Feb 23, 2024 Discussion: Outcomes and Efficiencies
Discussion: Outcomes and Efficiencies
Discussion: Outcomes and Efficiencies
The topic of the assignment is: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies Question.
New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.
Annotated Bibliography
Lewing, B. D., Hatfield, M. D., & Sansgiry, S. S. (2018). Impact of computerized provider order entry systems on hospital staff pharmacist workflow productivity: a three site comparative analysis based on level of CPOE implementation. Journal of Hospital Administration, 7(1)..
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The above study aimed at investigating the effect of computerized provider entry systems on the workflow productivity of staff pharmacists working in three hospitals in Houston, Texas. The research design used was an observational, prospective time as well as motion study. The sample consisted of pharmacists in three hospitals who were observed for one hour three block undertaking 38 different activities. The work categories the pharmacists were observed while undertaking them included distribution, clinical, miscellaneous, and administrative activities. The data obtained from the three hospitals was compared using descriptive as well as comparative analyses using ANOVA and Post-hoc Turkey’s range test.
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The outcomes that were investigated in the study included workflow and productivity of the pharmacists while undertaking different tasks. The study also investigated the use of CPOE on time allotment and the comparison of the observed differences in time spent in the implementation of the CPOE system. The results of the study revealed that the use of CPOE the time that the pharmacists spent in implementing short and long-term CPOE activities was shorter when compared to that they utilized in implementing non-CPOE activities. It was therefore concluded that the use of CPOE can improve the work flow and productivity of the pharmacists in clinical settings. It also reduces the time that they spent in engaging in different activities in their settings.
This article has shown the effectiveness of CPOE in reducing the time that healthcare providers spent in engaging in their professional activities in the clinical settings. It has revealed that effective implementation of the CPOE systems can result in easy allocation of tasks and tracking of workflow in an institution of healthcare. Therefore, institutions that aim at improving productivity and efficiency in their operations should adopt the use of the CPOE system. Improved productivity and workflow translates into other outcomes such as enhanced quality, safety, and cost-effectiveness of care.
Okumura, L. M., Veroneze, I., Bugardt, C. I., & Fragoso, M. F. (2016). Effects of a computerized provider order entry and a clinical decision support system to improve cefazolin use in surgical prophylaxis: a cost saving analysis. Pharmacy Practice (Granada), 14(3), 0-0.
The above study investigated the effects of using computerized provider order entry as well as clinical decision support system to enhance cost saving in the use of cefazolin in surgical units in Brazil. The study was before and after study design. The data on the prophylactic use of cefazolin was compared before and after the implementation of the CPOE and CDSS implementation. The authors believed that the comparative data would enable the accurate determination of the effectiveness of use of these systems. Data analysis was performed on 12-year data on cefazolin use. The 12-year data comprised of the first three years before CPOE and CDSS implementation while the remaining nine years was after the implementation of these systems. The obtained data was analyzed using Spearman rho on-parametric test to determine the use of cefazolin over the period of data collection.
The outcomes that were under investigation in the research included cefazolin use, product cost, and crude cost. The cefazolin use was defined by daily doses/100 bed-days. Product and crude costs were also defined by cefazolin use per 100 bed-days. The authors hypothesized that the implementation of the CPOE and CDSS systems will result in a net reduction in cefazolin prophylaxis use and overall costs incurred in health organizations. The outcomes of the research showed that the implementation of the CPOE and CDSS resulted in a reduction in cefazolin prophylaxis use from 6.31 DDD/100 bed-days in 2002 to 2.15 DDD/100 bed-days in 2014. The analysis also revealed that a lack of implementation of CPOE and CDSS in 2002 would have increased the costs incurred in the prophylactic use of cefazolin from $ 44, 722.99 to $116998.07.
The results from this study reveals that effective implementation of CPOE system has significant organizational benefits. It reduces resource wastage by increasing the utilization of evidence-based decisions in the provision of care. The system also promotes cost-efficiency in the organization. It is also evident from the research that optimum outcomes with CPOE system use can be achieved when combined with other systems such as CDSS. Therefore, health organizations should implement CPOE systems as a way of reducing wastage and cutting their operational costs.
Bucher, B. T., Ferraro, J. P., Finlayson, S. R., Chapman, W. W., & Gundlapalli, A. V. (2019). Use of computerized provider order entry events for postoperative complication surveillance. JAMA surgery, 154(4), 311-318.
The above study was conducted with the aim of determining the effectiveness of CPOE entry events in identifying post-operative complications. The researchers focused on determining the rates of post-operative complications that were identified with the use of CPOE when compared to the use of manual medical review. Cohort study design was used to achieve the objectives of the study. The researchers reviewed 21775 medical records for patients who had undergone surgical procedures at the University of Utah from 2007 to 2017. The data on the sensitivity of the CPOE system in the detection of the complications was analyzed using the logistic regression model. The CPOE-based surveillance system was used to validate the developed models for the identified post-operative complications.
The main outcome of the study was post-operative occurrences of complications. The complications included deep surgical site infection, superficial surgical site infection, organ space surgical site infection, pneumonia, sepsis, urinary tract infection, deep vein thrombosis, septic shock, and pulmonary embolism. The analysis of the obtained data revealed that the sensitivity of the CPOE events in detecting patients who experienced one or more complications was 74.8%, specificity of 86.8%, negative predictive value of 97.55%, and positive predictive value of 33.8%. The use of CPOE events also diminished the burden of manual review of records by 55.4% to 90.3%.
Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.
In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.
To Prepare:
· Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
· Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
· Identify and select 5 peer-reviewed articles from your research.
The Assignment: (4-5 pages)
In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:
· Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
· Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.
Determine the people who are involved in the issue and explain three reasons as to how their role will contribute to the problem or issue solution.
8. Identify three solutions and discuss the purpose, cost and desired outcome.
9. Pick one solution to share with the director and discuss why this solution was chosen over the others. Use a scholarly reference.
10. Make an action plan to share the solution with the director and staff.
11. Summarize issue, plan and desired outcome and purpose for quality improvement on slide.
12. Reflect on your learning and value of doing the assignment.
13. Include written speaker notes for all slides except title slide and reference slide
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
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