- Propose a change to one aspect of your local or regional health care system or program that would improve outcomes. Then, conduct a comparative analysis of other, non-U.S. health care systems, focusing on the proposed change. Summarize the proposed change and your comparative analysis in a 4-5 page report.
RUBRIC - Competency 1: Identify the challenges and opportunities facing health care.
Identify an aspect of a local or regional health care system or program that should be a focus for change.
- Competency 2: Compare the effects of different health care finance models and policy frameworks on resources and patient outcomes.
Define desirable outcomes, including who will pay for care and factors limiting achievement of those outcomes.
Analyze two non-U.S. health care systems or programs that offer insight into a proposed change for a health care system or program in the United States. - Competency 3: Evaluate the positive and negative influences of leaders on health care processes and outcomes.
Determine the financial and health implications of making—and not making—proposed changes to a health care system or program.
- Competency 4: Develop proactive strategies to change the culture of the organization by incorporating evidence-based practices.
Explain why specific changes will lead to improved outcomes.
- Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style consistent with applicable organizational, professional, and scholarly standards.
Write clearly and concisely in a logically coherent and appropriate form and style.
Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.
1
Assessment 1:
Kathy Ergle
Capella University
NURS-FPX 6218: Leading the Future of
Health Care
Prof. Donna Ryan
November 09, 2022
Proposing Evidence-Based Change
A healthcare system is crucial to improve health, enhance the quality of life, and prevent
diseases. A good health system ensures timely access to effective care delivery. It integrates
clarity in roles, better information transfer, and best care collaboration for better health outcomes
(Kruk et al., 2018). In this assessment, I will propose a change in the local healthcare system to
improve care quality for people struggling with mental health issues. Moreover, the change will
be compared with two non-U.S. healthcare systems.
Proposed Change
After heart and cancer problems, medication errors are the most common cause of high
death rates in the United States. Most errors occur due to faulty or ineffective processes in a
healthcare system (Carver & Hipskind, 2019). For example, the local health facility where I
work depends on paper records for patient medical information, rising the chances of medical
errors. Two other challenges that the healthcare system is facing due to paper records are related
to the security of the medical records, poor decision-making, and ineffective
information storage
(Honavar, 2020). All these challenges make up care process for patients unsafe. According to the
World Health Organization (WHO), unsafe care is one of the ten worldwide leading causes of
disability and mortality (World Health Organization, 2019). Therefore, the aspect of the local
healthcare system related to paper records should be changed. The focus for change in the local
and regional healthcare system is the utilization of an electronic medical record (EMR) system
instead of paper records.
The expectation from the EMR system is to reduce medication errors, reduce time spent
on data recording, and improve information storage, decision-making, and security of medical
records through effective methods of data management (Vaidotas et al., 2019). According to the
expectations, the EMR system will reduce medical errors occurring due to manual medical
records. Also, the system will help providers store information in one place, and
access the
complete medical history of patients without dual tests and waste of time, leading to effective
information and decision-making (Honavar, 2020). Moreover, the EMR system is encrypted and
provides access to only authorized stakeholders like relevant health providers and patients which
results in a secure medical record (Hodgson et
al., 2021).
Study shows that the use of EMR
reduced data recording time by 24.5% and 23.5% with equipment at the bedside and central
location, respectively (Vaidotas et al., 2019).
Desired Outcomes
The desired outcomes of the EMR system will be:
1. Decline in medical errors
2. Lesser time spent on data recording
3. Effective information storage and
decision-making
4. Secure medical records
These outcomes are defined as the desired consequences of using the EMR system in the
local healthcare system. The rationale behind this definition is the evidence-based results of the
EMR system that are associated with a reduction in medical errors, effective information storage,
decision-making, and security of the medical record. The reduction in medical errors by using
EMR is supported by a comparative study conducted by Vaidotas et al. (2019). They compared
the occurrence of medication errors in two emergency departments and two other units of a
health setting. Two were using electronic records while the other was dependent on handwritten
records. The results showed lesser medication errors and improved patient safety in the
departments using electronic records.
The evidence by Hodgson et al. (2021) supports the enhancement of clinical factors and
patient outcomes, including the integration of patient information in one place and improved
decision-making regarding patient health by using an EMR system. Likewise, the research by
Chen et al. (2020) supports the effective information storage and security of medical records with
the implementation of EMR. According to the authors, cloud computing technology used in
EMR can store a large amount of health data in one place which makes it easier for providers to
store and access the information effectively. Moreover, the research asserts that the system is
secured with certain encryptions; its software is HIPAA compliant, and avoids access to
unauthorized personnel, leading to the security of patient medical records.
To implement the EMR system, eligible providers and healthcare systems are provided
with incentives by Medicaid and Medicare Services. Moreover, the Office of the National
Coordinator for Health Information Technology (ONC) pays local and regional systems of the
country to use the EMR system (HealthIT, n.d.).
Limiting Factors
There can be some factors that can limit the achievement of the desired outcomes.
1. Training issues for the technological use of EMR exist in some health settings.
For instance, lack of adequate training hinders the proper use of EMR by
physicians. They do not know how to use the advanced features of EMR due to
poor vendor training. Thus, better outcomes are not achieved properly. (Rahal et
al., 2021).
2. Resistance to the use of EMR at the providers’ level. Physicians sometimes find
the use of new technology complex and challenging which makes them avoid the
technology (Singh et al., 2020).
The two non-U.S. systems selected for the comparative analysis are the Australian and
United Kingdom (UK) healthcare systems.
The Australian healthcare system (acute and primary health settings) uses an electronic
health record system to reduce medication errors, and improve information storage, decision-
making, and record security (Schofield et al., 2019). The usability of the system depends upon
the health sector and the features being used. For example, the positive experience of health
providers in decision-making is more positive in hospitals while in the primary care sector the
providers have positive EMR experience regarding easy storage of information and reduction in
errors (Lloyd et al., 2021). Studies show that medication errors after the implementation of the
EMR system in an Australian healthcare system rose to the highest level (44.6%) initially due to
lack of technology use. But after 1.5 years, the percentage of errors reduced below 7.3%. The
type of errors varies as per job role. The healthcare system can use the study to promote
providers’ training to effectively use the EHR system for the reduction in errors right after the
implementation of the system (Qian et al., 2020).
In the UK, the healthcare system uses the electronic patient record system to improve the
storage and access of patient information (McMillan et al., 2018). Study shows that the
information is securely gathered in a digital form by using the EHR system. Also, it reduces the
time for documentation. The healthcare system encourages the engagement of health providers in
improving usability processes to improve the system use (Tapuria et al., 2021). The use of
electronic medical records (known as NHS care records) in the healthcare system of the UK
reduces some types of medication errors. The study suggests system optimization to reduce
medication errors to a larger percentage (Slight et al., 2019).
Lessons from Both Systems
The lessons that I learned from studying both systems provide indicators for the US
healthcare system. First, the system should organize training of health providers and increase
their involvement in the usability of the EMR system to reduce difficulty in using the system.
Second, the system should be optimized according to departmental needs to reduce medication
errors of all kinds.
Proposed Change leading to Positive Outcomes
The use of the EMR system in the U.S. healthcare system will improve medication errors,
information storage, and security of records because it helps providers manage patient data using
online technology (Adane et al., 2019). The process of data management through EMR is much
easier than manual data recording (paperwork). In paper documentation, keeping patient records
in one place is difficult and can cause human errors. In the case of online data recording chances
of documentation errors are, reduce and providers can easily access the medical history of
patients to know about his\her allergies. Thus, the possible errors related to patient data and
health information can be reduced, improving outcomes (Vaidotas et al., 2019). Second, the use
of EMR reduces the time for paper documentation, gathers all patient medical history in one
place, and provides easy and timely access to health information. It makes the storage of
information effective and helps providers in decision-making regarding continuity of care
(Honavar, 2020). Moreover, the researchers showed that encryption methods in EMR make the
data of patients secure and safe from unauthorized access (Chen et al., 2020). The evidence
discussed above supports the rationale behind the proposed change and its contribution to
improved outcomes. The expectations related to the use of EMR in the existing healthcare
system are reasonable as they are supported by credible evidence. The associated benefits of
using EMR are also evidence-based which is why the change within the system will be
completely practical.
Financial and Health Implications
The use of EMR will reduce the financial burden on hospitals in certain areas such as
administrative, nursing, and documentation costs. One study also showed an increase in
reimbursement by using the EMR system (Tsai et al., 2020). Another study showed the short-
term and long-term effects of implementing EMR. The effects include an increase in the cost of
software updates and maintenance. But the cost related to paper documentation and staff in data
records decreased. Moreover, billing revenue increased with the use of the implementation of
EMR. According to the study, other health implications of using EMR were a reduction in
medication errors, increased confidentiality of data, better storage of information, increased
adherence to guidelines, and improved health outcomes (Gopidasan et al., 2022).
The implications of not making the proposed change may include the risk of medication
errors, lesser efficient decision-making regarding patient care, and risks associated with the
security of patient data. Poor care quality can increase readmissions and cost implications for
individuals and communities (Schopf et al., 2019). The United States government has to spend
more than $40 billion on patients affected by medication errors each year (Tariq et al., 2022).
Cost-Benefit Analysis
The overall spent cost of the implementation of EMR was $31 billion till 2018. It is now
considered a necessity for better patient outcomes. In 2019, the cost went to $27 billion which
highlights the benefits of EMR usage in the settings (Nguyen et al., 2022). The cost-benefit
analysis in different health settings showed a positive impact of EMR implementation on hospital
revenue, positive net financial benefit after 3 years, and benefits for the pharmaceutical market.
Other advantages included improvement in population health and patient experience (Nguyen et
al., 2022).
The use of the EMR system in the U.S. healthcare systems can reduce medication errors
and improve information storage, decision-making, and security of medical records. The
comparative analysis of two non-U.S, healthcare systems provide lessons related to EMR use in
U.S. health settings. Also, the financial and health implications of making and not making the
proposed change are discussed in the research work.
Table 1: Health Care System Comparative Analysis
Outcomes
Health Care
System of Australia
Health Care
System of Norway
Health Care
System of U. S
Reduction in
medical errors
Long-term reduction
in medication errors
with the use of EMR
Reduced come kinds
of medical errors
Increased chances of
medical errors due to
paper documentation
Effective information
storage and
decision-making
Positive experience
with EMR regarding
easy storage of
information and
decision-making
Improved
information storage
and decision-making
with the use of EMR
Ineffective way of
information storage
and poor decision-
making while using
paper documentation
Secure medical
records
The positive
experience of
keeping records safe
with EMR
Secure information
collection with EMR
Patient data on
papers is not secure
and anyone can
access the
information
10
Adane, K., Gizachew, M., & Kendie, S. (2019). The role of medical data in efficient patient care
delivery: A review. Risk Management and Healthcare Policy, Volume 12(12), 67–73.
https://doi.org/10.2147/rmhp. s179259
Carver, N., & Hipskind, J. E. (2019, April 28). Medical error. Nih.gov; StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK430763/
Chen, C.-L., Huang, P.-T., Deng, Y.-Y., Chen, H.-C., & Wang, Y.-C. (2020). A secure electronic
medical record authorization system for smart device application in cloud computing
environments. Human-Centric Computing and Information Sciences, 10(1).
https://doi.org/ 10.1186/s13673-020-00221-1
Gopidasan, B., Amanullah, S., & Adebowale, A. (2022). Electronic medical records – A review
of cost-effectiveness, efficiency, quality of care, and usability. Journal of Psychiatry
Spectrum, 1(2), 76. https://doi.org/ 10.4103/jopsys.jopsys_17_22
HealthIT. (n.d.). Is federal financial support available for implementing electronic health records
(EHRs)? | HealthIT.gov. Www.healthit.gov. Retrieved April 12, 2021, from
https://www.healthit.gov/faq/federal-financial-support-available-implementing-
electronic-health-records-ehrs
Hodgson, T., Burton-Jones, A., Donovan, R., & Sullivan, C. (2021). The role of electronic
medical records in reducing unwarranted clinical variation in acute health care:
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Honavar, S. G. (2020). Electronic medical records – The good, the bad and the ugly. Indian
Journal of Ophthalmology, 68(3), 417. https://doi.org/ 10.4103/ijo.ijo_278_20
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Barker, P., Daelmans, B., Doubova, S. V., English, M., Elorrio, E. G., Guanais, F., Gureje,
O., Hirschhorn, L. R., Jiang, L., Kelley, E., Lemango, E. T., Liljestrand, J., & Malata, A.
(2018). High-quality health systems in the Sustainable Development Goals era: Time for
a revolution. The Lancet Global Health, 6(11), e1196–e1252.
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Lloyd, S., Long, K., Oshni Alvandi, A., Di Donato, J., Probst, Y., Roach, J., & Bain, C. (2021). A
National Survey of EMR Usability: Comparisons between medical and nursing
professions in the hospital and primary care sectors in Australia and Finland.
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https://doi.org/ 10.1016/j.ijmedinf.2021.104535
McMillan, B., Eastham, R., Brown, B., Fitton, R., & Dickinson, D. (2018). Primary care patient
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Nguyen, K.-H., Wright, C., Simpson, D., Woods, L., Comans, T., & Sullivan, C. (2022).
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Proposing Evidence-Based Change
Executive Summary
Proposed Change
Desired Outcomes
Limiting Factors
Healthcare System Comparative Analysis
Lessons from Both Systems
The Rationale for the Proposed Change
Proposed Change leading to Positive Outcomes
Financial and Health Implications
Cost-Benefit Analysis
Conclusion
Appendix
References
Running head: SUMMARY REPORT 5
Change Proposal Summary Report
Your Full Name (no credentials)
School of Nursing and Health Sciences, Capella University
NURS-FPX6
2
18 Leading the Future of Health Care
Proposing Evidence-Based Change
Instructor’s Name
Month, Year
Change Proposal Summary Report
Note: Delete this note and all instructions from the template before submitting your report. Use headings to organize your text, rather than bullets.
Executive Summary
Proposed Change
Identify an aspect of a local or regional health care system or program that should be a focus for change.
Desired Outcomes
Define each desirable outcome you wish to examine, including who will pay for care and factors limiting achievement of those outcomes.
Health Care System Comparative Analysis
Use Table 1, in the appendix, for your comparative analysis of the specific outcomes you wish to examine.
Analyze outcomes in two non-U.S. health care systems that offer insight into your proposed change.
Choose one of the following options for selecting the two systems:
· Option 1: Select two systems at opposite ends of the scale in terms of desirable outcomes for the issue reflected in your proposed change.
· Option 2: Select two systems that both produce positive outcomes but take unique or innovative approaches to the problem.
Compare the outcomes in each non-U.S. system with each other and with present outcomes in your local or regional health care system.
Rationale for the Proposed Change
Explain why specific changes will lead to improved outcomes.
Financial and Health Implications
Determine the financial and health implications associated with the proposed changes.
Address the implications of making the changes.
Address the implications of not making the changes.
Conclusion
Summarize your analysis and provide your rationale for the proposed change.
1
2
Appendix
Table 1: Health Care System Comparative Analysis
Table directions:
Add the names of the two non-U.S. health care systems and the local or regional U.S. health care system to the applicable column headings.
In the first column, list each outcome. Add rows to your table, as needed.
Add the relevant information pertaining to each outcome for each health care system in the second, third, and fourth columns.
|
Outcomes |
|
[Health Care System 1] |
[Health Care System 2] |
[U.S. Health Care System] |
||||||||
|
List outcome 1 here. |
||||||||||||
|
List outcome 2 here. |
||||||||||||
|
List outcome 3 here. |
Place in-text citations here, along with any other information not included in the table itself.
SUMMARY REPORT 4
References
List your APA-formatted references here.
INSTRUCTION
Propose a change to one aspect of your local or regional health care system or program that would improve outcomes. Then, conduct a comparative analysis of other, non-U.S. health care systems, focusing on the proposed change. Summarize the proposed change and your comparative analysis in a 4-5 page report. Introduction
Note: Complete the assessments in the order in which they are presented. Health care systems around the world provide useful models for analysis. Familiarity with different models and approaches to health care enables leaders to identify what works and what does not, as the basis for proposing a change. As we continue to evaluate the complex and fragmented system in the United States, it is important for nurse leaders to become familiar with the programs and systems that provide evidence-based quality care that is affordable and focused on continual improvement. This assessment provides an opportunity to examine a local or regional health care issue from a global perspective. Preparation Your organization, in collaboration with the key stakeholders from the community, is funding an initiative to investigate potential improvements in the local or regional health care system. As a nurse leader attuned to the effects of health care policy and finance on the provision of affordable, high-quality care, you have been asked to join the task force conducting the study. You know that an examination of other countries’ health care systems can provide a solid, evidence-based foundation for evaluating outcomes and identifying benchmarks. Consequently, you have decided to undertake an analysis of selected, non-U.S. health care systems and compare them to each other and to the existing local or regional U.S. system to help inform decision making as the task force considers proposed changes. In this assessment, you will propose a change to one aspect of your local or regional health care system or program. Conduct a comparative analysis of different health care systems and summarize your proposed change and findings from your analysis in a report to executive leaders. To prepare for your assessment, you are encouraged to begin thinking about the non-U.S. health care systems you might like to examine. In addition, you may wish to:
· Review the assessment requirements and scoring guide to ensure that you understand the work you will be asked to complete.
· Review
Guiding Questions: Proposing Evidence-Based Change [DOCX]
, which includes questions to consider and additional guidance on how to successfully complete the assessment.
·
Note: As you revise your writing, check out the resources listed on the Writing Center’s
Writing Support
page. MSN PROGRAM JOURNEY The following is a useful map that will guide you as you continue your MSN program. This map gives you an overview of all the steps required to prepare for your practicum and to complete your degree. It also outlines the support that will be available to you along the way.
·
MSN Program Journey.
· TEMPLATES Use this template for your summary report.
·
Summary Report Template [DOCX]
.
· Requirements Complete this assessment in three steps:
1. Propose a change to one aspect of your local or regional health care system or program that would improve outcomes.
2. Conduct a comparative analysis of different health care systems, focusing on one aspect of the system you are proposing to change.
3. Summarize your proposed change and the results of your comparative analysis in a report to executive leaders.
4. The summary report requirements outlined below, correspond to the grading criteria in the scoring guide for Proposing Evidence-Based Change, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed. The Guiding Questions: Proposing Evidence-Based Change document provides additional considerations that may be helpful in completing your assessment. In addition, be sure to note the requirements below for document format and length and for citing supporting evidence.
· Identify an aspect of a local or regional health care system or program that should be a focus for change.
· Define desirable outcomes, including who will pay for care and factors limiting achievement of those outcomes.
· Analyze two non-U.S. health care systems or programs that offer insight into a proposed change for a health care system or program in the United States.
· Choose one of the following options for selecting the two systems or programs:
· Option 1: Select two systems at opposite ends of the scale in terms of desirable outcomes for the issue reflected in your proposed change.
· Option 2: Select two systems that both produce positive outcomes but take unique or innovative approaches to the problem.
· Compare the outcomes in each non-U.S. system with each other and with present outcomes in your local or regional health care system.
· Explain why specific changes will lead to improved outcomes.
· Determine the financial and health implications associated with the proposed changes.
· Address the implications of making the changes.
· Address the implications of not making the changes.
· Write clearly and concisely in a logically coherent and appropriate form and style.
· Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.
· Document Format and Length
· Use the Summary Report Template. This
APA Style Paper Tutorial [DOCX]
can help you in writing and formatting your assessment. If you would like to use a different worksheet for your community health assessment, obtain prior approval from faculty.
· Your summary report should be 4–5 pages in length, not including the title page and references page.
· Be sure to apply correct APA formatting to all source citations and references.
· Supporting Evidence Cite 3–5 credible sources from peer-reviewed journals or professional industry publications to support your comparative analysis. Additional Requirements Be sure to delete all directions from the template before submitting your summary report. In addition, proofread your report to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your analysis.
Portfolio Prompt: You may choose to save your summary report to your ePortfolio. Competencies Measured By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
RUBRIC
· Competency 1: Identify the challenges and opportunities facing health care.
· Identify an aspect of a local or regional health care system or program that should be a focus for change.
· Competency 2: Compare the effects of different health care finance models and policy frameworks on resources and patient outcomes.
· Define desirable outcomes, including who will pay for care and factors limiting achievement of those outcomes.
· Analyze two non-U.S. health care systems or programs that offer insight into a proposed change for a health care system or program in the United States.
· Competency 3: Evaluate the positive and negative influences of leaders on health care processes and outcomes.
· Determine the financial and health implications of making—and not making—proposed changes to a health care system or program.
· Competency 4: Develop proactive strategies to change the culture of the organization by incorporating evidence-based practices.
· Explain why specific changes will lead to improved outcomes.
· Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style consistent with applicable organizational, professional, and scholarly standards.
· Write clearly and concisely in a logically coherent and appropriate form and style.
· Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.
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