Question

Mitigating Patient Safety and Quality Issues Through the EHR Reporting Systems

Western Heights Hospital (WHH) is an 1125-bed, 5-hospital academic healthcare system Servicing central and Western Massachusetts. WHH is the only designated Level I Trauma Center for adults and children in the area and is home to New England's first hospital-based air ambulance and the region's only level III neonatal intensive care center. WHH launched a five-year strategic plan with the fundamental goal of a systemwide move from a predominantly paper environment to an electronic one. Phase 1 included the implementation of an EH our system consisting of order entry for all laboratory radiology region's radiology and patient care orders. Additionally, clinical documentation was implemented, including admission assessments and all nursing flow sheets. The nursing informatics counsel, a 25-member group of nurses representing all disciplines, developed the clinical content. The clinical contents custom-built using both text and structured data entry Fields within the application.

Three months after go-live, hospital leadership is reporting that it is unable to report on various state and federally mandated quality measures. These measures track health care quality based on national standards, and are compared to nationally accepted benchmarks, and are used to plan ways to improve quality. Leadership has communicated that the reports generated by the system are incomplete and are putting the hospital at Financial Risk due to lower reimbursement rates.

Clinicians are eager and excited to continue to develop content in the application. However, the project program manager is proposing a stabilization and optimization approach and does not want to go forward with content development until the issue of reporting has been assessed and addressed.

1. Assuming that you were the clinical content manager and lead all reporting efforts, what would you approach would you take to address the reporting problem?

2. Pre-admission testing data are currently collected on paper. The chief of surgery has identified an opportunity to have these data collected in the new admission testing in the outpatient setting. Many of the collected data elements are shared with the current admission assessment. Describe can be approached. What methods can be used to process?

3.Using the PSQRD methodology, identify an area of quality improvement in the hospital setting, develop a process plan, and identify the expected outcomes.

4. As a researcher, you have been assigned to obtain data from two different facilities. Both facilities have mapped their data to standardized terminologies within their data warehouses. Discuss how this will benefit your research. Alternatively, what if the data in both facilities were not coded using standards? What obstacles would need to be overcome?

Answer 1