Exercises in Measurement and validity For this assignment, you.docx
- 1. Exercises in Measurement and validity For this assignment, you will be working through questions regarding measurement and validity.. Your answers should be written in complete sentences. Some of the answers may require you to show your work. 1. You have just started a new diet program. To mark your progress, you start weighing yourself three times a day. You also notice that each time you weigh yourself in a given day, the number of pounds is different. Based on the rules regarding the scales of measurement, why is it wrong to weigh yourself more than once a day? 2. Your hospital administration has received several phone complaints from patients about rude behavior from registration staff and long wait times to register in both the Dermatology and Audiology Outpatient Clinics. A decision is made to send a patient satisfaction survey to all Outpatient Clinic patients to determine overall patient satisfaction in the hospital’s Clinic setting. The survey developed uses this type of scoring: 1 = strongly disagree and 5 = strongly agree. What type of scale of measurement is this? 3. Your hospital wants to study patients readmitted within 30- days. What measures (e.g. Medicare patients only) would you recommend be included in the study (identify at least 3)? Where would you locate the data elements (e.g. admission records)? 4. Your hospital’s Pharmacy and Therapeutics Committee undertook a quality review of Medication forms from discharges in the first quarter of the year and identified the errors by 5 general categories and then calculated the percentage of the total errors by category. The results were: Dosage Form 6%,
- 2. Name confusion 13%, Communication 19%, Labeling 20%, and Human Factors 42%. As the HIM Director you are a member of the P&T Committee, the Chair asks you to prepare a graphic display of the error results for Medical Staff review. What is the best choice of a graphic display to present this data to the Medical Staff? And why a. Line Graph b. Bar Graph c. Pie chart d. Data Table 5. Provide a definition and example for the following terms: a. Content validity b. Construct validity c. Criterion validity Running head: BUSINESS AND USER REQUIREMENTS DOCUMENT DRAFT 1 BUSINESS AND USER REQUIREMENTS DOCUMENT DRAFT 6 Business and User Requirements Document Draft thanks for your Draft report on the EHR project and requirements. There are 3 main parts to cover: Sources of information, departments affected: Provide more information about the clinical departments. HIM is not the "most important" department for this system. Clean up some of the writing
- 3. possible errors or misunderstandings, too. 5 /7 Methods to gather information: Glad you mentioned interviews, focus groups, and questionnaires and explained all three. 7 /7 Requirements statements:3 /6 You are not quite understanding what Requirements are yet. They are what the system must do. We will get later on in the class, onto project implementation tasks such as training and transitions. For this paper, focus on what the system itself needs to have as its functions; what must the EHR do? See attached comments on draft: Business and User Requirements Document Draft Gathering business and user requirements To implement the EHRS system, some departments will be more involved than others. As such, they will be the most important sources of information for the planning stages. The first among these is the information and communications technology. Comment by Judy Johnson: That is not a department name. Not sure what you were trying to say here about it. That is the title for the class, instead. The nursing department will also be crucial in collecting the information needed to determine business and user requirements. For nurses to be more efficient at doing their jobs, they need to have the backing of reliable and readily available information at their disposal. Since nursing care is such a core element in the providing of quality care, their needs and requirements will be useful to consider. In this department too is the medical staff, led by the Chief Medical Officer. The EHRS will be extensively used by the physicians to provide accurate information and to enter details of diagnosis, apart from other relevant information. As a result, their views should be considered as the hospital boards on the implementation of this system (Terry et al, 2008). Comment by Judy Johnson: Medical staff is not part of “nursing department.” Your sentence
- 4. here seems to be saying it is part of nursing when you say, “in this department too…” Comment by Judy Johnson: Yes, this is correct. The Health Information Management department is the most important of these departments in the implementation of the process. The department possesses unique expertise in the management of health information and is well aware of the regulations that such information should be managed with. As the custodians and managers of the information, the HIM department will be able to understand the particular needs of each of the other departments. The department is also heavily involved in billing as well, which the EHRS will view as one of the major operations in need of streamlining (Zeng, 2016). Comment by Judy Johnson: That is not actually the “most important” department. The clinical staff (physicians, nurses) have more hands-on with the EHR than other departments. While the senior management of every function will be extensively involved in the project overview and implementation process, their subordinates also have an important role to play in ensuring that the project is a success. Within the operations department, for instance, the personnel in the laboratory, radiology, and pharmacy will be using the system, in collaboration with medical personnel such as the doctors and nurses. Their input will, therefore, be highly valued. Also important will be the business development officers, who will have information on what competitors are doing or using, and thereby provide information that will be used to make the same enhanced (Zeng, 2016). List of business and user requirements for the project Comment by Judy Johnson: Title does not seem to fit with what is below. Your information gathering process is what is just below this heading. The data collection process will be designed in a way which ensures that the information collected is reliable accurate and complete. As such, a combination of several data – collection
- 5. techniques will be used, depending on the particular characteristics of the department. Interviews will be used to collect information from the senior management, since they are few, and time limitations do not allow for interviews with all potential suppliers of information. While interviews will be useful in giving the necessary information in a better way than questionnaires and other methods, they are costly to conduct, and will only be used carefully (Zeng, 2016). Comment by Judy Johnson: Yes, interviews can be time-consuming or costly. Making a poor decision on an EHR can be even more costly, though. To better collect information from the end users of the system – the HIM department, physicians, and nurses, conveniently - timed focus groups will be deployed. The groups will be helpful in helping the potential users come up with further information that would not be captured in a survey, or an interview, due to the lack of interaction with other users. Additionally, the use of focus groups will be amplified by the use of questionnaires, which will ensure that no information has been lost on the information collectors. After conducting the face to face interviews and focus group discussions, a meeting in which everyone is encouraged to attend will be held. During the meeting, additional views will be invited, as the findings are presented and members present air their opinions if contrary to what is proposed (Terry et al, 2008). Comment by Judy Johnson: How will you use these questionnaires? Who will be sent the questionnaires, what will be the topics? Requirements to be met for project to address project overview needs The cost of the system should be transparent and affordable. For instance, the cost of maintenance should be clearly spelled out, as well as other add-ons such as license agreements. The cost should be within the budget of the institution, to ensure smooth implementation. The system should be able to leave a clear audit trail. Due to the
- 6. sensitivity of health information, it is important to have a system that clearly shows who accessed the system, at what time, and what they viewed. It should be easy to change from whatever old system is being used to the new one. For this to happen, the system will need to have a user – friendly design that all members of the hospital, regardless of their computer proficiency, can easily use. The system should also be well documented so that any bugs can be easily detected and eliminated. Comment by Judy Johnson: You are talking about the transition needs. Before thinking of that though, we need to specify what this system must DO. What are its functions? That is how we specify systems Requirements. The system should be well secured. This is appreciative of the sensitivity of health information, and the need to ensure it from cyber breaches and attacks which might compromise the integrity of the information. Due to the widespread use of such systems, whereby they are currently government policy in all American hospitals, it is important for the system to be easily integrated with other systems, and other IT solutions currently used by the hospital. Server options should be specified. If possible, the server should be hosted on the hospital’s premises. This will ensure that the hospital has total authority over the system and that as a result, there is no possibility for jeopardizing the data that is stored within the system. Since most of the users are not experts, the system should come with ample training opportunities for potential users. The training should be tailored to cover the relevant areas for each department and individual personnel. The system should be well – versed in modern technology. For instance, the system should be enabled with instant sharing services such as text message. This should, however, be ensured to be secure and avoid unnecessarily compromising patient information.
- 7. References Terry, A. L., Thorpe, C. F., Giles, G., Brown, J. B., Harris, S. B., Reid, G. J., Stewart, M. (2008). Implementing electronic health records: Key factors in primary care. Canadian Family Physician, 54(5), 730–736. Zeng, X. (2016). The Impacts of Electronic Health Record Implementation on the Health Care Workforce. North Carolina Medical Journal, 77 (2), 112-114. The Good Apples Group EHRS Project Summary You are an employee of the Good Apples Group, a healthcare organization which runs MacIntosh Manor Hospital. The CEO of the hospital has made a priority for the hospital to enter the 21st century by converting its operations to an Electronic Health Records System. You have been assigned the role of project manager for this effort, and are therefore responsibility for ensuring that the needs of the hospital have been carefully assessed and that the planning process for bringing an EHRS online is effective. The Organization At first glance, MacIntosh Manor Hospital looks like any small town hospital, where the quality of care is certainly modern but the staff and patients still come to know each other and expect a down-to-earth pace. The Good Apples Group, a parent corporation maintaining several local clinics in addition to
- 8. MacIntosh Manor, has worked hard over the years to maintain that balance of customer service and cutting edge patient care. MacIntosh Manor Hospital is a 500-bed, critical access hospital in Shiminy, Pennsylvania. It is the largest hospital within 100 miles, and schedules between 22,000 to 26,000 visits a year. MMH provides surgical, medical and acute care, 24- hour emergency room services, outpatient services, health education, behavioral services, and home and hospice care to a primarily suburban region of about 124,000 residents. It employs 2200 people, including 275 physicians, and as a hospital is managed by its own CEO. MMH’s mission is to provide for the residents of Shiminy high quality services that enhance the quality of life and promote healthy lifestyles for patients, clients, employees, organization and communities. In its community MMH seeks to lead by example through compassionate, caring and comprehensive health care services. The direction of MacIntosh Manor’s strategic vision change greatly in 2010 when Dr. Phillip Kapp was named CEO of the Good Apples Group and made it clear that his own successes with implementing EHRS and related technologies in healthcare facilities in the Philadelphia area would be the kind of challenge he wished to take on again with MacIntosh Manor Hospital. Kapp formed a strategic planning committee to assess the use of technology and what MMH should implement, and to determine and monitor a migration path. Around the same time that Dr. Kapp took charge of the Good Apples Group, a federal mandate was issued that hospitals nationwide need to be using electronic medical records by 2015, giving Kapp and the strategic planning committee even more incentive to act quickly. The committee recommended beginning the transition to EHRS immediately and
- 9. implementing both financial and clinical solutions. “Creating a ubiquitous and common platform for timely access to clinical information is crucial for patient care and patient safety. By giving physicians and nursing staff access to the information they need at the point of care, we will eliminate unnecessary tests, and reduce patients’ exposure to medical errors and drug allergies.” Thomas Lytle Chief Information Officer at MacIntosh Manor Hospital Key Business Processes Clinical Decision Support A key business process to be addressed by the EHRS should be clinical decision support. When staff enter orders electronically, doctors should gain quick access to their patients’ medication history and be provided real-time potential adverse drug event alerts such as drug-drug and drug allergy. “Currently if a doctor adds a medication on paper they won’t necessarily see what other medications their patients are on unless they carefully go back and flip through the paper-based patient record,” noted Sam Guder, Head of Nursing. Nursing documentation Nursing admission assessments for inpatient and outpatient care are now a chaotic mess, as each member of the nursing staff has a different level of experience and often prepare records based on best practices at a facility where they had previously worked. Clinicians should be able to view historical patient information, ensuring appropriate and continuous care. Nursing shift assessment should be able to be pulled forward for review or editing prior to being accepted as part of the patient record.
- 10. "I can envision using a wireless LAN with laptop computers at each nursing unit to provide access to EHRS at the point of care, reducing the potential for transcription errors, saving everyone’s time, and eliminating lag time between gathering information and entry into the system. Ideally we would want to decrease nursing time for regular and overtime staff from 1.5 hour to 1.0 hour per day per nurse. Admission assessment should be reduced by two minutes per patient and shift assessment by seven minutes," says a member of the nursing staff interviewed for this project. Specific Need: Prevention of bedsores, falls and hospital-based infections Good Apples Group has recently been asked to comply with new patient safety and pay-for-performance standards. Medicare will stop reimbursing hospitals for treating eight “reasonably preventable” conditions patients acquire at hospitals. These conditions include pressure ulcers, better known as bedsores, patient falls and urinary tract infections. We need software that has built-in bedsore and patient fall risk assessments into the electronic nursing assessment, so that if certain elements are documented during the assessment, the EHRS will trigger electronic alerts to clinicians." Additional Business Processes Dr. Kapp has indicated that his experience demonstrates the value of a phased rollout of EHRS software. At one clinic where he had attempted a wholesale overhaul of the clinic’s business practices with an EHRS he saw an immediate decrease in the quality of care, combined with a great deal of swearing from the staff and anger among the facility’s managers. In order to phase in the EHRS carefully, Dr. Kapp has suggested that the following units within the organization be addressed first: Targeted Organizational Units
- 11. · Pharmacy · Radiology Unit · Respiratory Therapy · Food and Nutrition Services · Mom-Baby and Labor & Delivery MacIntosh Manor Hospital Organizational Chart “Many of our physicians are reluctant to adopt EHRS technology if it does not mirror their current workflow,” Dr. Phil Kapp, CEO of the Good Apples Group says. “An intuitive, easy-to-use system is the key to making something work here.” MacIntosh Manor Hospital at a glance Beds– inpatient: 500 Number of physicians: 275 Number of nurses: 7000 Annual inpatient visits: 24,480 Annual Emergency Room visits per year: 93,702
- 12. Desired Results • Real-time access to patient data • Improve quality and continuity of care • Enhance patient safety • Enterprise-wide connectivity • Improve physician recruitment Project Overview Throughout the course you will build a plan for delivering an EHRS system to a healthcare facility. This plan will cover several of the phases of the project lifecycle, from establishing business requirements to planning what will be required to support and maintain the system once it is up and running. In order to complete this project, please read the attached document Good Apples Group Case. This document describes the Good Apples Group facility, the way they do business, and the need they have for an EHRS. Each component of the project is based on the needs of the Good Apples Group. You will be
- 13. building a plan for delivering an EHRS system to Good Apples Group. Read the document attached below as Good apples group case Business and User Requirements Review the course project description above Introduction page in order to understand the overall needs of the organization and the specific business processes which the project should address. In response to these needs, prepare a draft requirements document which describes the following: · The sources of information within the organization which would be used to gather business and user requirements. Show your understanding of the departments that are in a typical hospital; be specific and include a variety. Explain what departments could be affected most by an EHR system implementation. Include not only Senior management levels, but also staff level of the organization, as part of your information gathering plans. · The methods that you would use to prepare a comprehensive list of business and user requirements for the project. Explain which methods you would use to gather information from each department you have decided on. Conduct your own background research on the web or in our library, on effectively using information gathering techniques including structured interviews, focus groups, and surveys, in order to effectively address this section. · 8-12 requirements that should be met in order for this project to satisfactorily address the needs expressed in the project overview. Requirements should be specific to an EHR system development. Remember that a requirement is not the same as a general "goal."
- 14. Note that these requirements must focus on the needs of the facility and of the people who will be using the project as an alternative means of performing business processes they already perform. Your paper should be approximately 4 pages in length. APA format