Transforming Health Care Through Information: Case Studies (eBook)

Laura Einbinder, Nancy M. Lorenzi, Joan Ash, Cynthia S. Gadd, Jonathan Einbinder (Herausgeber)

eBook Download: PDF

2010 | 3rd ed. 2010
XX, 196 Seiten
Springer New York (Verlag)
978-1-4419-0269-6 (ISBN)

Infos

With the growth of information and focus on Healthcare Informatics, there remains an interest in case studies. In the current field of Health Informatics there is no text that uses case studies to explain the difficulties that occur. . Edited by specialists in the field of Health Informatics, the third edition of Transforming Healthcare Through Information: Case Studies builds upon the specific examples of case studies to exemplify the various phases of introducing technological advancements into healthcare institutions. The new edition includes a section on how to implement Link2care, a system that will allow caregivers of ill patients, to seek reliable and informative online information and support. In addition the cases will be framed under new sections with discussion on new topics in the area of healthcare technology such as quality data management and knowledge management. The case studies described in the third edition will benefit not only the practicing professional but also the instructor and student studying in the field of health informatics.

Nancy Lorenzi, PhD, is a professor of Biomedical Informatics and Assistant Vice Chancellor for Health Affairs at Vanderbilt University Medical Center, Nashville, Tennessee.

Joan S. Ash, PhD, is a professor of Medical Informatics and Outcomes Research at the Oregon Health and Science University Medical School, Portland Oregon.

Jonathan Einbinder, MD, MPH is Corporate Manager in Quality Data Management at Partners Healthcare System, Wellesley, Massachusetts.

Cindy Gadd, PhD is a professor in Informatics at the Vanderbilt University Medical Center, Nashville, Tennessee.

Laura Einbinder, MBA is a Consultant at Einbinder & Associates in Medfield, Massachusetts.

---

By any measure, our field of clinical informatics is poised for rapid growth and expansion. A confluence of forces and trends, including pressure to contain health care costs and simultaneously expand access and coverage, a desire to reduce me- cal error and health care disparities, the need to better understand and optimize our clinical interventions and delivery systems, the need to translate new knowledge into practice quickly and effectively, and the need to demonstrate the value of our services, all call for the application of the methods and techniques of our field - some of which are well honed with experience, and some of which are still in the process of being discovered. Clinical informatics is not the only solution to what ails health care, but it is a critical component of the solution. Our methods and techniques are similar in many ways to the knowledge base of any interdisciplinary field: some are informed by experience, the trials and tribulations of figuring out what works through real world implementation, some are informed by controlled experimentation in randomized controlled trials and related studies, some are informed by critical observation and analysis, and some are developed through laboratory evaluation rather than field trials. As we develop both the basic science, as well as the applied science, of our field, there is a cri- cal role for learning from others by way of case reports and stories.

Inhalt

Foreword 6
Series Preface 8
Acknowledgments 10
Contents 11
Contributors 13
Managing Change 20
Back Breaking Work: Implementing a Spine Registry in an Orthopedic Clinic 24
Background 24
Implementation 25
Questions 29
Epilog 29
References 30
A RHIO Struggling to Form: Will it Get Off the Ground? 31
Introduction 31
Organizational Background 32
Viewpoints 34
Focus of the Case 38
Summary 39
Case Analysis 39
Politics 39
Power 40
Stakeholders Satisfaction and Retention 40
Strategic Planning 40
Trust 40
Change Management 41
Leadership 41
Culture 41
Project Management 41
Virtual Teams 41
Communication 42
Motivation 42
Groups vs. Teams 42
Question 43
A Rough Ride at the Theodore Roosevelt Cancer Center 44
Introduction 44
Organizational History/Background 45
IT Structure 45
Focus of the Case 46
Clinical System Vendor Selection 46
Phase I Implementation: User Resistance and Impact on Phase II 47
Nursing Documentation – Use of Consultants and Goals/Objectives 49
Nursing Documentation – Teams, Training, and Implementation Support 49
Postimplementation Issues 50
TRCC Evaluation and Project Closing Document 51
Unique Needs of a Cancer Center System 51
Stakeholders’ Points of View – Where Do We Go from Here? 52
Question 53
Analysis of Issues and Recommendations 53
Communication Gaps – User Satisfaction Issues 53
Recommendations 54
Top-Down Leadership and Decision-Making 55
Recommendations 55
Lack of a Unified Vision and Consistently Communicated Motivational Goals 55
Recommendations 55
Workflow Redesign and Training Issues Associated with the CDS 56
Recommendations 56
Technical Issues with Visionex 56
Recommendations 57
Managing Resistance to Change 57
Recommendations 57
Conclusion 57
Question 58
References 58
Implementation of an Electronic Prescription Writer in Ambulatory Care 61
Background 61
The OMC Environment 61
OMC Strategic Plan Prioritized ‘Patient Safety First’ 61
RxWriter’s Stakeholders and Team Organization 61
RxWriter Implementation 63
RxWriter’s Infrastructure and Dependencies 63
Major Features and Accomplishments RxWriter Already Applied 64
Workflow Integration Features 64
RxWriter Implementation Challenges 65
Technical Challenges 66
Political Challenges 67
Options 67
Questions 69
References 69
Online Health Care: A Classic Clash of Technology, People, and Processes 71
Introduction 71
Initiating and Evaluating Change 73
Evaluating Change 73
Initiating Change 74
Individual Response to Change 74
Motivation and Role Ambiguity 76
Change Management 77
Management and Leadership 79
Strategic Planning for FutureCare 80
References 81
A Dungeon of Dangerous Practices 86
Background: A Harmful Event 87
Organizational Overview 87
Information Systems Overview 89
The Problem 90
Main Issues 91
Options with Pros and Cons 92
Option 1 92
Pros 92
Cons 92
Option 2 92
Pros 92
Cons 92
Option 3 93
Pros 93
Cons 93
Option 4 93
Pros 93
Cons 93
Question 93
Key Stakeholders for BPOC Planning and Implementation 94
Different Sides of the Story 95
Introduction 95
The Location 95
The Actors 95
The Story 96
Summary/Questions 96
References 96
Barcode Medication Administration Implementation in the FIAT Health System 97
Introduction 97
Methods 98
Results 99
BCMA Readiness Survey Results 99
Nursing Survey Results 100
Cross-Survey Results 100
Analysis and Recommendations 101
Strategic Planning 101
Leadership – Integration of the Clinical and Technological Aspects 102
Recommendations Regarding Leadership 103
Project Management 104
Introduction of Technology into Workflow 105
Culture of Change 106
Conclusion 107
References 108
H.I.T. or Miss 109
Emily’s Story 109
Joanna’s Story 110
Jim’s Story 111
Conclusion 112
The Implementation of Secure Messaging 118
Background 119
Project Planning Stage 119
User Interface Issues 120
Policy Issue 122
Security Issue 122
Rolling Out to Clinics 123
Conclusion 124
Questions 125
References 125
Who Moved My Clinic? Donnelly University Pediatric Rehabilitation: The Wheelchair Clinic 126
Introduction to Children’s Hospital Pediatric Rehabilitation 126
Background 126
Mission and Goals 126
Available Resources and Services Provided 126
The Katie Darnell Wheelchair Clinic 127
Introduction 127
Background 127
Wheelchair Ordering Process 128
Patients of the Wheelchair Clinic 131
Change in Location 132
Technology Available 133
Amenities Provided 134
Team Communication 134
Vendor Representative-Therapist Relationship 134
Therapist-Therapist Relationship 135
Conclusion 135
Questions 136
References 136
OncoOrders: The Early Years 137
Introduction to OncoOrders 137
Background 137
Funding 139
The Whiteboard 140
Order Assistant 141
Evaluation 142
Questions 143
Implementing a Computerized Triage System in the Emergency Department 144
Introduction 144
The Institution and IT Environment 145
Triage Basics 146
Paper-Based Triage Process 147
Initial Triage IT Development 150
Quill 151
WizOrder 152
Designing the Current System 153
Analysis of Implementation Aspects 158
System Evaluation 159
Discussion 159
References 161
Medication Barcode Scanning: Code “Moo”: Dead COW 163
Introduction 163
Project Overview 164
Workstation Deployment and Support 164
Assessment of Needs for the BCMA Project 164
Procurement 165
Assembly and Deployment 165
Implementation Surprises 165
Batteries 165
Scanners 166
Volume of Equipment 167
Budget Freeze 167
The Cumulative Effect 168
Questions 168
Project NEED: New Efficiency in an Emergency Department 173
Introduction 173
The Pediatric Emergency Department 173
Case Study Site 174
Methodology 175
Results and Discussion 175
Staff Perceptions Regarding Efficiency and Length of Stay (LOS) 176
Staff Perceptions Regarding New Triage System and New CIS 176
Staff Perceptions on Bottlenecks 176
Doctors 177
Gathering Laboratory Results 177
Putting Patients in Examination Rooms 177
Staff Perceptions on Hospital Admissions 178
Staff Perceptions on Areas for Improvement 178
Clinical Decision Support Tools 178
Web Based Tools 178
Personalized Order Sets and Prescriptions 179
Management Systems with Robust Patient Tracking 179
Linking CIS with Other Systems 180
Integrated Laboratory Results 180
Recommendations 181
References 182
Digital Radiology Divide at McKinly 184
Background 184
PACS Overview 185
Workflow Changes 187
Motivation 189
McKinly’s Dilemma 191
Case Analysis and Conclusions 191
Question 193
References 193
Index 195

Produkt-Details

• Erscheint lt. Verlag: 14.3.2010
• Reihe/Serie: Health Informatics
• Reihe/Serie: Health Informatics
• Zusatzinfo: XX, 196 p.
• Verlagsort: New York
• Sprache: englisch
• Themenwelt: Mathematik / Informatik ► Informatik
• Themenwelt: Medizin / Pharmazie ► Allgemeines / Lexika
• Themenwelt: Medizin / Pharmazie ► Gesundheitswesen
• Themenwelt: Technik ► Medizintechnik
• Schlagworte: Disease Management • Healthcare • Health Care • Health Informatics • Hospital • patients • quality • Rehabilitation • Safety
• ISBN-10: 1-4419-0269-4 / 1441902694
• ISBN-13: 978-1-4419-0269-6 / 9781441902696