The Application of Data to Problem-Solving
Nursing informatics combines nursing, computer, information, and cognitive sciences to identify and fill gaps in the healthcare system to provide a better patient experience (Sweeney, 2017).
I currently work as a utilization review nurse for a company that administers self-insured health plans. My position requires uninterrupted focus as I review inpatient hospital stays for medical necessity based on national standards and evidence-based practice and compare the criteria against the specific health plan to ensure coverage The Application of Data to Problem-Solving. The health plans I work with require facilities to use up-to-date practice applications to ensure the best patient outcomes. I come across practices that are not up to par with the latest evidence-based practice in which I cannot approve; it has been estimated that evidence-based findings take an average of 17 years to reach clinical practice (Nagel et al, 2017). Our team is made up of both clinical and non-clinical members, and workflows are in place to ensure patient-facing nurses are not interrupted unnecessarily. Clinical leaders are available to take on non-clinical team members‘ questions. However, I have been receiving an abundance of internal calls that are not UR-related, in which the customer service representative acknowledges that I am not the appropriate person to outreach. However, no one else would answer their phone, so they tried me as a last resort. Unfortunately, when this happens, the customer service representative wastes their time and mine because I cannot answer their questions that are not UR specific. I have to recover my train of thought and figure out where I was in my review, which also be time-consuming. While I am happy to help in any way I can, the increased frequency at which this is occurring has become frustrating because I cannot help in this situation. Our Healthcare Informatics textbook explains the importance of establishing policies and coordinating communication is for effective patient care (Sweeney, 2017). This information further supports the importance of reviewing and establishing effective policies and processes for efficient communication and workflow.
Data to be used
Number of calls I receive in a day not meant for me, number of missed calls the appropriate staff member misses leading to call coming to me The Application of Data to Problem-Solving.
How data is collected and accessed
Data will be collected by monitoring the inbound calls I receive in a day and the clinical leader’s calls in a day through our phone system. The data will then be compared to assess for trends. Knowledge derived from the data: The knowledge derived from the data will allow the nurse to gain an understanding of the amount of unnecessary interruptions and time wasted per day and can be used to determine a course of action to resolve this issue as explained by McGonigle and Mastrian (McGonigle & Mastrian, 2018).
Use of Information
The nurse leader can use this information to use clinical reasoning and judgment in the formation of knowledge to determine what events prohibit the appropriate staff member from being available to take these calls. The knowledge gained will also provide insight as to what takes place that encourages the customer service representative to outreach me as the UR nurse for non-UR questions. Once this knowledge is gained, management can determine what education needs to be provided and to whom, at what level to ensure the appropriate process is being followed.
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References
McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge. Jones & Bartlett Learning.
Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1), 4–1 The Application of Data to Problem-Solving.
Discussion: The Application of Data to Problem-Solving
In the modern era, there are few professions that do not to some extent rely on data. Stockbrokers rely on market data to advise clients on financial matters. Meteorologists rely on weather data to forecast weather conditions, while realtors rely on data to advise on the purchase and sale of property. In these and other cases, data not only helps solve problems, but adds to the practitioner’s and the discipline’s body of knowledge.
Of course, the nursing profession also relies heavily on data. The field of nursing informatics aims to make sure nurses have access to the appropriate date to solve healthcare problems, make decisions in the interest of patients, and add to knowledge.
In this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation.
To Prepare:
- Reflect on the concepts of informatics and knowledge work as presented in the Resources.
- Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.
By Day 3 of Week 1
Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?
When looking at this weeks discussion board the first scenario or issue that came to mind was the COVID crisis we all encountered. I know in my own personal practice every ounce of knowledge I thought I had was thrown upside down. How we were used to treating respiratory illness simply did not seem to work when it came to the Pandemic. During COVID the EHR was essential in tracking cases and helping support providers during the crisis. The EHR helped to come up with standard of practice and care for these patients (Reeves,Hollandsworth, Torriani, Taplitz, Abeles, Seale, Millen,Clay, & Longhurtst, 2020) Along with the EHR the health organizations across the world were collaborating and coming together to formulate the best plan of care with the information that they had available to them at the time. The push in informatics to make EHR a possibility has lead to increased collaboration in both the public and private sectors. McGonigle, Mastrian, 2017)This pandemic required providers to be flexible and fluid because especially in the beginning there was no much that was unknown. There was a need for a centralized and trusted group to provide this evolving data. (Atique, Bautista, Block, Lee, Lozada-Perezmitre, Nibber, O’Conner,Peltoned,Ronquillo, Tayaben,& Thilo, 2020) This also means that hospitals need to keep track of important health care equipment such as Ventilators, Bi paps and Hi Flow also towards the end the need to track the oxygen patients were requiring on a daily basis was being tracked to monitor O2 tanks supplies. The same was being done in areas in NYC that had limited supplies available. Informatics was used to predict the availability of the equipment(Atique, Bautista, et al , 2020) The Application of Data to Problem-Solving
References:
Atique, S., Bautista, J. R., Block, L. J., Lee, J. J., Lozada-Perezmitre, E., Nibber, R., … & Topaz, M. ( 2020). A nursing informatics response to COVID-19: perspectives from five regions of the world.
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Reeves, J. J., Hollandsworth, H. M., Torrianti, F.J., Taplitz, R., Abeles, S., Tai- Seale, M., … & Longhurst, C. A. (2020) Rapid response to Covid-19; health informatics support for outbreak management in an academic health system. Journals of the American Medical Informatics Association, 27(6), 853-859
By Day 6 of Week 1
Respond to at least two of your colleagues* on two different days, asking questions to help clarify the scenario and application of data, or offering additional/alternative ideas for the application of nursing informatics principles.
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*Note: Throughout this program, your fellow students are referred to as colleagues.
Thanks for the great post xx
If there was an upside to COVID it was the collective collaboration between health care systems to share information for the advancement of best practices, treatments, and care for their communities. One of the main drivers for this sharing comes from a universal or unified electronic health record (EHR). One such health system in New York had just completed this process in 11 plus hospitals and outpatient facilities which in total serve 1.1 million residents in NY. The system was able to triage emergency patients with low acuity out quicker, order sets were designed for symptomatic presenting patients, and they integrated video capabilities for quarantined patients to talk with family members(Salway et al., 2020). This integrated multi-system EHR system was able to utilize the full scope of the health care engine to its advantage. The downside is that most health care systems aren’t fully integrated with one EHR system and in fact have multiple EHRs which don’t communicate at all. “The average health system, in fact, has 18 different EMR vendors when looking all the way across affiliated providers(Sullivan, 2018, p. 1).” In my current practice which operates out of 4 different states and 5 different health care systems, I have had to become fluent with, EPIC, Cerner, Meditech, Wound Docs, and ECW to just name a few. I think we have a long way to go to have organizations have the ability to share information but it is on its way. The state health information exchange program is a major initiative of the U.S. Department of Health and Human Services (HHS). “The ONC-funded State Health Information Exchange (HIE) Cooperative Agreement Program promotes innovative approaches to the secure exchange of health information within and across states and ensures that health care providers and hospitals meet national standards and meaningful use requirements(The Office of the National Coordinator for Health Information Technology (ONC), 2019, p. 1).” Hopefully, each organization can come together and put aside their objections for sharing this information and we can have a streamlined health care EHR system The Application of Data to Problem-Solving.
References
Salway, R., Silvestri, D., Wei, E. K., & Bouton, M. (2020). Using information technology to improve covid-19 care at new york city health + hospitals. Health Affairs, 39(9), 1601–1604. https://doi.org/10.1377/hlthaff.2020.00930
Sullivan, T. (2018, May 16). Why EHR data interoperability is such a mess in 3 charts. HealthcareITNews. https://www.healthcareitnews.com/news/why-ehr-data-interoperability-such-mess-3-charts
The Office of the National Coordinator for Health Information Technology (ONC). (2019). State Health Information Exchange Cooperative Agreement Program. https://www.healthit.gov/sites/default/files/get-the-facts-about-state-hie-program-2.pdf
sample response 2
I agree with your post, EHR played helped assist with standard care of practice for patients and commuted date for equipment and supplies. Electronic Health Record as a tool played a critical role in tracking Coronavirus cases and assisting healthcare providers during the crisis. Allowing access and sharing of data across the public health system, facilitating reporting of both the confirmed and suspected cases, and better monitoring of Coronavirus cases. This tool so permitted a faster understanding of the pandemic behavior (Reeves et al., 2020). Typically, responding to a serious health issue such as the present Coronavirus epidemic required access to large and timely data or information with the goals of providing appropriate and timely information to health providers and policymakers, to keep the people safe and make essential resources readily available where it is required and carry research in order to advance collective knowledge that can be used in the future (Madhavan et al., 2021). The push to make EHR a possibility led to increased collaboration in healthcare settings and both private and public sectors. This was evident during the pandemic, healthcare organizations across the globe came together and collaborated in formulating suitable plans for care with the information available to them. Most healthcare organizations depended on one another in terms of resources and information about the treatment of the coronavirus.
References
Madhavan, S., Bastarache, L., Brown, J. S., Butte, A. J., Dorr, D. A., Embi, P. J., … & Ohno-Machado, L. (2021). Use of electronic health records to support a public health response to the COVID-19 pandemic in the United States: a perspective from 15 academic medical centers. Journal of the American Medical Informatics Association, 28(2), 393-401.
Reeves, J. J., Hollandsworth, H. M., Torriani, F. J., Taplitz, R., Abeles, S., Tai-Seale, M., … & Longhurst, C. A. (2020). Rapid response to COVID-19: health informatics support for outbreak management in an academic health system. Journal of the American Medical Informatics Association, 27(6), 853-859.
sample response 3
As you stated, The COVID-19 pandemic has changed what even experienced nurses knew about healthcare. McGonigle & Mastrian (2017) states that “the increased use of technology to enhance nursing practice, nursing education, and nursing research will open new avenues for acquiring, processing, generating, and disseminating knowledge”. Last summer the sudden rise of patients battling severe COVID-19 cases and the healthcare facilities running out of equipment such as ventilators, bipaps, ecmo machines, and personal protective equipment (PPE) showed us how important nursing informatics is in practice. In an article by Nahm et al. (2020), they discussed how health information exchange (HIE) services allows physicians as well as patients access to medical records from different facilities and companies. Having access to all of a patient’s medical history can help the providers create a more personalized plan of care for patients battling the virus The Application of Data to Problem-Solving.
References
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Nahm, E. , Schoenbaum, A. , Behm, C. & Rowen, L. (2020). Health Information Exchange. JONA: The Journal of Nursing Administration, 50 (11), 584-589. doi: 10.1097/NNA.0000000000000941 The Application of Data to Problem-Solving.