Question

Sheila Baumgarten, PhD, RN has been the director of the medical product line for 20 years. She is also a nurse informaticist and would like to see more use of software for clinical and management analyses. She is responsible for bot acute and post-acute care services, including clinical, diagnostic facilities, and home health services. She has long been challenged by the limited utility of the financial productivity model. She recognizes that some of the resistance of executives has been due to the lack of software applications to collect and sort essential data elements for more comprehensive analysis of multiple data points. The organization recently purchased the ideal software to create a comprehensive clinical productivity system. The nurse executive of the system asked Sheila to lead a team to develop the optimal clinical productivity system. She is excited and also cautious about how to do this work effectively using the current evidence for practice and outcomes and how to be innovative in designing a robust model to address the current challenges. She has decided to start small and selected DRG 89, simple pneumonia and pleurisy, to begin this work. Sheila has identified stakeholders to collaborate with and create the desired model. The following information has been identified by the group as necessary to create a clinical productivity system: Inputs (number of patients with DRG 89 for the past 12 months, hours of care provided to each patient by RNs and nursing assistants, intensity projected needs for patient care [patient acuity] in hours, budgeted hours of care for each patient), outcomes (average actual length of stay, average target length of stay, average cost of care per patient, average HCAHPS score for patients, patient satisfaction with clinical outcomes, number of falls/medication hours/pressure ulcers). The following information was readily available: 200 patients with diagnosis of DRG 89, RNs provided an average of 47 hours to each patient (data extracted from patient acuity system and staffing information), nursing assistants provided an average of 14 hours to each patient, patient intensity hours from the acuity system averaged 65 hours for each patient, budgeted RN and nursing assistant hours for each patient averaged a total of 68 hours for the RNs and nursing assistants, patient satisfaction is 10% lower than the target performance goal, patient falls with injury increased by 10%, and no change in pressure ulcers and medication errors. Case study obtained from D. Weberg and S. Davidson 2021 book leadership for evidence-based innovation page 203-204. This is all the information I have available for this question.

As a team, consider these data and discuss what they mean.

Is this data adequate for new clinical productivity system?

What actions would you take, knowing that the hours used were below both the acuity and budgeted hours?

Answer 1

In these days of emerging diseasesof various kinds and types ,known to and also new to the medical fraternity,the need for for proper documentation,which is prompt & accurate is inevitable.This not only makes access to patient info in a healthcare facility easier, but also saves a lot of time. Use of softwares that assists gracefully to these needs is a blessing to the hard working medical front office and other healthcare staff including data collectors. A patient info list is just a tap away with these kinds of softwares. Use of such medical documentation softwares also helps in distributing & imparting the duties and time allotment provision for each patient or a group of patients with a similar specific deformity or disease by a head doctor or head nurse to the remaining subordinates. There are also provisions for notifications for routine checkup alerts and test report notification alerts for the patients after a discharge from the medical facility,through these softwares.

Modifiying the software or purchasing a software from a dealer should be strictly based on the amount of workload or info to be saved and also considering the patient inflow in a medical facility. The software technology varies in both clinical practice and clinical documentation.For example in dental clinic,the front office staff saves the inpatient"s basic info whereas the treating doctor saves the info of the patient's health status, drugs prescribed,medical history in past,allergies to be noted, and also saves the radiographs taken ,in the same software.

Therefore a clinical/medical recording ,documentation software helps in smooth and organized running of a healthcare firm in the patient care and data collection aspects.