Workflow Analysis of a Selected Nursing Activity 'Data Analysis' chapter

Excerpt from 'Data Analysis' chapter :

Workflow Anaysis

Workflow Analysis Of A Selected Nursing Activity

Workflow Analysis:

The Tele-Management System

Medication errors have resulted to numerous injuries, which has led to some healthcare providers adopting IT systems such as electronic records and information systems as a measure to minimize the errors. The adoption of these technologies involves several stakeholders, but most importantly, the informatics nurses. These nurses play an important role in optimization by representing the needs of clinicians. In addition, they also assist in improving technological solutions in case of technological hitches with the IT systems. When hospitals adopt technology solutions, it will influence their workflow process (McGonigle and Mastrian, 2012).

The informatics nurses come in to redesign the workflow to accommodate the solution, through evaluation of tasks that will require the utilization of technology. However, the solutions adopted should allow for exchange of information across different hospitals to improve or eliminate dependence on one hospital. This means that an individual's data concerning health is accessible in any hospital setting. Prior studies suggest that the use of technology in healthcare provision will lead to improved healthcare quality, reduce costs and reduce medical errors. Nevertheless, the studies emphasize that this is only achievable if the implementation of the technology is comprehensive (Hussain, 2011).

Tele-management Workflow

The system comprises of a Bluetooth, patent support system, data repository and decision support system, and the physician reporting and alerting system. The Bluetooth has an enabled BP monitoring device and a programmable mobile. The phone receives home readings, conveyed wirelessly from the monitor and subsequently sends them safely to the server. On the phone, the patients can access and review previous data. At the back of the system, there is a server, which collects results from the patient's devices, stores them in a database and subsequently acts appropriately by applying some medical rules on the BP monitoring routine and alerts. The rules initiate events that the reporting and alerting component handles (Logan et al., 2007).

Flowchart of Tele-management Workflow

Tele-Management Model

Nursing Activity: Controlling Blood Pressure

Uncontrolled hypertension is a significant challenge to health and healthcare systems in the globe. In addition, blood pressures (BP) in most of the states in the globe show that <25% of patients with hypertension have controlled blood pressure. Some of the reasons to this involve patient-related aspects, insufficiencies of the healthcare system and the clinical inertia of the providers of healthcare. Additional barriers include the type of hypertension, characterized with lower control rates for systolic blood pressure, and the presence of diabetes type II. In reaction, the healthcare system or providers have come up with strategies of improving the control of hypertensions. One of the strategies is the use of specialized clinics (Logan et al., 2007).

Although the use of specialized clinics is effective, the approach is neither cost effective nor applicable for highly prevalent conditions of hypertension and diabetes type II. Therefore, this has further pushed the healthcare providers to develop new strategies to curb and reduce the situation, or face dire consequences. Therefore, some hospitals have adopted new healthcare provision approaches that promote self-management in patients and advanced communication systems. Such systems have made patients become more willing to manage their own care, and monitoring at home is one strategy to increase their involvement.

In addition, there has emerged a wide range of healthcare aids designed for management at home. For hypertension, they range from simple monitoring equipment aimed at monitoring BP, to multifaceted tele-management systems. Although some of these devices are of invaluable help, they are not short of limitations. Some of the limitations arise because of the internet challenges especially for elderly individuals. In addition, these devices have led to disruption of the normal workflow pattern for doctors and healthcare staff. Into the bargain, the lack of wired connections of the systems and lack of direct communication from hospitals to homes and vice versa, have also contributed to the low rates of adoption by patients and healthcare providers. In scrutinizing such shortcomings, this calls for new solutions (Pickering et al., 1999).

Workflow Analysis Process

According to McGonigle and Mastrian (2012), a workflow refers to the events that constitute a work process involving a team of people, and adds value to the activities of an organization. In addition, the authors suggest that the adopted technology should meet the needs of the organization's workflow. Moreover, it is possible that technology will influence the organization's workflow; therefore, there is a need for redesigning the workflow by utilizing the informatics nurses. Into the bargain, the redesign team consists of people who directly take part in the workflow.

For this paper, process owners include the patients, nurses, informatics nurses and physicians. They take part directly in the workflow process. The Tele-Management system is home-based; the system has a mobile phone and a wireless connection, plus a BP monitor. The monitor automatically records the BP levels and conveys the alerts to the hospital, which the nurses receive, and act accordingly. If the patient needs medication, they inform the physicians who take part in the treatment process. The informatics nurses offer solutions in cases where the system is not working as expected (McGonigle and Mastrian, 2012).

Nurses, doctors, patients and informatics nurses should take part in the design of a hospital's workflow. This will work well to an IT system that will benefit patients, hospitals and other stakeholders. Decision-making is core in the design of the workflow. Therefore, decision makers qualify as stakeholders in this process. The main objective of decision-making is to develop a way, which will reflect the system's performance or functionality by keeping the steps for use simple and understandable. For example, the usability of this BP monitoring system does not rely on personal computer as main requirement for communication, but it can also utilize mobile phone (Logan et al., 2007).

The design of the workflow includes some steps. The value-added activity step is one that assists in bringing the process closer to completion or alters for improved functionality (McGonigle and Mastrian, 2012). In the Tele-management system, it does not entirely depend on PC. The system incorporates a mobile phone, meaning that every patient can access or use the phone. In addition, for people who lack proficiency in the use of the internet, such as the elderly, the system has the capacity to convey alerts without the patient's intervention. The two activities are value-added activities because they improve the workflow, or rather assist in bringing the process into a successful completion. In addition, the design team will come together to develop tasks that will bring the process into a successful completion, or alters the process for the good of the organization, patients and other stakeholders.

The elderly were to plug the mobile phone into an electric circuit and leave it an attended, as it automatically conveyed information to the main server (Pickering et al., 1999). This is a value-added step because it provides manual intervention for people without the knowledge of internet, further improving workflow because it can automatically convey results to the nurses. Although the incorporation of technology in medical filed will have its challenges ranging from perceptions of nurses, the significance is to bring all the issues and provide a platform for discussion. This is where the nurses with divergent views will learn about the benefits of technology for future use in areas such as communication.

Meaningful Use Measures

The adoption of technology is central to healthcare reforms in an effort to reduce costs and improve healthcare quality. However, the adopted technology must show the value in relation to provisions of healthcare (Hussain, 2011). The benefits achieved or realized after adoption of these solutions, will further enhance sustainability (Hussain, 2011) in the meaningful use of technology (Hussain, 2011). Meaningful policies presume that technology will enhance dynamic improvement of healthcare quality. In the nursing practice, nurses have a consensus that meaningful use of IT systems, when combined with quality care, has the capacity to improve healthcare provision.

Meaningful use will require correct recording of clinical data, which is central to reduction of medical errors. Although workflows used across hospitals may act as a barrier to meaningful use of technology, redesigning the workflow by utilizing the informatics nurses and process owners (McGonigle and Mastrian, 2012), is the first step to efficient implementation of technological solutions. Another significant measure is ensuring that the aim of adopting a technological solution is to improve patient safety and quality. Overall, meaningful use of technology is only possible if implementation is comprehensive and includes all the stakeholders (Hussain, 2011).

Future Implications

The main objective of workflow analysis is to establish a future state solution that utilizes technology and removes non-value add activities. Owing to the advancement in technology, it is likely that the medical field will witness development of applications and other systems that will take healthcare provision to another level. Therefore, informatics nurses have a duty because the new designs will call for redesigning of current workflows (McGonigle and Mastrian, 2012). In conclusion, the healthcare providers must explore…

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