NURS 8210 Week 4 Discussion: HIT Projects and Decision Maker

NURS 8210 Week 4 Discussion: HIT Projects and Decision Makers

Week 4: System Development Life Cycle

In this week’s discussion, we will explore Health Information Technology (HIT) projects and the critical role of decision-makers in their implementation.

A notable incident occurred when a nurse leader proposed enhancing security in the children’s wing of a hospital by installing a new alarm and monitoring system. Unfortunately, the Chief Nursing Officer (CNO) rejected this proposal due to budget constraints, deeming the existing security measures sufficient. Shortly after this rejection, a security breach resulted in the abduction of a young child from the children’s wing. Fortunately, the child was found and safely returned to her parents. This incident prompted the CNO to quickly allocate funds for the installation of the proposed security system.

While not all HIT projects carry such urgent implications, this example highlights the importance of engaging key stakeholders and decision-makers when planning new HIT initiatives.

Preparation

Reflect on an HIT project that was implemented in your organization. Consider the following questions:

• Who identified the project?
• Which stakeholders and decision-makers were instrumental in advancing the project?
• What methods were employed to gain the support of stakeholders and decision-makers?

Discussion Prompt

By Day 3, please post a cohesive response that includes the following:

1. Provide an example of a HIT project implemented in your organization. Analyze how the project was identified and the steps taken to advance it.
2. Evaluate the influence of key decision-makers on the progress of the HIT project.

Additionally, engage with your colleagues’ postings by Day 6 by responding to at least two of them in one or more of the following ways:

• Pose a probing question, supported by relevant background information, evidence, or research.
• Share an insight gained from your colleagues’ postings, synthesizing the information to offer new perspectives.
• Present and support an alternative viewpoint, referencing readings from the classroom or research from the Walden Library.
• Validate a colleague’s idea by connecting it to your own experiences and additional research.
• Make a suggestion based on evidence drawn from readings or by synthesizing multiple postings.
• Expand upon your colleagues’ contributions by offering additional insights or contrasting perspectives, supported by evidence.

After a few days, return to this discussion to review responses to your initial posting. Reflect on what you have learned or any insights gained from your colleagues’ comments.

Please ensure that your contributions are supported by specific citations from this week’s Learning Resources and any additional sources.

NURS 8210 Week 4 Discussion: HIT Projects and Decision Makers – Sample

To achieve more affordable and high-quality healthcare, disruptive innovations are necessary, particularly through the adoption of technologies that enhance efficiency (Townsend, 2013). The implementation of new health information technology (HIT) within healthcare systems often follows the Systems Development Life Cycle (SDLC), which encompasses five stages: planning, design, implementation, maintenance, and evaluation (Laureate Education, 2011). This discussion aims to examine a specific HIT project within my healthcare system and analyze the impact of key decision-makers on its implementation.

HIT Project Overview

In our healthcare system, five regional cancer centers utilized a common electronic health record (EHR) system that was first implemented in 2005 and had undergone two upgrades since. The maintenance phase of the SDLC necessitates awareness of evolving business needs and refining the system accordingly (Dennis, Wixom, & Roth, 2012). Physicians within the cancer center were proficient in Computerized Provider Order Entry (CPOE), with all orders being entered electronically. The cancer center encompassed an outpatient clinic, surgery, infusion center, and inpatient settings, all relying on the EHR.

Given that patients frequently transitioned between different levels of care, the necessity for electronic medication reconciliation became evident. The Institute of Medicine’s report, To Err is Human, advocates for organizations to utilize CPOE, barcode medication administration, and medication reconciliation to enhance patient safety and reduce medication errors (To Err Is Human: Building a Safer Health System, 2000). While our healthcare system had already implemented barcode medication administration, it had yet to progress to medication reconciliation using the EHR.

The project was initiated by physicians within the cancer center, prompted by the need for improved medication reconciliation as patients transitioned from outpatient to inpatient care. Manual reconciliation processes during patient discharge from inpatient status often took physicians over two hours and led to frequent mistakes. The director of clinical informatics at the hospital, a colleague of mine, collaborated with the chief hospitalist to address this issue. Together, they convened a meeting with the chief hospitalists and informatics directors from the other four hospitals to reach a consensus. This group then submitted an enhancement request to the governance committee for information systems. However, the request was initially denied due to the prioritization of other projects.

Week 4: System Development Life Cycle

“He who fails to plan, plans to fail.” — Proverb

Whether constructing a house, purchasing new software, or planning a vacation, a well-considered plan can significantly influence the outcome. In healthcare, effective planning for the adoption and integration of health information technology systems requires thorough research, analysis, communication, and collaboration. During the planning phase, leaders of HIT system projects must evaluate potential challenges concerning patient needs, staff workloads, and costs, among other factors. Utilizing planning frameworks can aid leaders in this endeavor.

This week, we will explore the widely used planning framework—the Systems Development Life Cycle (SDLC)—as you embark on your Major Assessment for this course, which involves investigating a health information technology system or application. You will also examine how leaders facilitate the implementation of HIT projects and consider strategies for securing support from key stakeholders and decision-makers.

Learning Objectives

By the end of this week, students will:

• Analyze how HIT projects are identified and advanced within an organization.
• Evaluate the impact of leaders and key decision-makers on the implementation of HIT projects.
• Critically assess the development and implementation of a health information technology system or application.

Required Readings

To access this week’s required library resources, please click on the link to the Course Readings List found in the Course Materials section of your syllabus.

Course Texts:

• Ball, M. J., Douglas, J. V., Hinton Walker, P., DuLong, D., Gugerty, B., Hannah, K. J., & Troseth, M. R. (Eds.). (2011). Nursing informatics: Where technology and caring meet (4th ed.). London, England: Springer-Verlag.
  • Chapter 17, “Disruptive Innovation: Point of Care,” discusses real-world integration examples to highlight the visions and challenges inherent in Smart Point of Care systems.
• American Nurses Association. (2008). Nursing informatics: Scope and standards of practice. Silver Spring, MD: Author.
  • “Standards of Nursing Informatics Practice” (pp. 67-79) outlines the specific measurement criteria within each nursing informatics standard.
• Madsen, M. (2010). Knowledge and information modeling. Studies in Health Technology and Informatics, 151, 84-103. Retrieved from the Walden Library databases.
  • This article connects the overall design models of information systems to metastructures, data, information, knowledge, and wisdom.
• Peleg, M. (2011). The role of modeling in clinical information system development life cycle. Methods of Information in Medicine, 50(1), 7-10.
  • Discusses the importance of conceptual modeling in health information technology systems and its effectiveness in system development.
• Philip, A., Afolabi, B., Adeniran, O., Oluwatolani, O., & Ishaya, G. (2010). Towards an efficient information systems development process and management: A review of challenges and proposed strategies. Journal of Software Engineering and Applications, 3(10), 983-989. Retrieved from the Walden Library databases.
  • Examines the phases and methodologies within the SDLC and proposes a framework for defining the crucial roles of participants throughout the process.
• Szydlowski, S., & Smith, C. (2009). Perspectives from nurse leaders and chief information officers on health information technology implementation. Hospital Topics, 87(1), 3-9. Retrieved from the Walden Library databases.
  • Utilizes qualitative research to explore trends, goals, outcomes, barriers, and challenges faced by hospital leaders when implementing HIT systems.

Required Media:

• Laureate Education, Inc. (Executive Producer). (2011). Transforming nursing and healthcare through technology: Systems analysis. Baltimore, MD: Author.
  • This media presentation (approximately 11 minutes) outlines the stages involved in implementing a new technology system.

Discussion: Welcome to the Week 4 Discussion Area!
Please post your responses based on the course requirements.

Your discussion contributions should be composed in standard edited English and adhere as closely as possible to APA guidelines, considering the constraints of the online platform. Ensure that your work is supported by specific citations from this week’s Learning Resources and additional scholarly sources as needed. For correct in-text citations and reference lists, refer to the Essential Guide to APA Style for Walden Students. Initial posts should range from 250 to 350 words, excluding references. NURS 8210 Week 4 Discussion: HIT Projects and Decision Maker.

Submission and Grading Information
Grading Criteria
To view your rubric:
[Week 4 Discussion Rubric]

Post by Day 3 and Respond by Day 6
To engage in this discussion:
[Week 4 Discussion]

Assignment: Application 3: Health Information Technology Project [Major Assessment 5]

In previous discussions and applications, you have examined various aspects of health information technology (HIT) systems, including their historical development, data flow, and standards and interoperability requirements relevant to your practice setting. This application assignment offers an opportunity to enhance your analytical skills by closely analyzing the implementation of a health information technology system. As a doctorally prepared nurse, you may find yourself leading a HIT project team. To effectively guide and advance HIT projects within your organization, you must critically analyze the various aspects and challenges of implementing such systems and present your insights professionally. This exercise aims to refine those skills.

NURS 8210 Week 4 Discussion: HIT Projects and Decision Maker.

Carefully review the project requirements below and manage your time effectively. Be sure to reference the standards of nursing informatics practice as you prepare this application, which serves as your major assessment for this course.

Preparation:

1. Investigate a health information technology system or application within your area of interest. This may involve any setting where health care information is developed or managed. You can select your system or application from any organization or virtual environment.
   • Examples of acceptable systems/applications include:
     • Consumer health applications
     • Clinical information systems
     • Electronic medical record (EMR) systems in hospitals or provider offices
     • Home health care applications
     • School health applications
     • Patient portals/personal health records
     • Public health information systems
     • Telehealth applications (e.g., from facility to home)
     • Simulation laboratories
     • Health care informatics research and development centers
2. Discuss your chosen health information technology system/application with your instructor before finalizing your selection. Consider visiting a healthcare organization, either in person or virtually, to assist in your decision.
3. Choose the best strategy to gather information about your selected system/application. Possible methods include virtual visits, vendor demonstrations, on-site visits, or interviews conducted face-to-face, via phone, or teleconference. You must conduct at least one interview for this project.
4. Complete a literature search to collect information about your chosen system. You may need to review additional scholarly articles to answer the questions listed below.

Note: In your report, refrain from sharing proprietary information, personal names, or organization names without permission.

Deliverable:

Your final submission will be a scholarly report of 12 to 15 pages, excluding the title page and references. A successful report should instill confidence in the reader regarding your answers to all questions outlined below. Use graphics to illustrate key points as needed.

Organization Information

• Briefly describe the health information technology system/application and the type of organization (e.g., hospital, clinic, public health agency, healthcare software company, government health information website, private virtual health information site, etc.).
• Is the system/application clinical, administrative, educational, or research-related?
• What were the key reasons for developing this system/application? How did the organization identify these needs? Did they utilize specific tools for needs assessments, solicit staff opinions, or analyze workflows?
• How did the organization conclude that this specific system/application could meet its identified needs?
• Who manages this system/application, and where are they situated within the organization’s administrative structure?

Information System Application Design and Development

• In a collaborative healthcare environment, how do various stakeholders make decisions regarding this system/application? Were end users involved in its development?
• How is training conducted for individuals using the system/application?
• How are security issues managed? How does this system/application maintain a legally compliant health care record?
• Where did the initial funding for this system/application originate?
• Who oversees the budget for the system/application?
• Have organizational or political issues influenced ongoing funding for the system/application?
• What arrangements exist for both planned and unplanned downtime?
• How are upgrades to the system/application scheduled or planned?
• In what ways has the system/application evolved in response to healthcare reform and related legislation?
• What recommendations would you suggest to enhance support for healthcare reform and related legislation?

Innovative Aspects of the System

• How does the system/application incorporate technological innovations?
• What technology innovations would you recommend for this organization? Which innovations discussed in this course or found through your research could benefit the organization?
• What additional innovations could further promote evidence-based practice and efficiency within the organization?

End Product

Your report must be a scholarly paper that includes at least 10 citations from peer-reviewed journals. Every assertion made in the report must be supported by a reference. Be careful when expressing opinions or using absolute terms, as these must be backed by credible sources. Note that course textbooks are composed of information from other sources (see the reference section in the course textbooks). Thus, ensure an adequate number of suitable references (a minimum of 10). Primary sources should be used, with peer-reviewed journal articles constituting the majority (90%) of your references. If referencing a book, include all details in APA style, including specific page numbers when necessary. Remember that citing an article mentioned in a book counts as a secondary source. More information is available in the APA Publication Manual and the Walden Writing Center. Please also review the “Policies on Academic Honesty” listed on the Walden website.

NURS 8210 Week 4 Discussion: HIT Projects and Decision Maker.

A high-quality paper demonstrates comprehensive knowledge and critical thinking suitable for doctoral-level scholarship. The report must conform to APA Publication Manual guidelines (6th edition) and be free of typographical, spelling, and grammatical errors. This application serves as the major assessment for this course and is due by Day 7 of Week 9.

By Day 7 of Week 9
Final Report: 12- to 15-page scholarly report due.

Health Information Technology Project Evaluation

Program Learning Outcome: 3
Educator / Consultant
DNP Essential: 4
Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care

ASSIGNMENT PROMPT

Evaluation Criteria

Category	Target (5 points)	Acceptable (3 points)	Unacceptable (1 point)	Score/Level
Part 1: Organization Information	Exemplary quality, meeting all assignment requirements, demonstrating advanced critical thinking and mastery of content. Discusses the health information technology system/application and organization type, reasons for development, and management structure with personalized reflections.	Good quality work that addresses at least 80% of requirements. Involves some summarizing of literature, showing adequate critical thinking and personalization.	Needs significant revision, addressing less than 50% of requirements. Primarily summarizes literature without demonstrating understanding.	Insufficient for LO 3 and Essential 4.
Part 2: System Application Design	Professional quality work covering all major subsections. Clearly outlines stakeholder collaboration, budget management, and challenges faced during design and funding. Reflects advanced critical thinking and mastery of content.	Well-developed content addressing at least 80% of major subsections. Some summarization of literature but shows adequate personalization and understanding.	Superficial content needing substantial revision. Addresses less than 50% of subsections, mainly summarizing literature without applied understanding.	Insufficient for LO 3 and Essential 4.
Part 3: System Application Implementation	Professional quality, fully addressing all major subsections. Identifies key security issues and management practices, offering detailed analysis and recommendations related to health care reform.	Good quality work covering at least 80% of subsections. Addresses security issues and management practices but includes some summarizing of literature.	Requires substantial revision, with less than 50% of requirements met, primarily summarizing literature without clear understanding.	Insufficient for LO 3 and Essential 4.
Part 4: Innovative Aspects of the System	Professional quality addressing all major subsections, describing the role of innovation and making thoughtful recommendations for future innovations.	Well-developed work covering at least 80% of subsections with adequate critical thinking. Includes some summarizing of literature.	Needs significant revision, addressing less than half of requirements with a focus on summarizing literature rather than demonstrating understanding.	Insufficient for LO 3 and Essential 4.
Part 5: End Product	Majority of references from scholarly journals, supporting the topic well. At least 7 peer-reviewed citations used, adhering to APA format. The paper effectively conveys the informatics system’s understanding.	Most references are scholarly and current, with at least 7 citations. Some minor APA formatting errors may exist.	References insufficient, lacking peer-reviewed sources. Fewer than 7 citations used, with significant APA formatting issues.	Insufficient for graduate-level work.

Health Information Technology Project Assignment

Instructions: Write a 12- to 15-page paper (plus references) that includes the following sections:

1. Organization Information (5 points)
   • Briefly describe the health information technology system/application and the type of organization (e.g., hospital, clinic, public health agency, software company, etc.).
   • Indicate whether the system/application is clinical, administrative, educational, or research-related.
   • Discuss the key reasons for the development of this system/application.
   • Identify who manages the system/application and their position within the organization’s administrative structure.
2. System Application Design (5 points)
   • Explain how various stakeholders collaborated in making decisions regarding the system/application. Were end users involved in its development?
   • Describe the initial funding of the health information system/application.
   • Discuss any organizational or political issues that may have impacted ongoing funding.
   • Identify who manages the budget for the system/application.
3. System Application Implementation (5 points)
   • Describe how security issues are addressed and how the system supports legally sound health care records.
   • Explain how individuals are trained to use the system/application.
   • Discuss plans for both planned and unplanned downtime.
   • Describe how upgrades to the system/application are scheduled or planned.
   • Explain how the system/application has adapted to health care reform and related legislation, including suggestions for necessary changes.
4. Innovative Aspects of the System (5 points)
   • Discuss how technology innovations are being utilized in the health information technology system/application.
   • Provide recommendations for additional technology innovations for the organization.
5. End Product (5 points)
   • Ensure the paper is 12-15 pages long and leaves the reader confident in understanding the informatics system.
   • Include graphics to illustrate key points.
   • Provide at least 7 citations from peer-reviewed journals in appropriate APA format.

Note: Up to 5 points (20%) may be deducted for grammar and APA style errors.

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