NURS 8210 DISCUSSION Week 6 HIT Usability and Design Challenges INSTRUCTIONS PLUS RUBRIC

NURS 8210 DISCUSSION Week 6 HIT Usability and Design Challenges INSTRUCTIONS PLUS RUBRIC

Sample Answer for NURS 8210 DISCUSSION Week 6 HIT Usability and Design Challenges INSTRUCTIONS PLUS RUBRIC Included After Question

Discussion: Welcome to the Week 6 Discussion area!

Post your responses to the Discussion based on the course requirements.

Your Discussion postings should be written in standard edited English and follow APA guidelines as closely as possible given the constraints of the online platform. Be sure to support your work with specific citations from this week’s Learning Resources and additional scholarly sources as appropriate. Initial postings must be 250–350 words (not including references).

Submission and Grading Information

Grading Criteria

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Week 6 Discussion Rubric

Post by Day 3 and Respond by Day 6

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Week 6 Discussion

HIT Usability and Design Challenges

Reflect on your experiences with the integration of new technology. How have these implementations affected the procedures that you perform at work? As the end user, it can be easy to overlook all of the important decisions that went into the finished product that you see before you. In looking at the final data management screens, you may find yourself at the crossroads of two options. You may either 1) be ecstatic about the needed change that this system brought, or 2) frustrated because you feel the system brings new hurdles into your already busy day. If you have ever experienced the latter option, the comment “I could have implemented a better system than this” may resonate strongly with you. Though research agrees that user input assists HIT designers, the development and implementation of new systems is not as straightforward as it may appear. HIT development teams find themselves in constant phases of trial and error as they strive to meet the needs of all users within the proposed development timeline. Failure to achieve promised usability benefits can lead to increased costs and job complications. Applying effective strategies to overcome usability challenges is essential.

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In this week’s Discussion, you move from the standpoint of the “ outsider looking in” (end user) and place yourself into a real-world implementation example. To complete this Discussion, you evaluate a case study to determine where the implementation process took a wrong turn. Use this week’s Learning Resources to propose changes that could have put this operation on the road to success.

To prepare:

• Review the Learning Resources, focusing on the TIGER Usability and Clinical Application Design Collaborative.
• Consider the “Best Practice Exemplars” provided in the course text Nursing Informatics: Where Technology and Caring Meet.
• Review “Case Study 1: A Usability and Clinical Application Design Challenge” presented on page 238 of the course text Nursing Informatics: Where Technology and Caring Meet.
• Determine the causes of the noted usability challenges (i.e., human factors, ergonomics, human-computer interaction), as well as potential usability concerns experienced by staff during implementation. Consider the possible design failures that lead to the usability challenges.
• What strategies might you employ to overcome these HIT usability challenges and concerns?

By Day 3 post a cohesive response to the following:

• Place yourself in the role of the clinical administrator tasked with implementing the case study’s new health information technology system.
  • Evaluate the usability challenges that you faced during implementation as well as the factors that caused these challenges.
  • Determine whether these challenges were a result of implementation or design.
  • Formulate strategies for overcoming these usability challenges.

Read a selection of your colleagues’ postings.

By Day 6 respond to at least two of your colleagues in one or more of the following ways:

• Ask a probing question, substantiated with additional background information, evidence, or research.
• Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
• Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
• Validate an idea with your own experience and additional research.
• Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
• Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.

Click on the Reply button below to post your response.

A Sample Answer For the Assignment: NURS 8210 DISCUSSION Week 6 HIT Usability and Design Challenges INSTRUCTIONS PLUS RUBRIC

Title: NURS 8210 DISCUSSION Week 6 HIT Usability and Design Challenges INSTRUCTIONS PLUS RUBRIC

Usability refers to the ability of individuals to utilize tools and computer applications that are specific to their environment. An example within a healthcare organization would be nurses who utilize an electronic medical record (EMR). It is expected that the EMR is user-friendly and accessible to all. This would include technology availability, capacity, as well as education/training provided (Ball et al., 2011). In the given case study, four usability challenges are present. These challenges include those which were a result of implementation such as the lack of specific training provided to staff and the minimal consideration and testing of workflow. Also present were challenges of design which included preestablished order sets and documents from other sites, and the delayed arrival of technology.

As usability allows nurses to give feedback in a structured way, it would have been appropriate to engage bedside staff within the design and implementation of the EMR (Ball et al., 2011). Within previous health information technology implementation, bedside staff have been seconded to be involved firsthand in projects. As noted in Ball et al (2011), physicians, nurses and other professionals are pivotal in all phases of the design and implementation process. Involving staff would have been beneficial to mediate the challenges regarding education and training of staff (Gruber et al., 2009). Nurses who are currently practicing in the environment are the best fit to provide information regarding order sets and documents that are frequented. Furthermore, these nurses can be super-users that staff can access if they are having issues during implementation after formal training is provided (Gruber et al., 2009). The staff should also be involved in placement of technology including bedside and nursing desk computers. By engaging staff early, this ensures that an appropriate amount of technology is ordered and will arrive in a timely manner. Another method is to ensure adequate resources is to perform a needs assessment in the earlier stages of the project (Kaufman et al., 2006).

Further challenges can be overcome by conducting usability evaluations (Ball et al., 2011). This allows for systems to be tested and redesigned as necessary to ensure a successful implementation. This would be crucial in ensuring evaluation is not an afterthought and would present as a summative approach in the later design stages of the project (Kaufman et al., 2006) In design, it is beneficial to utilize order sets and documents from other sites as these have been tested and trialed.

References

Ball, M. J., Douglas, J. V., Hinton Walker, P., DuLong, D., Gugerty, B., Hannah, K. J., . . .

Troseth, M. R. (Eds.) (2011). Nursing informatics: Where technology and caring meet

(4th ed.). London, England: Springer-Verlag.

Gruber, D. , Cummings, G. , Leblanc, L. & Smith, D. (2009). Factors Influencing Outcomes of

Clinical Information Systems Implementation. CIN: Computers, Informatics, Nursing, 27 (3), 151-163. doi: 10.1097/NCN.0b013e31819f7c07.

Kaufman, D. , Roberts, W. , Merrill, J. , Lai, T. & Bakken, S. (2006). Applying an Evaluation

Framework for Health Information System Design, Development, and Implementation. Nursing Research, 55 (2), S37-S42.

A Sample Answer 2 For the Assignment: NURS 8210 DISCUSSION Week 6 HIT Usability and Design Challenges INSTRUCTIONS PLUS RUBRIC

Title: NURS 8210 DISCUSSION Week 6 HIT Usability and Design Challenges INSTRUCTIONS PLUS RUBRIC

The assigned scenario is the implementation of an electronic medical record (EMR) system using orders, clinical documentation and results in the perinatal units of a medical center.  Because of a previous implementation at another facility, the administration thought they could ‘plug and play’ the system with a six-month implementation timeline (Staggers & Toroseth, 2011).  The Expanded Systems Life Cycle (ESLC) framework defines four risk areas during an implementation which include key executive support, user-driven planning, buy-in from stakeholders, use of product lines, impact on workflow, and evaluation (Gruber, Cummings, Leblanc, & Smith, 2009).  Many of these aspects were not accomplished.  Usability challenges included not having order sets developed specific to perinatal as a specialty.  Workflow was not assessed for current state and future state.  Not enough computer equipment and training was not specific to the specialty (Staggers & Toroseth, 2011).

There are multiple challenges that the implementation did not plan for ahead of time, and caused frustration for the end-users. Clinical application design (CAD) should take place throughout the system designs process.  It is an iterative process including the clinicians from planning to implementation.  Evidence-based ractice (EBP) specific to the clinical specialty should be integrated into the design of the application (Staggers & Toroseth, 2011).  The lack of the clinical documentation and order sets into the system based on the new perinatal units at the medical center is a design issues.  It should have been developed based on the EBP being used for these specific units. The workflow and the training are both implementation issues.  The changes will significantly impact the clinicians and should be considered prior to the implementation.  The workflow changes should be integrated into the training plans for the clinicians (Coplan & Masuda, 2011).  The final implementation challenge is the ordering of workstations to be placed in the clinical units. It also could be considered a design issue.  Nursing informatics (NI) functional areas include consultation and coordination, facilitation, and integration.  During the implementation the NI can be used to determine the equipment to be used and placement that assists in the usability by the end users (“American Nursing Association “, 2015).

The first strategy is to use the NI in the planning and design of the system and implementation.    As the NI, the role included designing the inpatient rooms and clinic areas to facilitate the usability for the clinicians.  It was to determine where to place the computers, bar code scanners, and printers within the facilitate.  Staggers and Troseth (2011) recommend having an informatics team with knowledge of the human factors and usability issues.  The design of the system can also use the NI to work with the end users to define the needs and the characteristics of the system to make sure it includes EBP based on their patient population (Staggers & Toroseth, 2011).

The implementation of an electronic health record (EHR) is a change that includes having to learn new technology, no matter if the facility was on paper or a different EHR, and learning new workflows.  Part of the implementation project is to obtain feedback from the user about the configuration of the new system and the workflow.  The project team should listen to individuals who are resistant but offer improvements for the configuration or workflow (Coplan & Masuda, 2011).  Mcbride (2012) studied the training and practice flows of EMR implementations, and the physicians surveyed responded that more attention needs to be made on training and the background of the trainers (McBride, 2012).  Because of the specific needs for the training of the oncologists, we did not use any vendor training.  Instead we brought in twelve physicians for two days of training with the clinical informatics directors who understood the workflow and had advance experience with the system.  The concentration was on the basic usage and chemotherapy order sets.  Every two weeks after the initial training the EMR educators rounded to give advance training the system.  It was well received, and the physicians were able to function in the system.  There was also a training developed that focused on physician specialty such as pulmonary, gastro, or anesthesia and the initial setup of their user profile included tools within the EHR specific to their needs.  It was found that the physicians were less resistant to change, when the focus was on their “need to know” in training.  This type of implementation can be done with any specialty, and the organization in the scenario could have been successful if they included configuration and training specific to perinatal units.

References

American Nursing Association (2015) Nursing Informatics: Scope and standardsof practice (2nd ed.). Silver Spring, MD: American Nursing Association.

Coplan, S., & Masuda, D. (2011). Change mangement Project management for healthcare information technology (pp. 193-237). New York, NY: McGraw Hill Companies.

Gruber, D., Cummings, G. G., Leblanc, L., & Smith, D. L. (2009).Factors influencing outcomes of clinical information systems implementation. CIN: Computers, Informatics, Nursing, 27(3), 151-163. doi:10.1097/NCN.0b013e31819f7c07

McBride, M. (2012). Training, new practice flow critical with EHR installation. Study participants share insights about the effects of the technology in their practices as they approach year mark. Medical Economics, 89(22), 36.

Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management (Harrow, London, England: 1994), 20(1), 32-37.

Staggers, N., & Toroseth, M. R. (2011). Usability and Clinical Application Design. In M. J. Ball, J. V. Douglas, & P. H. Walker (Eds.), Nursing Informatics: Where technology and caring meet (Fourth ed., pp. 219-241). London New York: Springer.

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Name: NURS_8210_Week6_Discussion_Rubric

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RESPONSIVENESS TO DISCUSSION QUESTION Discussion post minimum requirements: *The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.		Points Range: 8 (26.67%) – 8 (26.67%) Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.	Points Range: 7 (23.33%) – 7 (23.33%) Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.	Points Range: 6 (20%) – 6 (20%) Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.	Points Range: 0 (0%) – 5 (16.67%) Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.
CONTENT KNOWLEDGE		Points Range: 8 (26.67%) – 8 (26.67%) Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.	Points Range: 7 (23.33%) – 7 (23.33%) Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.	Points Range: 6 (20%) – 6 (20%) Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course	Points Range: 0 (0%) – 5 (16.67%) Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.
CONTRIBUTION TO THE DISCUSSION		Points Range: 8 (26.67%) – 8 (26.67%) Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.	Points Range: 7 (23.33%) – 7 (23.33%) Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature	Points Range: 6 (20%) – 6 (20%) Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.	Points Range: 0 (0%) – 5 (16.67%) Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas
QUALITY OF WRITING		Points Range: 6 (20%) – 6 (20%) Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.	Points Range: 5 (16.67%) – 5 (16.67%) Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.	Points Range: 4 (13.33%) – 4 (13.33%) Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.	Points Range: 0 (0%) – 3 (10%) Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.
Total Points: 30

Name: NURS_8210_Week6_Discussion_Rubric

 

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NURS 8210 DISCUSSION Week 6 HIT Usability and Design Challenges INSTRUCTIONS PLUS RUBRIC Grading Rubric Guidelines

Performance Category	10	9	8	4	0
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic decisions.	Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions Evaluates literature resources to develop a comprehensive analysis or synthesis. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion	Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions. Evaluates information from source(s) to develop a coherent analysis or synthesis. Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis. Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion. Demonstrates little or no understanding of the topic.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) without any interpretation/evaluation. The posting uses information that is not valid, relevant, or reliable	No evidence of the use of scholarly inquiry to inform or change professional or academic decisions. Information is not valid, relevant, or reliable
Performance Category	10	9	8	4	0
Application of Course Knowledge – Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources; Applies concepts to personal experience in the professional setting and or relevant application to real life.	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources. Applies concepts to personal experience in their professional setting and or relevant application to real life Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content	Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson. Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life Does not demonstrate a solid understanding of the principles and concepts presented in the lesson	Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post. Posts are superficial and do not reflect an understanding of the lesson content Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life	Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category	5	4	3	2	0
Interactive Dialogue Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. (5 points possible per graded thread)	Exceeds minimum post requirements Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days. Replies to a post posed by faculty and to a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days Replies to a question posed by a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Meets expectations of 2 posts on 2 different days. The main post is not made by the Wednesday deadline Does not reply to a question posed by a peer or faculty	Has only one post for the week Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments	Does not post to the thread No connections are made to the topic
	Minus 1 Point	Minus 2 Point	Minus 3 Point	Minus 4 Point	Minus 5 Point
Grammar, Syntax, APA Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition	2-3 errors in APA format. Written responses have 2-3 grammatical, spelling, and punctuation errors. Writing style is generally clear, focused, and facilitates communication.	4-5 errors in APA format. Writing responses have 4-5 grammatical, spelling and punctuation errors. Writing style is somewhat focused.	6-7 errors in APA format. Writing responses have 6-7 grammatical, spelling and punctuation errors. Writing style is slightly focused making discussion difficult to understand.	8-10 errors in APA format. Writing responses have 8-10 grammatical, spelling and punctuation errors. Writing style is not focused, making discussion difficult to understand.	Post contains greater than 10 errors in APA format. Written responses have more than 10 grammatical, spelling and punctuation errors. Writing style does not facilitate communication. The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
	0 points lost				-5 points lost
Total Participation Requirements per discussion thread	The student answers the threaded discussion question or topic on one day and posts a second response on another day.				The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement per discussion thread	The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.				The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.

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