, Jacks & Brown, 2015). Paper documentation is
the documentation method which has been used by organisations so that all the patients and their
records could be handled and managed properly. Despite this, there are several aspects of paper
documentation process such as time, environment, accessibility, cost, and security due to which
the paper documentation process becomes full of error and loopholes. Barrett and Stephens
(2015) mentioned that paper documentation is the process due to which healthcare facilities are
required to employ professional whom would maintain and handle the patient documents
effectively. Besides this, paper documentations require high costs of handing and maintenance
(Sittig & Singh, 2015). Hence, EHR implementation should be the next quality improvement
process that should be implemented in the healthcare facility so that with development and
improvement of the healthcare documentation process, quality and accessibility to effective
healthcare could be implemented (Krousel-Wood et al., 2017).
Importance of quality improvement and implementation of EHR in care process
Several researches have been conducted to understand the effectiveness of EHR
implementation in the healthcare facilities for the quality improvement and ease of accessibility.
The primary aim of the research conducted by Curtis et al. (2018) was to understand the use of
electronic health records was to understand the accountability and quality improvement of care
process through the implementation of EHR system. The researchers conducted a narrative
review and with the use of palliative care quality metrics that has been used in the healthcare
system and has been implemented so that the care process becomes effective, drives quality
improvement, increased the accountability and increases value based payment system (Curtis et
al., 2018). Upon conducting the research, it was found that the healthcare system is effective in
making the care process accessible as the healthcare professionals were able to collect patient

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data without any complexity and were able to obtain the important patient information required
for quality and holistic treatment (Curtis et al., 2018). They were able to understand that
palliative care metrics program was designed and hence it was effective in making the
documents and information interoperable due to which upon receiving consent from the patient,
the nursing professionals and healthcare physicians were able to share the details of the patients
effectively (Curtis et al., 2018).
Another research article was destined to understand the strategies developed by the
healthcare facilities so that they could understand the effectiveness of the care process and
improves the primary healthcare system by implementing the EHR system (Olayiwola et al.,
2016). As the usage of EHR has increased exponentially in the recent times, the researchers were
eager to understand the strategies which have been used to implement and use it effectively. It
was seen that prior to implement the EHR system, the healthcare facilities conducted a survey to
understand the response of the care professionals about the system and their needs and feedback
about the system and process (Olayiwola et al., 2016). Hence thorugh the application of this
strategy, they were able to collect strategies and designs for the implementation of EHR and then
develop priorities and strategies of implementation of this in care system (Olayiwola et al.,
2016). Another research article by Asan et al. (2015) mentions of the strategies using which
healthcare facilities limited the adverse effects of communication errors. As per Sittig and Singh
(2015), the EHR helps in the development of continuous flow of information with its
accessibility so that people could be provided with quality healthcare (Asan et al., 2015). Further,
with application of HER, the flow of passive healthcare information has been prevented due to
which miscommunications and lack of knowledge related primary concerns have been
eliminated and hence, the care process has become effective (Asan et al., 2015). Hence, these

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primary research articles provide a clear and concise idea about the way this EHR
implementation has provided the healthcare facilities with the opportunity to achieve high quality
and sustainability in the care process (Asan et al., 2015).
Steps required for the quality improvement process
As per World Health Organization (2015), while implementing any quality improvement
related aspects in any organisation, it is important that the employees and professionals working
in that organization should be made aware about the changes they would be facing in their
workplace. As Sligo et al. (2017) mentions, this would help the organisation to gain their trust
and make the implantation of change effective and supported by the work force, who would
eventually use those means for the growth and development of the facility. Hence, spreading
awareness and receiving feedbacks would be the first step to for the implantation of this changed
process. The second aspect would be arrangement of training and educational sessions for the
employees so that they could understand the processes and step of using the EHR system
implemented for their benefit (Kadu & Stolee, 2015). This would make the care process effective
and error free as all the employees would be aware of the level of accuracy and awareness
required for an error free entry in the EHR system (Sligo et al., 2017). Hence, these two would
be the primary and most effective processes of implementing the change in the care process.
The evaluation of the process
The evaluation of implemented change or quality improvement measures would be an
effective process so that the extent to which the healthcare professionals have acquired the
change could be understood (Durbin et al., 2016). Implementation of audit process both quarterly
and half yearly would be an effective process so that the ability of the care professionals of using

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EHR, their rate of error and their ability to overcome the adverse conditions could be understood
(Sligo et al., 2017). Further, the employees would be asked to fill a small questionnaire so that
their knowledge about the system, its usability, its errors and troubleshooting could be
understood (Durbin et al., 2016). Hence, this would be the evaluation process of the implemented
quality improvement measure.
Conclusion
In conclusion, it could be said that quality improvement is the process that is
implemented in the healthcare facilities so that they could implement new processes and
overcome the adverse conditions emerged as a result of the obsolete processes. Paper
documentation is one such process that should be replaced with usage of electronic health record
system so that the quality and accessibility of the patient documentation process could be
understood. In the process, this report mentions of the recent research findings as per which
implemented change related to EHR helps in making the healthcare process error free and cost
effective.

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References
Asan, O., Young, H. N., Chewning, B., & Montague, E. (2015). How physician electronic health
record screen sharing affects patient and doctor non-verbal communication in primary
care. Patient education and counseling, 98(3), 310-316.
Barrett, A. K., & Stephens, K. K. (2017). Making electronic health records (ehrs) work: Informal
talk and workarounds in healthcare organizations. Health communication, 32(8), 1004-
1013.
Curtis, J. R., Sathitratanacheewin, S., Starks, H., Lee, R. Y., Kross, E. K., Downey, L., ... &
Lindvall, C. (2018). Using electronic health records for quality measurement and
accountability in care of the seriously ill: opportunities and challenges. Journal of
palliative medicine, 21(S2), S-52.
Durbin, J., Selick, A., Casson, I., Green, L., Spassiani, N., Perry, A., & Lunsky, Y. (2016).
Evaluating the implementation of health checks for adults with intellectual and
developmental disabilities in primary care: the importance of organizational
context. Intellectual and developmental disabilities, 54(2), 136-150.
Kadu, M. K., & Stolee, P. (2015). Facilitators and barriers of implementing the chronic care
model in primary care: a systematic review. BMC family practice, 16(1), 12.
Krousel-Wood, M., McCoy, A. B., Ahia, C., Holt, E. W., Trapani, D. N., Luo, Q., ... & Milani,
R. V. (2017). Implementing electronic health records (EHRs): health care provider
perceptions before and after transition from a local basic EHR to a commercial

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comprehensive EHR. Journal of the American Medical Informatics Association, 25(6),
618-626.
Olayiwola, J. N., Rubin, A., Slomoff, T., Woldeyesus, T., & Willard-Grace, R. (2016). Strategies
for primary care stakeholders to improve electronic health records (EHRs). The Journal
of the American Board of Family Medicine, 29(1), 126-134.
Palvia, P., Jacks, T., & Brown, W. S. (2015). Critical Issues in EHR Implementation: Provider
and Vendor Perspectives. CAIS, 36, 36.
Sittig, D. F., & Singh, H. (2015). A new socio-technical model for studying health information
technology in complex adaptive healthcare systems. In Cognitive informatics for
biomedicine(pp. 59-80). Springer, Cham.
Sligo, J., Gauld, R., Roberts, V., & Villa, L. (2017). A literature review for large-scale health
information system project planning, implementation and evaluation. International
journal of medical informatics, 97, 86-97.
Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). Health care information systems: a practical
approach for health care management. John Wiley & Sons.
World Health Organization. (2015). Health Worker Role in Providing Safe Abortion Care and
Post Abortion Contraception. World Health Organization.