Putting it all together, a case based team discussion
First identify a team leader for this discussion. Next discuss the following case scenario. With a focus on EI and CQ the team will decide how best address the barriers identified in this case study.
You may find Chapter Seven in Institute of Medicine [IOM]. (2009). Leadership commitments to improve value in health care: Finding common ground: Workshop Summary to be a nice resource to help get the conversation started.
You are the Nurse Administrator of a small community hospital which has recently acquired a skilled nursing facility (SNF). The SNF provides long and short term rehabilitation for patients across the spectrum from children through geriatric age groups. You have been charged with spearheading the implementation of a standardized electronic documentation system for both the hospital and the SNF. The hospital has been using an EMR for five years; however the SNF has never used any electronic documentation system. With the hospital’s system in need of updating / replacement you, the Nurse Administrator, along with the executive administration see this as the perfect time to introduce a new system at both facilities. However, with the mention of this at a joint meeting of hospital administration, SNF leadership, physicians, and nurse managers from both facilities you quickly identify the following barriers to this strategic initiative:
Physicians at the hospital are worried about having to learn a new system
Physicians are not interested in having a system which incorporates a practice management component containing evidence base care recommendations into the planning of patients’ care
Nurses at the hospital like the system just the way it is. They do not see the need for an entirely new documentation system.
Nurses at the SNF like the paper records and do not see how an electronic documentation program will improve quality of care or safety. In addition, they have never used computers for documentation.
Nurses at the SNF are afraid their lack of technology competence will give the new administration a reason for lay-offs.