Question

Describe the action(s) you would take if you were part of a project team tasked to define requirements and identify system improvements to upgrade or update an existing clinical system. Be sure to include in the discussion general information about the organization and your role on the project team.

Answer 1

The present scenario is about King Abdulaziz Specialist Hospital situated in Taif region of Saudi Arabia. Its a 500 bedded multispeciality hospital with referral services. The hospital has a vast infrastructure with well equipped departments. The total quality management department of the organization is always actively contributing to improve its quality care and standard of services. The organization at different departmental level conducts numerous projects that has resulted in its positive outcome.

I am working in the Medical Surgical ward as a Charge nurse and is a TQM coordinator of my ward. All the projects carried out by TQM reaches to ward through me and after completion is submitted back to them. The documentation system in this organization is still traditional for which the TQM is planning to adapt new electronic health record. They put forward a project to evaluate the problems with the existing documentation process and also to find out the staff willingness to change to a new system of documentation.

At first in order to begin the project, the TQM took the approval of the hospital and nursing director for conducting the project. The aim and benefits of such project was explained to them by the TQM manager. Once the management is convinced, approval for the project was received. The TQM manager with all the coordinators of different department conducted several meetings to discuss the method and tools that will be adopted to conduct the project work. The health information system department and the medical record department members were also included within the project.

This project aimed at upgrading the existing clinical system of documentation and maintaining health record into a easy accessible, time saving ,and worldwide accepted documentation method. As a team member, I was assigned to trace out the benefits and drawbacks of the use of existing system based on a certain criteria like

• Time taken for documentation
• Staff willingness to use this method
• Incidences of error due to misinterpretations
• Writing errors
• Storage and accessibility of the records
• Security and privacy

Based on all these factors, a list of advantages and disadvantages was generated by each coordinator. On account of this report the conclusion was made that improvement has to be made in the existing clinical system. On the meantime the health information system that is the IT department of the organization was advised to develop a software which will help in electronic documentation of data. After it was developed, a meeting was conducted by the IT professional who demonstrated the use of the software to TQM manager and other coordinators. In the meeting certain issues were raised which was later solved by the IT department.

All the coordinators were advised to conduct classes within their unit in order to teach the use of new technique. The staff was found to be excited with the implication of a new documentation system as it would save their effort, time and reduce their work of writing too many papers. At first, the project was conducted for a week. During this week, both the new and the old system was asked to be followed so that every member i.e doctors, nurses, pharmacist, physiotherapist, lab technicians, nutritionist who comes across the health record in every day documentation can understand the use of new system. After a week, the existing system was weaned off and entirely the new system was started.

Thus, with a collaborative efforts of the various health personnels and staff cooperation an existing clinical system could be upgraded.