NRS 451 Executive Summary

There are many quality improvement initiatives in healthcare. Some of the most common ones include Six Sigma, Lean, and Total Quality Management (TQM). Six Sigma is a data-driven methodology that aims to improve the quality of products and services. It uses a set of tools and techniques to measure defects and identify ways to reduce them. Lean is a process improvement approach that aims to eliminate waste and increase efficiency. It focuses on eliminating steps or activities that do not add value to a product or service. TQM is a management philosophy that promotes the pursuit of excellence in all areas of business operations. It emphasizes continuous improvement, customer satisfaction, and teamwork. The purpose of this assignment is to analyze a quality improvement initiative involving improved electronic medical record documentation, including target population, benefits, cost, and the basis upon which the quality improvement initiative will be evaluated.

Main Problem

In my healthcare settings, incomplete or illegible documentation continues to be a major problem that requires improvement. One potential solution is improved electronic medical record documentation. Incomplete physician notes are the leading cause of malpractice claims, and account for almost half of all paid malpractice claims. In my healthcare organization, incomplete or illegible documentation lead to miscommunication and errors. For example, if a doctor’s notes are incomplete or illegible, another doctor may not be able to understand them and could end up prescribing the wrong medication or performing the wrong procedure.

Solution to the Problem

Improved electronic medical record documentation is one way to help mitigate the problems caused by incomplete or illegible documentation. With accurate and complete patient information, clinicians can deliver consistent healthcare services to patients. Electronic health records (EHRs) can help improve the accuracy and completeness of patient information. EHRs can also help reduce the amount of time clinicians spend on documentation, which can free up time to provide more patient care. Improved electronic medical record documentation is a quality improvement initiative that will ensure proper and accurate information.

Purpose of the Quality Improvement Initiative

The purpose of the quality improvement initiative is to improve electronic medical record documentation by reducing the number of incomplete or illegible documentation. The goal of this initiative is to improve patient care by ensuring that all information pertinent to the patient’s care is documented in the electronic medical record (Fazio et al., 2020). Incomplete or illegible documentation can lead to errors in treatment, which can potentially have adverse impacts on patients. By improving electronic medical record documentation, we can ensure that all information pertinent to a patient’s care is available when it is needed most (Gandrup et al., 2020). This will help us provide the highest level of care possible for our patients.

Target Population or Audience

The target population for a quality improvement initiative involving improved electronic medical record documentation would be healthcare professionals who are responsible for providing patient care. This would include physicians, nurses, and other clinical staff. The goal of the initiative would be to improve the accuracy and completeness of medical records documentation (Fitzgerald et al., 2021). This would ultimately improve patient care by ensuring that all relevant information is available to healthcare professionals when making decisions about treatment plans. It would also help to ensure that patients receive appropriate care based on the most current information available.

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Benefits of the Quality Improvement Initiative

The benefits of the quality improvement initiative involving improved electronic medical record documentation include: A reduction in medical errors and adverse drug events, improved patient care and safety, efficient and accurate communication between providers, time savings for clinicians, and reduced costs for healthcare providers. Improved EMR can help to ensure that all members of the healthcare team have accurate and up-to-date information about a patient’s medical history, medications, and allergies. This can help to reduce the risk of medical errors, which can potentially lead to serious injury or even death. EMR also makes it easier for healthcare professionals to track patients’ progress over time and to identify any potential problems early on. This can lead to more timely and effective treatment plans, which in turn results in improved patient care.

The Cost or Budget Justification

A recent study published in the Journal of the American Medical Association found that improved electronic medical record documentation, or “EHR use”, can result in significant cost savings for healthcare organizations. The study was conducted over a two-year period and found that EHR use led to a 11.8% reduction in hospital admissions and a 13.6% reduction in total hospital costs. The study also found that increased EHR use was associated with reductions in both length of stay and costs for patients who were admitted to the hospital.

The overall cost of this project will be $36,000,000 on the lower side and $49,500,000 on the higher side.The breakdown is as follows:

Cost Category for EMR Improvement	Start-up Costs per bed-low ($)	Start-up Costs per bed-high ($)
External IT Consulting	26,000	30,000
Hardware	14,000	25,000
Clinical Software Licenses	15,000	20,000
External Training Services	10,000	12,000
Other Software Licenses	5,000	7,000
Internal IT Support	2,000	5,000
Total	72,000	99,000

Total Bed Capacity	500
Grand Total	36,000,000	49,500,000

Interprofessional Collaboration Required For the Quality Improvement Initiative

Interprofessional collaboration is key for the success of any quality improvement initiative. In order to improve electronic medical record documentation, all healthcare professionals involved in the patient’s care will work together to create and implement a plan that meets the specific needs of each individual patient (Tajirian et al., 2020). There is also the need for collaboration with external organizations and partners to ensure the implementation of all the processes required. By involving all members of the healthcare team, one can ensure that everyone has a shared understanding of the patient’s care plan and are able to properly document all interventions and treatments in the EMR (Sutton et al., 2020). This improved documentation will help to improve patient care overall and ensure that all members of the healthcare team are working towards the same goal.

The Basis for Evaluating a Quality Improvement Initiative

There are a few key factors that will be considered when evaluating the quality of an electronic medical record documentation improvement initiative. First, it will be important to look at how the new system is being used by clinicians – is it making their lives easier or more difficult? If it is making their lives more difficult, then the initiative is not likely to be successful in the long run. Second, the implementation team will look at how well the system is capturing patient data (Sutton et al., 2020) and to determine whether sufficient information in the records are available to support clinical decision-making. Other question that will be asked when evaluating the quality improvement initiative will be: Are all of the necessary fields being completed, and are they populated with accurate data? If not, then there will be problems downstream when the data is analyzed for quality improvement purposes.

Conclusion

A quality improvement initiative involving improved electronic medical record documentation can have a number of benefits, including: improved patient care, increased efficiency and accuracy in data entry, reduced administrative costs, and enhanced overall quality of care. Anytime a change is introduced to a given process, it is important to evaluate the impact of those changes. In this case, you’re talking about introducing an electronic medical record documentation system. There are a number of factors to consider when evaluating the impact of such a change.

References

Fazio, S., Doroy, A., Da Marto, N., Taylor, S., Anderson, N., Young, H. M., & Adams, J. Y. (2020). Quantifying mobility in the ICU: Comparison of electronic health record documentation and accelerometer-based sensors to clinician-annotated video. Critical care explorations, 2(4). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188433/

Fitzgerald, M. P., Kaufman, M. C., Massey, S. L., Fridinger, S., Prelack, M., Ellis, C., … & Hagopian, S. (2021). Assessing seizure burden in pediatric epilepsy using an electronic medical record–based tool through a common data element approach. Epilepsia, 62(7), 1617-1628. https://doi.org/10.1111/epi.16934

Gandrup, J., Li, J., Izadi, Z., Gianfrancesco, M., Ellingsen, T., Yazdany, J., & Schmajuk, G. (2020). Three quality improvement initiatives and performance of rheumatoid arthritis disease activity measures in electronic health records: results from an interrupted time series study. Arthritis care & research, 72(2), 283-291. https://doi.org/10.1002/acr.23848

Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I. (2020). An overview of clinical decision support systems: benefits, risks, and strategies for success. NPJ digital medicine, 3(1), 1-10. https://www.nature.com/articles/s41746-020-0221-y

Tajirian, T., Stergiopoulos, V., Strudwick, G., Sequeira, L., Sanches, M., Kemp, J., … & Jankowicz, D. (2020). The influence of electronic health record use on physician burnout: cross-sectional survey. Journal of medical Internet research, 22(7), e19274. https://www.jmir.org/2020/7/e19274/PDF

NRS 451 Executive Summary