Abstract

Purpose:

The purpose of this evidence based practice project is to improve usability of the Electronic Medical Record (EMR) to demonstrate consistent compliance with venous thromboembolism (VTE) and heart failure (HF) Core Measures. Consistently meeting core measures is important for optimal patient care and reimbursement..

Strength of Evidence: Systematic reviews, a multinational cross-sectional study, and a multicenter, randomized controlled trial all demonstrate a positive impact on suboptimal prophylaxis and treatment for VTE and HF quality measures, with improved EMR usability.

Proposed Practice Change:

The proposed change involves modifying the EMR program in order to improve usability in order entry, documentation, efficiency of review, and communication between reviewers and clinicians. This will require modifying the EMR program in order to improve usability, order entry, documentation, efficiency of review, and communication between reviewers and clinicians

Implementation Strategies: EMR program changes aimed at promoting appropriate orders include building specific orders into all admission order sets. The changes aimed at promoting appropriate documentation include building in reminders for nursing staff. Those intended to promote efficient review include creating views for quality nurses to review orders and documentation for these quality measures which pull pertinent information from the EMR, negating the need for individual, manual chart review. The changes to the EMR aimed at improving communication include developing instant messaging within EMR to facilitate communication between quality nurses and staff nurses and physicians.

Stakeholders/Evaluation:

Stakeholders include physicians ordering interventions required by VTE and HF Core Measures, nurses implementing and documenting these interventions, and quality nurses reviewing the ordering and documentation. Patients and healthcare leaders must also be included due to associated clinical and financial outcomes.

The impact on efficiency of the audit for core measure compliance will be measured based on comparisons of time tests conducted before and after changes to the EMR have been made. Perceptions of system usability will be evaluated using pre and post implementation data from Brookes' System Usability Scale.

Author Details

Sarah E. Shultz, MSN, RN, NE-BC; Mikel W. Hand, EdD, RN, OCN, NE-BC, NEA-BC

Sigma Membership

Omicron Psi

Type

Poster

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Pilot/Exploratory Study

Keywords:

Electronic Medical Records, Usability, Core Measures, Evidence Based Practice

Conference Name

Unknown

Conference Host

UCLA Healthcare

Conference Location

Los Angeles, California, USA

Conference Year

2015

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Peer-review: Single Blind

Acquisition

Self-submission

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Optimizing Usability of Electronic Medical Records to Meet and Measure Quality Initiatives

Los Angeles, California, USA

Purpose:

The purpose of this evidence based practice project is to improve usability of the Electronic Medical Record (EMR) to demonstrate consistent compliance with venous thromboembolism (VTE) and heart failure (HF) Core Measures. Consistently meeting core measures is important for optimal patient care and reimbursement..

Strength of Evidence: Systematic reviews, a multinational cross-sectional study, and a multicenter, randomized controlled trial all demonstrate a positive impact on suboptimal prophylaxis and treatment for VTE and HF quality measures, with improved EMR usability.

Proposed Practice Change:

The proposed change involves modifying the EMR program in order to improve usability in order entry, documentation, efficiency of review, and communication between reviewers and clinicians. This will require modifying the EMR program in order to improve usability, order entry, documentation, efficiency of review, and communication between reviewers and clinicians

Implementation Strategies: EMR program changes aimed at promoting appropriate orders include building specific orders into all admission order sets. The changes aimed at promoting appropriate documentation include building in reminders for nursing staff. Those intended to promote efficient review include creating views for quality nurses to review orders and documentation for these quality measures which pull pertinent information from the EMR, negating the need for individual, manual chart review. The changes to the EMR aimed at improving communication include developing instant messaging within EMR to facilitate communication between quality nurses and staff nurses and physicians.

Stakeholders/Evaluation:

Stakeholders include physicians ordering interventions required by VTE and HF Core Measures, nurses implementing and documenting these interventions, and quality nurses reviewing the ordering and documentation. Patients and healthcare leaders must also be included due to associated clinical and financial outcomes.

The impact on efficiency of the audit for core measure compliance will be measured based on comparisons of time tests conducted before and after changes to the EMR have been made. Perceptions of system usability will be evaluated using pre and post implementation data from Brookes' System Usability Scale.