NURS FPX 6614 Assessment 3 Disseminating the Evidence Scholarly Video Media Submission

Student Name

Capella University

NURS-FPX 6614 Structure and Process in Care Coordination

Prof. Name:

Date

Disseminating the Evidence Scholarly Video Media Submission

Hello everyone. I am —-, and I will discuss improving care coordination for chronic disease patients by recommending an evidence-based intervention in this video. In this video, I will discuss the care coordination struggles required to meet clinical preferences based on a designed PICOT question. Moreover, I will highlight the services and resources that will promote interprofessional care coordination to improve patient health outcomes in chronic conditions. Additionally, I shall summarize the ways that encouraged stakeholder engagement for the subject purpose. Lastly, the session will end with future steps to support the attentive and thoughtful use of resources and a safe environment in providing coordinated care to patients.

Analysis of Care Coordination Efforts related to PICOT Question

The PICOT question analyzed is as follows:

“In adult patients with chronic diseases (P) in local healthcare organizations, does implementing a centralized Electronic Health Record system (I) compared to no technology-oriented coordination (C) result in improved care coordination (O) within two years (T)?”

Managing chronic conditions among adults requires comprehensive and collaborative care within healthcare organizations. For this purpose, adequate communication among the interprofessional healthcare workforce is deemed necessary to ensure care delivered is based on a shared and patient-centered care approach. Gaps in information sharing among interprofessional team members have been identified as a critical issue that hinders effective care coordination (Schot et al., 2019). This fragmented care delivery leads to delayed treatments or higher incidences of medication or treatment errors.

NURS FPX 6614 Assessment 3 Disseminating the Evidence Scholarly Video Media Submission

There is a pressing demand for the integration of health information technologies like Electronic Health Records (EHR) to address this challenge. This can facilitate smooth communication and coordination when all healthcare professionals can assess health information electronically from a bird’s eye view (Martyn et al., 2022). Healthcare professionals can access real-time patient data through a unified electronic platform. Moreover, they can be notified of changes in patient health data to ensure all team members are alerted with updated health information and prevent adverse events.

Care coordination is enhanced by implementing a centralized EHR system that integrates care plans and ensures all providers are aligned with the patient’s treatment goals (Schot et al., 2019). Furthermore, EHR provides a wealth of patient health data that can be effectively analyzed by healthcare administration and quality assurance departments to identify trends, track outcomes, and make shared and informed decisions regarding patient care. This data-driven approach enhances the ability to prioritize and address clinical priorities more effectively and evidence-based (Classen et al., 2020).

Key Implications and Conclusions

Implementing a centralized EHR system within local healthcare organizations can positively impact care coordination for chronic disease patients. By leveraging technology-oriented coordination, information can be seamlessly shared with enhanced communication, leading to more effective patient-centered care. Moreover, the use of EHR contributes to increased efficiency and timeliness in care delivery (Mullins et al., 2020).

Rapid access to patient information and real-time communication enhance the ability of healthcare providers to respond promptly to changes in patients’ conditions and adjust care treatment plans accordingly. Another significant implication of EHR use in care coordination is enabling strategic decision-making through optimized resource allocation and quality improvement initiatives. This strategic planning supports improving healthcare services for patients with chronic diseases (Mullins et al., 2020).

Change in Practice related to Services and Resources Available for Interprofessional Care Coordination Team

A centralized EHR system will significantly transform the resources and services necessary for interprofessional collaborative care teams. The changes in practice will be evident in the form of unified patient information access with the integration and effective use of a centralized EHR system (Renoux et al., 2020). This system provides a unified platform where an interprofessional care coordination team of physicians, pharmacists, nurses, behavioral specialists, psychologists, and nutritionists can access up-to-date patient health information. This rules out the need for physical communication meetings and prevents treatment delays. Moreover, it increased the productivity and efficiency of healthcare providers (Lourie et al., 2020).

Additionally, communication barriers and delays due to reliance on traditional communication methods such as phone calls or paper records are overcome by EHR. The EHR will enable real-time communication among team members and foster immediate collaboration on patient care for chronic diseases. Above all, EHR supports collaborative care planning and allows team members to contribute to and access a unified care plan, which is absent in traditional and current practices of inconsistent alignment among healthcare without EHR integration (Mullins et al., 2020).

The shift towards a centralized EHR system is well-grounded in the need for more efficient and patient-centered care coordination. Various evidence-based studies demonstrate that improved access to patient information through EHR is associated with better health outcomes and enhanced chronic disease management (Mullins et al., 2020). Moreover, research indicates that real-time communication facilitated by EHR reduces communication errors, treatment delays, lower response times, and enhanced team collaboration, which promotes coordinated care delivery (Lourie et al., 2020). These changes in practice associated with EHR use are evidence-based and logical and must be considered in delivering effective coordinated care delivery to chronic disease patients.

Efforts to Build Stakeholder Engagement within Interprofessional Team

Building stakeholder engagement within interprofessional teams is crucial for successfully implementing a centralized EHR system in healthcare organizations. Effective leadership and a comprehensive strategy are essential to address uncertainties and the active involvement of all stakeholders (Robertson et al., 2022). In this scenario, the relevant stakeholders include physicians, nurses, administrative staff, IT personnel, and support staff. To build a robust stakeholder engagement with the relevant stakeholders, I developed the interprofessional team by conducting interprofessional meetings.

I addressed the essential roles of each team member and how they can significantly improve the lives of adult patients with chronic disorders by using EHR collaboratively. This caused enhanced buy-in from stakeholders and resulted in the development of interprofessional care plans for targeted patients by EHR use (Robertson et al., 2022). Additionally, ongoing support was provided during the implementation of EHR to address immediate concerns and issues. This demonstrated the team’s commitment to a smooth transition to technology-oriented care coordination (Vos et al., 2020).

NURS FPX 6614 Assessment 3 Disseminating the Evidence Scholarly Video Media Submission

The potential challenges and uncertainties can be addressed by conducting a comprehensive risk assessment approach. This strategy allows healthcare professionals to identify potential challenges and uncertainties before they become significant issues. The risk assessment team will initiate the risk assessment within the interprofessional care coordination team and EHR use (Sittig et al., 2022). The team will evaluate and assess the specific areas of EHR implementation for interprofessional care coordination and establish the scope to focus on critical aspects such as data security, user adoption, technical challenges, and workflow disruptions (Sittig et al., 2022). Team members will identify these potential risks and encourage open communication to capture various concerns.

Once the risks are assessed, they will be prioritized or categorized to allocate resources optimally to mitigate them. For each high-priority risk, the team will collaborate to develop targeted mitigation strategies that outline specific actions like reducing the impact of the identified risk. The team will also involve external experts on demand to prevent risks effectively. This proactive strategy will identify and mitigate potential uncertainties and issues before they escalate and prevent organizational costs associated with unforeseen challenges (Sittig et al., 2022).

Future Steps to Thoughtful Resource Utilization and Safe Care Coordination

The recommended next steps to promote attentive resource use and foster a safer environment to enhance care coordination include continuous training education. This step will ensure that the interprofessional care coordination team is well-versed in effectively using a centralized EHR system. The continuous training and education programs must be tailored to specific needs and updates on technology (Samadbeik et al., 2020). Additionally, routine audits of EHR systems are conducted to identify and address any issues related to data accuracy and security of systems. These audits are essential for mitigating risks associated with data breaches and system vulnerabilities (Poulos et al., 2021).

The current positive outcomes in managing adult chronic conditions will be sustained by implementing ongoing quality improvement initiatives based on feedback and audits. The continuous improvement mindset will ensure that care coordination processes and outcomes evolve to meet the changing needs of patients (Yurkofsky et al., 2020). Additionally, the benchmarking activities to compare care coordination outcomes will help sustain the current outcomes established with the coordinated care interprofessional team (Mollica et al., 2021). Involving patients and their families in the care coordination process will improve care coordination and a patient-centered approach. These approaches will enhance adherence to treatment plans and provide a safer environment centralized to patient’s healthcare outcomes (Sauers-Ford et al., 2021).

Conclusion

To conclude, we discussed a PICOT question for chronic health conditions. The care coordination efforts are discussed based on the PICOT question. The interprofessional team will require critical care coordination efforts such as unified patient information access. The stakeholder engagement was built with strategic leadership, such as regular team meetings and raising awareness on collaborative and coordinated care. The future recommendations include communication protocols, continuous training programs, and regular audits to ensure continuous improvements.

References

Classen, D. C., Holmgren, A. J., Co, Z., Newmark, L. P., Seger, D., Danforth, M., & Bates, D. W. (2020). National trends in the safety performance of electronic health record systems from 2009 to 2018. JAMA Network Open, 3(5), e205547. https://doi.org/10.1001/jamanetworkopen.2020.5547

Lourie, E. M., Utidjian, L. H., Ricci, M. F., Webster, L., Young, C., & Grenfell, S. M. (2020). Reducing electronic health record-related burnout in providers through a personalized efficiency improvement program. Journal of the American Medical Informatics Association. https://doi.org/10.1093/jamia/ocaa248

Martyn, T., Montgomery, R. A., & Estep, J. D. (2022). The use of multidisciplinary teams, electronic health records tools, and technology to optimize heart failure population health. Current Opinion in Cardiology, 37(3), 302–306. https://doi.org/10.1097/hco.0000000000000968

NURS FPX 6614 Assessment 3 Disseminating the Evidence Scholarly Video Media Submission

Mollica, M. A., Buckenmaier, S. S., Halpern, M. T., McNeel, T. S., Weaver, S. J., Doose, M., & Kent, E. E. (2021). Perceptions of care coordination among older adult cancer survivors: A SEER-CAHPS study. Journal of Geriatric Oncology, 12(3), 446–452. https://doi.org/10.1016/j.jgo.2020.09.003

Mullins, A., O’Donnell, R., Mousa, M., Rankin, D., Ben-Meir, M., Boyd-Skinner, C., & Skouteris, H. (2020). Health outcomes and healthcare efficiencies associated with the use of electronic health records in hospital emergency departments: A systematic review. Journal of Medical Systems, 44(12). https://doi.org/10.1007/s10916-020-01660-0

Poulos, J., Zhu, L., & Shah, A. D. (2021). Data gaps in Electronic Health Record (EHR) systems: An audit of problem list completeness during the COVID-19 pandemic. International Journal of Medical Informatics, 150, 104452. https://doi.org/10.1016/j.ijmedinf.2021.104452

Renoux, J., Veiga, T. S., Lima, P. U., & Spaan, J. (2020). A unified decision-theoretic model for information gathering and communication planning. Örebro University Library (Örebro University). https://doi.org/10.1109/ro-man47096.2020.9223597

Robertson, S. T., Rosbergen, I. C. M., Burton-Jones, A., Grimley, R. S., & Brauer, S. G. (2022). The effect of the electronic health record on interprofessional practice: A systematic review. Applied Clinical Informatics, 13(03), 541–559. https://doi.org/10.1055/s-0042-1748855

Samadbeik, M., Fatehi, F., Braunstein, M., Barry, B., Saremian, M., Kalhor, F., & Edirippulige, S. (2020). Education and training on Electronic Medical Records (EMRs) for health care professionals and students: A scoping review. International Journal of Medical Informatics, 142(1), 104238. https://doi.org/10.1016/j.ijmedinf.2020.104238

Sauers-Ford, H., Statile, A. M., Auger, K. A., Wade-Murphy, S., Gold, J. M., Simmons, J. M., & Shah, S. S. (2021). Short-term focused feedback. Medical Care, 59(8), S364–S369. https://doi.org/10.1097/MLR.0000000000001588

Schot, E., Tummers, L., & Noordegraaf, M. (2019). Working on working together: A systematic review on how healthcare professionals contribute to interprofessional collaboration. Journal of Interprofessional Care, 34(3), 1–11. https://doi.org/10.1080/13561820.2019.1636007

Sittig, D. F., Sengstack, P., & Singh, H. (2022). Guidelines for US hospitals and clinicians on assessment of electronic health record safety using SAFER guides. JAMA, 327(8), 719. https://doi.org/10.1001/jama.2022.0085