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NUR 514 Benchmark Assignment Electronic Health Record Implementation Paper

NUR 514 Benchmark Assignment Electronic Health Record Implementation Paper

The introduction of electronic health records (EHRs) has brought significant changes in healthcare provision. For instance, EHRs has led to reduction in healthcare costs, improved provision of quality healthcare, increased health safety, and reduction in errors. Besides, EHRs ease the process of obtaining, organizing, examination, and presentation of health data for decision making process. This paper seeks to explore various questions relating to the roles of registered nurse during EHR implementation in the organization. NUR 514 Benchmark Assignment Electronic Health Record Implementation Paper

Key Information Needed in Database to Track Opportunities for Care Improvement

There are various information needed in healthcare database to track opportunities for care improvement. However, some of the key information that may be required includes the level of patient

NUR 514 Benchmark Assignment Electronic Health Record Implementation Paper

NUR 514 Benchmark Assignment Electronic Health Record Implementation Paper

satisfaction. This information should be coupled up with patients’ feedback on the possible areas that the organization should improve to facilitate positive outcomes. This information is crucial in enabling the organization to determine the areas and manner of providing effective services to realize the diverse needs of clients (Waters, Edmondston, Yates & Gucciardi, 2016). The other important information in the database is quality of services offered to patients. The quality of care should aim at enhancing safety, recovery, cost-effective, and reduces chances of negative consequences. As such, such information should be used to inform care improvement. The other key information needed include the manner of prescription, tracking results, and referral tracking. Moreover, the process of patient appointments is also an important information that should be incorporated in the database. Since the organization should be ready to serve the patients anytime, incorporating information such as the time it takes from requisition of appointment to the actual appointment, the promptness of reminders, and canceled appointment is necessary in determining and improving how the organization responds to the patients. NUR 514 Benchmark Assignment Electronic Health Record Implementation Paper

Role of Informatics in Capturing this Data

The informatics plays a vital role in capturing the data by enabling a means of exchanging important healthcare data between the patients and healthcare providers to ensure positive health outcomes (Mehta & Pandit, 2018). The shared information within the interdisciplinary team ensures collaboration in healthcare provision. Further, informatics also ensures that patients are engaged in their care through joint decision-making. Moreover, informatics also plays a role in reduction of errors while utilizing the data collected by ensuring the establishment of standards of information to direct the understanding of every data category and its possible implication in healthcare. NUR 514 Benchmark Assignment Electronic Health Record Implementation Paper

NUR 514 Benchmark Assignment Electronic Health Record Implementation Paper

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Systems and Staff Needed in the Design and Implementation Process and Team

The required system in the EHR implementation process should be the ones anchored on the needs of the organization. The system should be easy to use and ensure greater flexibility in delivering health care. Besides, the system should facilitate interaction between the patients and healthcare providers. Overall, the systems adopted should be simple to use to ensure minimum possible efforts while implementing EHR and also improve the effectiveness of the system while being used. On the other hand, the needed staff in the design and implementation process includes nurses, physicians, administration, IT experts, and EHR lead team. The input of the staff is critical in the process of designing the EHR system by working collaboratively to ensure inclusion of better features in the system. In the implementation process, the staff is vital in determination of the system’s usability and its simplicity in use. Taken together, the staff is crucial in evaluation and success of the process.

Professional, Ethical, and Regulatory Standards needed in Design and Implementation of the System

The professional standards required in the design and implementation of the system include enhancement of safety of patients and positive patient outcomes. Besides, professionalism is required to ensure due procedure, accuracy, and effectiveness in collecting, documenting, storing, analysis, and reporting of data. Regarding ethical principles, the design and implementation of the system ought to ensure the security of the health data and also safeguard the privacy and confidentiality of the patients (Heart, Ben-Assuli & Shabtai, 2017). On the other side, the regulatory standards should also be taken into consideration while designing and implementing the system. The leading regulatory standards include the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule and the Health Information Technology for Economic and Clinical Health Act (HITECH). These regulations are crucial in safeguarding the privacy and confidentiality of the patient health records and in ensuring legal liability for failing to set standards. NUR 514 Benchmark Assignment Electronic Health Record Implementation Paper

How EHR Team Would Ensure that All Order Sets Are Part of the New Record

Ensuring that all order sets become part of the new record requires a multifaceted process. The first step in the process should be to ensure the establishment of a governance system. This step requires the creation of a small support group to help in communication and decision making to ease the management, integration, and customization of the project. The governance system may include any member of the staff.  The next step is the planning stage where the hopes, objectives, and targets of all order sets are established.  Besides, all the currently available order sets are amended and included into the new system in this phase. The subsequent step is development of a guide, which involves creation of an approach that ensures stability in vital aspects of order sets such as outline, sequencing, size, evidence, and naming (Peters & Khan, 2014). The final step is the engagement stage where all the pertinent stakeholders of the order set are called to review and acclimatize with the system.

How to Communicate Changes in the Plan

The communication of changes would require the use of simple communication techniques in the organization such as organizing formal meetings with the employees to review the development, possible requirements, and potential changes to the implementation process. Other means of communicating changes include use of posters, follow ups, emails, and using the change lead team. The effective utilization of these communication techniques is crucial in creating awareness among the staff on the progress and also helping in thwarting or reduction in possibility of resisting the system by the staffs.  Importantly, the management should ensure an environment that encourages free and open communication to enable the staff a better opportunity to contribute to the design and implementation process.

Measures and Steps to Evaluate the Success of EHR Implementation from Staff, Setting and Patient’s Perspective

There are several ways to evaluate the success of the EHR implementation process. Overall, the success can be evaluated through the manner of adopting the change process, reduction in errors, high level of staff satisfaction with the system, improvement in the efficiency of network and infrastructure, and the overall culture (Nordan et al., 2018). On the other hand, the steps that can be used to evaluate the success of EHR implementation include planning, determination of the return on investment, examining the efficiency of the system, and reviewing the quality of care after the implementation. Moreover, success can also be evaluated by determination of profitability of the EHR system by performing cost-benefit analysis. Other techniques of evaluating the success includes determination of satisfaction levels of patients and the healthcare providers using surveys.

Leadership Skills and Theories to Facilitate Collaboration with the Interprofessional Team and Provide Evidence-Based, Patient-Centered Care

The EHR implementation process requires various leadership skills to succeed. The skills include effective communication. Communication is key in any change process because it helps in keeping the stakeholders informed about the progress of implementation process. Besides, it ensures that stakeholders give their inputs freely and also voice their concerns about the EHR implementation process. The other leadership skill is technical aptitude to help in understanding the technical nature of the process and systems used in the implementation process. The project management leadership skills are also necessary to help the leader in evaluation of different deliverables. The leader should also have problem-solving skills to help in addressing controversies that may arise during the implementation process. Essentially, the designing and implementation of EHR systems involve employees with diverse understanding, knowledge, perspectives, and experience. This diversity increases the chances of controversies, which can only be addressed by a leader with exceptional problem solving skills.

On the other hand, the most appropriate leadership theories in this context include transformational leadership style. According to Mittal & Dhar (2015), this leadership style emphasizes on collaborative effort by the employees to realize a common objective. It motivates the stakeholders to take active part in ensuring the success of the project. Transformative leaders ensure success by inspiring their subjects to be creative in their endeavors.


The implementation of an EHR system comprises several stages. The involvement of various stakeholders is particularly important as they will impact various facets of the process. Importantly, the facilitation of interprofessional collaboration through leadership theories is fundamental to the success of such a project.


Heart, T., Ben-Assuli, O., & Shabtai, I. (2017). A review of PHR, EMR and EHR integration: A more personalized healthcare and public health policy. Health Policy and Technology, 6(1), 20-25.

Mehta, N., & Pandit, A. (2018). Concurrence of big data analytics and healthcare: A systematic review. International journal of medical informatics, 114, 57-65.

Mittal, S., & Dhar, R. L. (2015). Transformational leadership and employee creativity. Management Decision.

Nordan, L., Blanchfield, L., Niazi, S., Sattar, J., Coakes, C. E., Uitti, R., & Spaulding, A. (2018). Implementing electronic patient-reported outcomes measurements: challenges and success factors. BMJ quality & safety, 27(10), 852-856.

Peters, S. G., & Khan, M. A. (2014). Electronic health records: current and future use. Journal of comparative effectiveness research, 3(5), 515-522.

Waters, S., Edmondston, S. J., Yates, P. J., & Gucciardi, D. F. (2016). Identification of factors influencing patient satisfaction with orthopaedic outpatient clinic consultation: a qualitative study. Manual therapy, 25, 48-55.

NUR 514 Benchmark – Electronic Health Record Implementation Paper


One way informatics can be especially valuable is in capturing data to inspire improvements and quality change in practice. The Agency for Healthcare Research and Quality (AHRQ) collects data related to adverse events and safety concerns. If you are working within a practice setting to implement a new electronic health record (EHR) system, this is just one of the many considerations your team would need to plan for during the rollout process.

In a paper of 1,500-1,750 words, discuss the following:

1. Consider an opportunity for tracking care improvement. What key information would be needed in the database? Example: Time lapse from medication order documented in the EHR to delivery of medication to the patient for the cardiology service.
2. Describe the role informatics plays in the ability to capture this data. What type of project management strategies and methodologies can be implemented to support informatics initiatives to help improve quality within the clinical practice?
3. Discuss which systems and staff members would need to be involved in the design and implementation process. What is the role of the advanced registered nurse in promoting evidence-based practice and leading quality and performance improvement initiatives within this setting?

4. Outline strategies for implementing the new EHR proposal. Consider communication changes, transitioning to the new EHR, and managing resources (human, fiscal, and health care resources).
5. Discuss what professional, ethical, and regulatory standards must be incorporated into the design and implementation of the system.
6. Describe the measures and steps you would take to evaluate the success of the EHR implementation from a staff, setting, and patient perspective to measure effectiveness and ensure continuous quality improvement in practice?
7. Explain what leadership skills and theories would be needed to facilitate collaboration with the interprofessional team and provide evidence-based, patient-centered care?

You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper. NUR 514 Benchmark Assignment Electronic Health Record Implementation Paper

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Course Materials if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

2.3: Develop leadership skills to collaborate on interprofessional teams in the provision of evidence-based, patient-centered care.

5.2: Apply professional, ethical, and regulatory standards of practice in the provision of safe, effective health care. NUR 514 Benchmark Assignment Electronic Health Record Implementation Paper

Topic 8 DQ 1


Open and clear communication is critical for the effective functioning of the interprofessional team and the delivery of safe patient care. Discuss the way communication technologies can enhance coordination of care by interprofessional teams. Be sure to discuss a specific communication technology in your response.

Topic 8 DQ 2


Virtual care and telehealth technologies have the capability to greatly expand access to quality health care. Discuss some benefits and drawbacks of virtual care/telehealth, particularly related to the collaboration and coordination of care and the role of the advanced registered nurse.

Topic 8: Interprofessionalism and Interrelationships in Informatics and Information Systems



1. Analyze the role of the advanced registered nurse in promoting evidence-based practice and leading quality and performance improvement initiatives.
2. Analyze quality standards and performance measures related to the use of informatics for continuous quality improvement in practice settings.
3. Discuss project management strategies and methodologies for implementing health care informatics initiatives that improve quality within clinical practice.

Study Materials

Nursing Informatics and the Foundation of Knowledge


Read Chapters 16 and 20 in Nursing Informatics and the Foundation of Knowledge.

Health IT


Explore the HealthIT.gov website.

Artificial Intelligence Research: The Utility and Design of a Relational Database System


Read “Artificial Intelligence Research: The Utility and Design of a Relational Database System,” by Diling, from
Advances in Radiation Oncology (2020).

Application of Project Management Tools and Techniques to Support Nursing Intervention Research

Read “Application of Project Management Tools and Techniques to Support Nursing Intervention Research,” by Rew, Cauvin, Cengiz, Pretorius, and Johnson, from Nursing Outlook (2020).

How Data Can Save Lives: Informatics for Health 2017


Read “How Data Can Save Lives: Informatics for Health 2017,” by Cookson, from BMC Series Blog (2017), located on the BioMed Central website.

Electronic Health Record (EHR) System Testing Plan


Read “Electronic Health Record (EHR) System Testing Plan,” located on the HealthIT.gov website.

EHR Testing: Specifics and Best Practices


Read “EHR Testing: Specifics and Best Practices,” by Mikhailau (2019), located on the Health IT Outcomes website.

Health IT Standards


Read “Health IT Standards,” located on the HealthIT.gov website.

Perspectives of Healthcare Practitioners: An Exploration of Interprofessional Communication Using Electronic Medical Records


Read “Perspectives of Healthcare Practitioners: An Exploration of Interprofessional Communication Using Electronic Medical Records,” by Bardach, Real, and Bardach, from Journal of Interprofessional Care (2017).

Best Practices for Health Informatician Involvement in Interprofessional Health Care Teams


Read “Best Practices for Health Informatician Involvement in Interprofessional Health Care Teams,” by Holden, Binkheder, Patel, and Viernes, from Applied Clinical Informatics (2018).

Impact of Information and Communication Technology on Nursing Care: Results of an Overview of Systematic Reviews

Read “Impact of Information and Communication Technology on Nursing Care: Results of an Overview of Systematic Reviews,” by Rouleau et al., from Journal of Medical Internet Research(2017).

Top 10 Telehealth Benefits and Challenges Concerning Hospitals


Read “Top 10 Telehealth Benefits and Challenges Concerning Hospitals,” from Delabano (2020), located on the Access website.

Perspectives of Nurses Toward Telehealth Efficacy and Quality of Health Care: Pilot Study


Read “Perspectives of Nurses Toward Telehealth Efficacy and Quality of Health Care: Pilot Study,” by Bashir and Bastola, from JMIR Medical Informatics (2018).

Topic 3 DQ 1

How have you seen or experienced organizational change within an organization? Did it go well or not? Was there any correlation in how the organizations used stakeholders or change models?

Re: Topic 3 DQ 1
At the level of charge nurse, organizational change is often experienced as a bystander. The change is apparent; however, the stakeholders and model are a mystery. Being bought by a large organization and going from a nonprofit to a for-profit acute care hospital was a rough transition. From the viewpoint of the nursing staff, most of the change was not favorable. There was the loss of ancillary staff, changes to inferior supplies, gaps in leadership, and highly drawn-out contract negations resulting in significant delays in step and other raises. If you asked the nursing staff know how the change went, they would probably say, “not good, but we made it through.” If you asked the major stakeholders who influenced the change plan, their answer would be different because it was a success. Five years later and it is business as usual with talks of a new hospital on the horizon.
All the hospitals in the area are now for-profit facilities. This is a trend in the United States, hospitals are consolidating at an accelerating rate, and healthcare costs continue to rise (Findlay, 2018). From 2013 to 2017, nearly 1 in 5 hospitals were acquired or merged with another hospital (Findlay, 2018). In most cases, mergers are necessary for the survival of the hospital. To keep up with advancing technology, modern data management, and top clinical talent, merging with large corporations is the only option (Findlay, 2018).
Nevertheless, at what cost to the communities these hospitals serve. You would think community services would suffer; however, a recent study showed only slightly higher spending in charity care for nonprofit facilities and showed higher charity care spending in for-profit hospitals with 300 beds or more (Garber, 2020). The same study showed that the most significant deviation in charity care spending was from state to state and had little bearing on whether the facilities were nonprofit or for-profit (Garber, 2020). Major organizational change is complex, and some areas of nursing suffer; however, the more significant picture points to the necessity to survive.

Findlay, S. (2018, July 19). Can a Community Hospital Stick to its Mission When it Goes For-Profit? Retrieved from npr.org: http://npr.org/sections/health-shots/2018/canacommunityhospitalsticktoitsmissionwhenitgoesforprofit

Garber, J. (2020, October 1). Nonprofit and for-profit hospitals provide similar levels of charity care, study finds. Retrieved from Lown Institute: https//lowninstitute.org/nonprofitandfor-profithospitalsprovidesimilarlevelsofcharitycare,studyfinds

Topic 3 DQ 2

You have been selected to serve on a community outreach committee within your state’s nursing organization. The committee includes registered nurses of different specialties. At your first meeting, it becomes evident that not everyone is in agreement with a recent position statement about the role of spiritual care, with some members arguing they will no longer support the committee if the position statement is not revised or reversed. As a nurse leader, how could you draw from change theory to address these concerns and encourage collaboration on the committee?

Re: Topic 3 DQ 2
Being a leaders comes with many challenges. Sometimes these challenges will call for creative solutions to bring multiple parties to the table with a solution that will work for everyone. In healthcare, the common goal is serve the needs of the patients and the public’s health needs. In the scenario presented, the nurse leader will have to start of by reminding everyone involved in the committee what the common goal is of the committee and who they are serving (the public). Disagreements and the unwillingness to comprise can overcloud judgments and decisions. “When teams are faced with adversity, the tendency can be to pass blame and begin to question the system, management or leadership. Challenges require every member to remain committed to the ultimate goal, which in the case of health care is patient care” (Bosch & Mansell, 2015)

Lewin’s change theory provides a blueprint on resolving conflicts among groups who have differences of opinion. Lewin’s Change Theory discusses three major components: driving forces, restraining forces and equilibrium. “Driving forces are those that push in a direction that causes change to occur, restraining forces are those forces that counter the driving forces and Equilibrium is a state of being where driving forces equal restraining forces, and no change occurs” (Nursing Theory, n.d.). When dealing with conflict among groups of individuals with different visions, I would draw from the equilibrium force. The obvious reason would be due to the fact that in this states, parties can be brought to the table with each of their ideas presented and from their choose from each side what closely matches the vision and purpose of the committee and ultimately the public. This will allow the leader to pull all parties in the same direction with the ideas that the each party has the closely aligns with the end goal.


Bosch, B., & Mansell, H. (2015). Interprofessional collaboration in health care: Lessons to be learned from competitive sports. Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPC, 148(4), 176–179. https://doi.org/10.1177/1715163515588106

Nursing Theory. (n.d.). Lewin’s Change Theory. Retrieved from: https://nursing-theory.org/theories-and-models/lewin-change-theory.php

Re: Topic 3 DQ 2

Almost all aspects of our daily life will change at some point or another. There are times when change is accepted with open arms, and other times change is met with resistance. Meeting resistance within an organization or committee is expected when members have originated from different specialties. There are certain models in place that ease the resistance when change is necessary.

As a nurse leader to this community outreach committee, I would use the Eight Steps of Change Process to the best of my abilities to, “combine lesions from traditional theories of change with those of complexity science” (DeNisco & Baker, 2016, p. 111). First, it is important to make sense of the resistance and figure out what exactly some members want revised. A Change team must then be created because “the best change outcomes involve the ideas and expertise of many people” (DeNisco & Baker, 2016, p. 112). Representation from all committee members would be carefully considered. The team then develops a shared vision, and the forces of change are considered. Data and information can be analyzed to assist in this process. Next, a work plan for change implementation would be used. These plans may need to remain flexible or consider multiple actions for one or more objectives (DeNisco & Baker, 2016). The changes need to then be implemented and then evaluated. Time needs to be taken into consideration when these two steps are completed because effective change happens over time. When the needs have been met, refreezing or incorporating the changes into the culture occurs. It is important to take the ideas of all committee members into consideration to ensure effective collaboration with one another. Collaboration from all helps the nurse leader enact changes in the most successful of ways. NUR 514 Benchmark Assignment Electronic Health Record Implementation Paper


Denisco, S.M., Baker, A.M. (2016). Advanced practice nursing: essential knowledge for the profession. Burlington, MA. Jones & Bartlett Learning.

Re: Topic 8 DQ 1

My hospital recently switched over to a new communication system called Vocera. It is like a walkie-talkie and you push the button and say the name or group that you want to speak to and I can connects you. For example, if you needed to contact speech therapy but do not know who is working that day, you simply say call speech therapy and it connects you to someone who is working. It is an improvement over telephones because we spent so much time trying to find the phone number of the person we need to call. But at the same time there are some flaws, sometimes the Vocera doesn’t understand the name that you are saying. Quick communication in real time can help improve continuity of care for patients. “Technology provides nurses with a new set of tools to enable and improve the nurse–patient relationship” (Dewsbury, 2019). The implementation of the Vocera decreased wasted time and allow for more time its patient care or expediting their care. McGonigle and Mastrian discuss a safety culture and how it relates to keeping patients safe (2017). This kind of technology is helpful in providing safety for staff as well. If staff are in positions where they are unable to reach call lights or even staff emergency buttons they simply press a button and call for help. There is no need to fumble with a phone especially the old brick size telephones we used to have. Vocera provides very limited hands on feature which can be useful when your hands need to be else where to provide safety for yourself or your patient.

Dewsbury, G. (2019). Use of information and communication technology in nursing services. British Journal of Community Nursing, 24(12), 604–607. https://doi.org/10.12968/bjcn.2019.24.12.604
McGonigle, D., Mastrian, K. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning. ISBN-13:9781284121247

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