DEVELOPING A SMALL INFORMATICS PROJECT FOR YOUR ORGANIZATION, PART 2: IMPLEMENTATION – OnlineNursingPapers


Rubric

NURS_8210_Week9_Assignment_Rubric

NURS_8210_Week9_Assignment_Rubric

Criteria Ratings Pts
All documents from Part 1 are included in the Part 2 submission.

150 to >134.0 pts

Excellent

All documents and tracking tools submitted from Part 1 have been revised and accurately updated in detail to sufficiently support the proposed small nursing informatics project.

134 to >119.0 pts

Good

All documents and tracking tools submitted from Part 1 have been revised and updated to support the proposed small nursing informatics project.

119 to >104.0 pts

Fair

All documents and tracking tools submitted from Part 1 have been inaccurately or vaguely revised and may support the proposed small nursing informatics project.

104 to >0 pts

Poor

All documents and tracking tools from Part 1 have been inaccurately and vaguely revised, and do not lend support to the proposed small nursing informatics project, or it is missing.

150 pts

Is the project staying within scope?

40 to >35.0 pts

Excellent

The response accurately and clearly explains in detail whether the project is staying within scope…. The response accurately and clearly adheres to the project scope provided in the final submission.

35 to >31.0 pts

Good

The response accurately explains whether the project is staying within scope. … The response accurately adheres to the project scope provided in the final submission.

31 to >27.0 pts

Fair

The response inaccurately or vaguely explains whether the project is staying within scope. … The response inaccurately or vaguely adheres to the project scope provided in the final submission.

27 to >0 pts

Poor

The response inaccurately and vaguely explains whether the project is staying within scope, or it is missing. … The response inaccurately and vaguely adheres to the project scope provided in the final submission, or it is missing.

40 pts

Were all of the gaps identified?

20 to >17.0 pts

Excellent

The response accurately and clearly explains in detail whether all the gaps were identified for the proposed small nursing informatics project. … The response accurately and clearly adheres to the Gap Analysis provided in the final submission.

17 to >15.0 pts

Good

The response accurately explains whether all the gaps were identified for the proposed small nursing informatics project…. The response accurately adheres to the Gap Analysis provided in the final submission.

15 to >13.0 pts

Fair

The response inaccurately and vaguely explains whether all the gaps were identified for the proposed small nursing informatics project. … The response inaccurately or vaguely adheres to the Gap Analysis provided in the final submission.

13 to >0 pts

Poor

The response inaccurately and vaguely explains whether all the gaps were identified for the proposed small nursing informatics project, or it is missing. … The response inaccurately and vaguely adheres to the Gap Analysis provided in the final submission, or it is missing.

20 pts

Is the project following the timeline?

40 to >35.0 pts

Excellent

The response accurately and clearly explains in detail whether the project is following the timeline. … The response accurately and clearly adheres to the project timeline provided in the final submission.

35 to >31.0 pts

Good

The response accurately explains whether the project is following the timeline. … The response accurately adheres to the project timeline provided in the final submission.

31 to >27.0 pts

Fair

The response inaccurately or vaguely explains whether the project is following the timeline. … The response inaccurately or vaguely adheres to the project timeline provided in the final submission.

27 to >0 pts

Poor

The response inaccurately and vaguely explains whether the project is following the timeline, or it is missing. … The response inaccurately and vaguely adheres to the project timeline provided in the final submission, or it is missing.

40 pts

If you had a budget, is it on track?

40 to >35.0 pts

Excellent

The response accurately and clearly explains in detail whether the project is adhering to the proposed budget.

35 to >31.0 pts

Good

The response accurately explains whether the project is adhering to the proposed budget.

31 to >27.0 pts

Fair

The response inaccurately or vaguely explains whether the project is adhering to the proposed budget.

27 to >0 pts

Poor

The response inaccurately and vaguely explains whether the project is adhering to the proposed budget, or it is missing.

40 pts

Were all of the work activities correctly assigned?

20 to >17.0 pts

Excellent

The response accurately and clearly explains in detail whether all the work activities were correctly assigned. … The response accurately and clearly adheres to the Work Breakdown Structure provided in the final submission.

17 to >15.0 pts

Good

The response accurately explains whether all the work activities were correctly assigned. … The response accurately adheres to the Work Breakdown Structure provided in the final submission.

15 to >13.0 pts

Fair

The response inaccurately or vaguely explains whether all the work activities were correctly assigned. … The response inaccurately or vaguely adheres to the Work Breakdown Structure provided in the final submission.

13 to >0 pts

Poor

The response inaccurately and vaguely explains whether all the work activities were correctly assigned, or it is missing. … The response inaccurately or vaguely adheres to the Work Breakdown Structure provided in the final submission, or it is missing.

20 pts

Are team members responsible?

20 to >17.0 pts

Excellent

The response accurately and clearly explains in detail whether all team members were responsible for the proposed small nursing informatics project. … The response accurately and clearly adheres to the responsibility chart provided in the final submission.

17 to >15.0 pts

Good

The response accurately explains whether all team members were responsible for the proposed small nursing informatics project. … The response accurately adheres to the responsibility chart provided in the final submission.

15 to >13.0 pts

Fair

The response inaccurately or vaguely explains whether all team members were responsible for the proposed small nursing informatics project. … The response inaccurately or vaguely adheres to the responsibility chart provided in the final submission.

13 to >0 pts

Poor

The response inaccurately and vaguely explains whether all team members were responsible for the proposed small nursing informatics project, or it is missing. … The response inaccurately and vaguely adheres to the responsibility chart provided in the final submission, or it is missing.

20 pts

Did the project start on time, inline to meet due dates?

40 to >35.0 pts

Excellent

The response accurately and clearly explains in detail whether the small nursing informatics project started on time and is inline to meet due dates. … The response accurately and clearly adheres to the Gantt chart provided in the final submission.

35 to >31.0 pts

Good

The response accurately explains whether the small nursing informatics project started on time and is inline to meet due dates. … The response accurately adheres to the Gantt chart provided in the final submission.

31 to >27.0 pts

Fair

The response inaccurately or vaguely explains whether the small nursing informatics project started on time and is inline to meet due dates. … The response inaccurately or vaguely adheres to the Gantt chart provided in the final submission.

27 to >0 pts

Poor

The response inaccurately and vaguely explains whether the small nursing informatics project started on time and is inline to meet due dates, or it is missing. … The response inaccurately and vaguely adheres to the Gantt chart provided in the final submission, or it is missing.

40 pts

Are you holding weekly status meetings and documented all activities? Are all team members in attendance and communicated with?

20 to >17.0 pts

Excellent

The response accurately and clearly explains in detail whether weekly status meetings and documentation of all activities for the project has occurred. … The response accurately and clearly explains in detail whether all team members have participated, attended, and been in active communication for the project. … The response accurately and clearly adheres to the communication plan provided in the final submission.

17 to >15.0 pts

Good

The response accurately explains whether weekly status meetings and documentation of all activities for the project has occurred. … The response accurately explains whether all team members have participated, attended, and been in active communication for the project. … The response accurately adheres to the communication plan provided in the final submission.

15 to >13.0 pts

Fair

The response inaccurately or vaguely explains whether weekly status meetings and documentation of all activities for the project has occurred. … The response inaccurately or vaguely explains whether all team members have participated, attended, and been in active communication for the project. … The response inaccurately or vaguely adheres to the communication plan provided in the final submission.

13 to >0 pts

Poor

The response inaccurately and vaguely explains whether weekly status meetings and documentation of all activities for the project has occurred, or it is missing. … The response inaccurately and vaguely explains whether all team members have participated, attended, and been in active communication for the project, or it is missing. … The response inaccurately and vaguely adheres to the communication plan provided in the final submission, or it is missing.

20 pts

Are all changes approved and documented?

20 to >17.0 pts

Excellent

The response accurately and clearly explains in detail whether all changes for the small nursing informatics project were approved and documented. … The response accurately and clearly adheres to the change management plan provided in the final submission.

17 to >15.0 pts

Good

The response accurately explains whether all changes for the small nursing informatics project were approved and documented. … The response accurately adheres to the change management plan provided in the final submission.

15 to >13.0 pts

Fair

The response inaccurately or vaguely explains whether all changes for the small nursing informatics project were approved and documented. … The response inaccurately or vaguely adheres to the change management plan provided in the final submission.

13 to >0 pts

Poor

The response inaccurately and vaguely explains whether all changes for the small nursing informatics project were approved and documented, or it is missing. … The response inaccurately and vaguely adheres to the change management plan provided in the final submission, or it is missing.

20 pts

Are all risks identified, prioritized, assigned an owner, and mitigation plan developed?

20 to >17.0 pts

Excellent

The response accurately and clearly explains in detail whether all risks were identified, prioritized, assigned an owner, and whether mitigation plans were developed. … The response accurately and clearly adheres to the risk management plan provided in the final submission.

17 to >15.0 pts

Good

The response accurately explains whether all risks were identified, prioritized, assigned an owner, and whether mitigation plans were developed. … The response accurately adheres to the risk management plan provided in the final submission.

15 to >13.0 pts

Fair

The response inaccurately or vaguely explains whether all risks were identified, prioritized, assigned an owner, and whether mitigation plans were developed. … The response inaccurately or vaguely adheres to the risk management plan provided in the final submission.

13 to >0 pts

Poor

The response inaccurately and vaguely explains whether all risks were identified, prioritized, assigned and owner, and whether mitigation plans were developed, or it is missing. … The response inaccurately and vaguely adheres to the risk management plan provided in the final submission, or it is missing.

20 pts

A final summary that includes complete evaluation of the full project and lessons learned: what went well and what needs updated and revised.

55 to >48.0 pts

Excellent

The response accurately and clearly summarizes in detail a complete and comprehensive evaluation of the proposed small nursing informatics project. … The response accurately and clearly explains in detail lessons learned from the proposed small nursing informatics project.

48 to >43.0 pts

Good

The response accurately summarizes a complete evaluation of the proposed small nursing informatics project. … The response accurately explains lessons learned from the proposed small nursing informatics project.

43 to >37.0 pts

Fair

The response inaccurately or vaguely summarizes a complete evaluation of the proposed small nursing informatics project. … The response inaccurately or vaguely explains lessons learned from the proposed small nursing informatics project.

37 to >0 pts

Poor

The response inaccurately and vaguely summarizes a complete evaluation of the proposed small nursing informatics project, or it is missing. … The response inaccurately and vaguely explains lessons learned from the proposed small nursing informatics project, or it is missing.

55 pts

Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.

5 to >4.0 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. … A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

4 to >3.5 pts

Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. … Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.

3.5 to >3.0 pts

Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. … Purpose, introduction, and conclusion of the assignment is vague or off topic.

3 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. … No purpose statement, introduction, or conclusion was provided.

5 pts

Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

5 to >4.0 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

4 to >3.5 pts

Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

3.5 to >3.0 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

3 to >0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

5 pts

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.

5 to >4.0 pts

Excellent

Uses correct APA format with no errors.

4 to >3.5 pts

Good

Contains a few (1 or 2) APA format errors.

3.5 to >3.0 pts

Fair

Contains several (3 or 4) APA format errors.

3 to >0 pts

Poor

Contains many (≥ 5) APA format errors.

5 pts

Total Points: 500

 

Developing a Small Informatics Project Part 2: Implementation

Better patient experience and outcomes have been a central focus of the healthcare sector, especially nursing, as nurses are the healthcare professionals who spend the most time with patients. The implication is that nurses can always be at the center of initiatives used to improve patient outcomes. Such initiatives can range from administrative to the use of technology to improve patient care outcomes. Through quality improvement projects, nurses can positively contribute to the efforts to improve patient experience and outcomes (Wells et al.,2018). Such quality improvement projects are accomplished in phases, where subsequent phases systematically follow the project initiation phase. Among the vital phases of such projects is implementation. During implementation, the actual proposal is put into action to effect the desired changes. Nursing informatics can play a critical role in improving patient outcomes. As such, the project regarding small nursing informatics was proposed in the previous section after identifying a patient problem in the patient settings. In addition, ten tracking documents were formulated. Therefore, the purpose of this project is to explore implementation and track the project and ensure that the implementation is going as planned.

 Project Conformance to Scope (Scope)

            The scope entails the specifications of a project that defines what a project should cover, the required resources, and the possible times for its completion. The implication is that a project scope defines the project boundaries, what needs to be done and what should not be covered (Abdilahi et al.,2020). As part of the overall project plan, it is key to determine if the project is staying within the defined scope, as it can be an indicator of the eventual success of the project. The scope also focuses on what the problem should be carried out and how it is to be monitored and established. In the initial stages of the project, the project’s aims and objectives were formulated. For example, the aim of the project was to streamline the discharge decision-making process by the interdisciplinary team utilizing data analytics at Riverside University Health System (RUHS). This still remains the aim and focus of the project; as such, in terms of the project’s aim, the project is still within scope.

The project also had targeted deliverables. These deliverables are an important part of the project as they are indicators of the project’s success. The targeted deliverables, such as various documentation, still remain the central focus. Among the aims was to come up with a system that improves patient outcomes in terms of discharge. The informatics system is to streamline the discharge decision-making process by the interdisciplinary team when using data analytics to improve patient outcomes in terms of discharge. These deliverables still remain the main focus; as such, in terms of the deliverables, the project is still within scope.

Gaps Identification (Gap Analysis)

            Patient care improvement requires that the healthcare professionals such as nurses identify problems that hinder effective patient care, patient experiences, and patient outcomes. Such a problem calls for a careful analysis of the services rendered and the impacts of such on patients. This is where gap analysis comes in. Through gap identification or gap analysis, the project team can appropriately identify the gaps that exist and formulate quality improvement goals around the identified gaps (Skivington et al.,2021). Having carried out a gap analysis, it is important to explore if, indeed, all the necessary gaps were identified. A close analysis of the operations at the Riverside University Healthcare System (RUHS) revealed that various gaps exist in the operations hence exposing the patients to poorer health outcomes.

The analyzed data from the facility indicated disheartening cases of patient discharge protocol. Such protocols have negatively impacted patient outcomes and the financial well-being of the organization. For example, the data also indicated that the patients were wrongfully discharged. Such wrongful discharges occur due to the lack of clear discharge protocols, hence endangering their lives. As such, this is one of the largest gaps identified in the organization. In addition, some of the patients were referred to a general ward since some of their information regarding medication progress was missing. These patients went on to experience a downturn in their health leading to readmissions into critical care. The gap analysis also revealed that the organization has been experiencing overcrowding in the patient units. Such overcrowding incidences lead to functionality challenges in the facility. For example, overcrowding has led to delays in therapeutic procedures hence poorer patient outcomes (Jeanmonod & Jeanmonod, 2018). From the discussed aspects, it is evident that all the gaps were appropriately identified and hence need to be addressed.

Project Conformance to Timeline (Project Timeline)

            A project life cycle is characterized by various phases which must be accomplished within the required time. Therefore, it is usually key to formulate a timeline that dictates when each activity is to be accomplished.  A project timeline is also key in helping the project team to stay on course and ensure that every activity is implemented as planned (Ford & Lyneis, 2020). In the previous sections, a timeline was formulated, and therefore it is important to determine if the project is staying within the scheduled timelines.

The project involved various phases and steps. The steps include an assessment of the feasibility of the EHR programs, identification of a multidisciplinary team to help in addressing the proposed change, the introduction of the EHR, reviewing the compliance reports, and piloting reports with adequate data. Other steps included data validation, creation of report strategies, development of a plan for the implementation of the new strategies, monitoring the implementation, review of the HER program, and sustaining the efforts.

The first month of the project was generally dedicated to planning. The planning activities included assessing the feasibility of the proposed electronic health records project at the chosen facility, identifying the multidisciplinary team to help in addressing the change, and introducing the EHR program at the chosen health facility. The four activities of the first phase of the project were accomplished within the first month of the project as planned. Review of the reports on compliance and completing the assessment of compliance were also completed within the time schedule.

Finding out if the proposed project complies with the general standards and the HIPPA rules is key. It is important that the project complies with these guidelines and the rules as it touches on patient data (Mbonihankuye et al.,2019). As such, the project has to uphold the privacy, security, and confidentiality of the patient data as appropriate. After a careful assessment, it was noted that the project and its aspects are compliant. As such, the general phase of the planning was successfully completed within the time scheduled.

The next phase entailed piloting a report with adequate data and validating the data, which occurred after the first two phases. This phase entailed trials that were run to determine the validity of the collected data. It is important to test for the validity of such data through piloting to enhance the chances of success when the actual phase of rollout comes around. It is important to note that all other phases of the project were accomplished based on the proposed timeline and as appropriately as possible. Therefore, it can be reported that so far the project’s phases have stayed within the initially formulated timeline.

Work Activities Assignment (Work Breakdown Structure)

From the earlier discussions, it was noted that this small nursing informatics project has various phases and, therefore, has to be implemented in phases as appropriate. The implication is that, in every phase, there are activities that have to be accomplished in time to enhance the chances of the project succeeding. In addition, these activities cannot all be accomplished or completed by an individual; hence a need to assign individuals with expertise and interest who can accomplish these tasks as appropriate (Müller et al., 2019). In the previous sections, various individuals were assigned to accomplish various tasks. Therefore, it is imperative to evaluate whether the tasks were appropriately assigned.

The three major phases, as identified in the Work Breakdown Structure, included planning, implementation, and evaluation. Various activities are associated with the planning phase, including the feasibility assessment, definition of the project scope, and development of the resource plan. This phase was assigned to the project leader, who was tasked with ensuring that this phase was successful and that the associated deliverables were timeously accomplished. The project leader has expertise in project implementation and has experience in leading projects. Therefore, the activities were correctly assigned to the individual who would complete them in time.

The next phase entailed implementation. Under the implementation, various activities were identified, including an introduction of the EHR program, development, documentation, user training plan, training of users, and monitoring of implementation. This phase was assigned to the project leader, the nurse educator, and the nurse informaticist. These three individuals have a rich experience and expertise in project implementation. While the project leader was tasked with leading the other three and coordinating them to accomplish the associated activities, the nurse educator was responsible for educating individuals on the requirements of the new project and what should be done to comply with the requirements. The nurse informaticist has the technical expertise needed in the informatics project; as such, the nurse informaticist helps with the technical aspects of the project for a successful implementation. Therefore, the activities related to the implementation of the project were appropriately and correctly assigned.

The other phase is evaluation. During the evaluation phase, various activities were also identified, including a review of the report on compliance, completing the assessment on compliance, provision of support, and formulating the documentation for lessons learned. These activities were also assigned to various individuals on the project team. The individuals include the nursing leader, nursing staff, nurse educator, and nurse informaticist. The evaluation phase usually explores the efficacy of the methods used in the project, how well they help in accomplishing the project goals and how best they were used (Müller et al.,2019). Therefore, this phase is a vital part of the project as it can help the project team to determine the next steps that should be taken to ensure that the project moves in the right direction. The nursing staff have a good knowledge of the organization, as informed by years of experience working in the organization. As such, the nursing staff is able to help determine the impact of an implemented project. It is important to note that the analysis of the expertise and experience of the team members assigned the tasks revealed that the tasks were correctly assigned as needed to help drive the project forward.

Team Members Responsibilities (RACI Chart)

Formulating, implementing, and evaluating a quality improvement requires a collaborative effort from all the team members such that every team member performs the assigned tasks. Therefore, the project leader should be able to apply effective leadership skills to inspire every team to work hard and fulfill the laid down goals or objectives. For the success of the project, it is also key to determine if the team members are responsible and are accomplishing or fulfilling their responsibilities as outlined in the RACI (Responsible, Accountable, Consulted and Informed) chart (Suhanda & Pratami, 2021). The major team members in the implementation of this small nursing informatics project include the project leader, nursing staff, allied health staff, medical officer, nurse educator, and nurse informaticist. In the initial stages of the project, the project leader made it clear in the meeting that each and every team member should strive to achieve the project goals, objectives, and deliverables. Therefore, every team member was made aware of their responsibilities and the need to achieve the goals individually and as a team. As part of the project plan, it is important to find out how responsible the members have been.

The project leader was assigned to be responsible for various tasks including assessment of the feasibility of the EHR program that has been selected, identifying the multidisciplinary team to help in addressing the proposed change, introducing the new technology program, and reviewing the compliance report. The other aspects include completion of the compliance assessment, data validation, creation of report strategies, ensuring that implementation is accomplished, monitoring of implementation, reviewing the EHR program, and sustaining the effort. While the project leader was responsible for the completion of the mentioned tasks, they were also accountable for the completion of particular tasks, were to be consulted by those responsible for some tasks and they were also to be kept updated. It is worth noting that the project leader has so far carried out the tasks assigned as expected while also showing high levels of responsibility.

The nursing staff was also expected to be responsible for the implementation strategies and accepting the use of reports. As earlier highlighted, the nursing staff have experience working in the facility, and some of them have been part of the facility for years; therefore, they can play a big role in implementing the strategies (Suhanda & Pratami, 2021). Up to this point, the nursing staff has also shown commitment and acceptable levels of responsibility in their efforts to accomplish the project goals and the assigned duties. Various reports have also been generated so far, and the nursing staff has also fulfilled their responsibility of accepting to use the reports on the use and implementation of the new technology. Apart from the activities which the nurse staff was responsible for, there were also other activities that they were to be consulted such as in the effort sustenance due to the fact that they have experience working in the organization, some for a long time. They were also accountable for the completion and approval of various tasks, and they were also to be kept updated on some of the tasks. The nurse staff has so far shown commitment and responsibility regarding the tasks assigned as appropriate.

The allied health staff is another group of team members who were to play a significant role in the project to ensure the successful implementation of the small nursing informatics project. The allied health staff was responsible for various tasks, such as accepting to use the reports and implementation strategies. Therefore, they have been involved in various activities to ensure that appropriate implementation strategies are used in the project. The allied health staff has also accepted the use of reports generated so far.

The staff has shown an acceptable level of responsibility and commitment. The allied health staff also had major roles of being consulted due to their expertise and competence. Therefore, they have been consulted in activities such as the assessment of the feasibility of the EHR program which was selected, and in the identification of the multidisciplinary team to take part the addressing the proposed change. They also played this role appropriately; hence they have been responsible. There are also many tasks where the allied health staff were just to get updates and get informed; hence they did not have to take actions in such roles.

From the RACI chart, the other individual who was responsible for various tasks in the project was the medical officer. The medical officer, just like other members, was responsible for some tasks. For example, just like the allied health staff, the medical officer is responsible for accepting the use of the reports generated and the implementation strategies. The medical officer has accepted the use of the reports generated so far and has also been critical of ensuring the right strategies are used. As such, it can also be argued that the medical officer has also been responsible for the tasks assigned so far. The medical officer has also played a significant role at consulting level. The medical officer offered the needed advice on the assessment of the feasibility of the proposed program at the facility and in the identification of the multidisciplinary team to participate in the change effort or the change project. The medical officer has so far played the roles related to consultations well.

The other important team member, as documented in the RACI chart, is the nurse educator. The nurse educator was also expected to fulfill various responsibilities to help the team members achieve the project’s goals and objectives. The nurse educator was responsible for three major tasks or activities, including completing the assessment of compliance, piloting a report with adequate and accepting the use of reports, and implementation strategies. The nurse educator has also played a significant role in the project so far. Under the guidance of the project leader, the nurse educator successfully participated in completing the assessment of compliance. The nurse educator has also collaborated with the nurse leader to pilot a report with adequate data and ensure that the appropriate implementation strategies are used in the project. The nurse educator was also to be consulted by other personnel regarding the completion of various activities such as reviewing the reports on compliance, identification of a multidisciplinary team to address the change and assessing the feasibility of the project. The nurse educator has so far played these roles appropriately; hence it can be said that the nurse educator has been responsible.

The last team member as documented in the RACI chart is the nurse informaticist. As earlier indicated, this technology project was about a small nursing informatics project which focused on improving patient outcomes connected to patient discharge which has, for a long time led to poorer outcomes at the facility. Therefore, nurse informaticists play a significant role in this project. Therefore the nurse informaticist was assigned various roles that needed to be accomplished to support the implementation of the project. The role included research review and dissemination, and piloting reports with adequate data. The nurse informaticist has so far accomplished these roles as appropriate with a substantial sense of responsibility.

The informaticist was also to play an advisory role as they were to be consulted by other team members regarding the implementation of the project. Some of the roles where they were to be consulted include sustaining the change effort, assessment of the feasibility of the EHR program at the facility, and in identifying the multidisciplinary team to accomplish the proposed change. It is worth noting that the nurse informaticist has also diligently played these consultative roles as appropriate. Therefore, it can also be reported that the nurse informaticist has been responsible up to this point.

The level of responsibility shown by the team members was a show of a united group that is focused on achieving the formulated goals. All five staff members have so far collaborated with each other, be it in lead or reporting, or consulting roles. The implication is that the leadership style employed so far by the project leader has been successful in inspiring the team members to work towards common goals and ensure that the project is implemented as scheduled for success (Moran et al.,2019).

Project Expectations and Timeliness (Gantt Chart)

The small informatics project was designed to take a period or duration of six months, meaning that the various phases of the project should be completed within the scheduled time according to the timeline to ensure that the project meets its due date. The first phase of planning with its activities started on time. However, due to the delays experienced in obtaining and reviewing the compliance report, this phase ended two days late, which instilled some fear that the project may fail to meet the targets and be completed within the due date. The first phase was scheduled to take a total time of four weeks but was extended into week five. However, the lost time was recovered in the second phase. The second phase of the project, which is implementation, had various activities which were completed on time and as required. The phase entailed activities key to the project, and the time the project team also worked hard enough to ensure that they gained or recovered the time lost in the first phase of the project.

As part of the second phase, the project team accomplished various activities such as designing and developing the project (Moran et al.,2019). Therefore, the project team, as led by the project leader, performed various activities such as looking at the requirements of the project and developing the architecture needed; the team was able to introduce the electronic health records project into the organization and formulate various documents associated with it. Since the use of the new system may be a challenge to most users, the project team, led by the nurse educator undertook a training exercise where the individuals were taught and educated on how to interact with the new program’s user interface. This training was accomplished following a user training plan which was formulated earlier. The team, through the guidance of the project leader, was also able to appropriately monitor the implementation of the proposed projects. Therefore, through collaboration and hard work, the team members ensured that the second phase of the project was completed in time, even though it commenced two days late.

Since the second phase of the project was completed on time as was designed in the project timelines, the third phase commenced on time. The third phase of the project, as documented in the Work Breakdown Structure, entailed the evaluation of the project as a wider part of the implementation plan (Moran et al.,2019). In the evaluation phase, the project leader led the team members for the duration of the scheduled eight weeks to complete every activity associated with the phase. Some of the activities which were accomplished during this phase include reviewing the report on compliance, completing an assessment on compliance, providing support, and documentation of the lessons learned. This phase of the project was associated with the project’s completion and eventual closure.

The Gantt chart formulated in the previous section outlined the expected dates for starting the phases and ending the phases (Moran et al.,2019). Even though the phases could be broadly categorized into three, it is important to note that every section or phase had several other activities which had to be accomplished within the scheduled timeline. From the previous discussion, only the first phase did not end in time, even though it started in time. However, the lost time in the first phase was appropriately recovered in the second phase while also ensuring that the second phase ended in time as had been planned. Since the second phase obeyed the timelines, it was easy for the third phase to be started on time as was scheduled in the Gantt chart. Therefore, the last phase of the project which mainly entailed evaluation, also started on time as scheduled and was completed within the scheduled timeline.

The Weekly Status Meetings (Communication Plan)

Status meetings form a vital part of a project since through such meetings, the team members get to know the progress of the project and what needs to be adjusted to enhance the chances of the project succeeding (Kerzner, 2022). In addition, during the weekly status meetings in a question and answer session, the team members get an opportunity to inquire and ask about various project aspects that need clarification and explanation. Therefore, it is important that the project leader make appropriate arrangements for the weekly status meetings. The project leader sent a communication at the start of the project and indicated that the status meeting would be held every Friday morning. As communicated at that time, the major function of the weekly status meetings would be to offer a brief regarding the overall status of the project and ensure inquiring about what needs to be adjusted for the following week.

At every weekly status meeting, the status of the prevailing phase of the project would be discussed, and the project would always lead such discussions, or another person would perform the function if appointed by the project leader to do so. The first weekly status held was majorly about the planning phase, and the project leader communicated to the members by highlighting the status of the resource acquisition and a brief on the assessment results on the feasibility of the project on the facility. Again in this meeting, the project leader also discussed with the members of the multidisciplinary team identified to help in driving the proposed change project (Kerzner, 2022).

The other weekly status meeting during the first phase of the project also entailed information and discussion of the feedback obtained from the prospect of introducing the proposed electronic health records program at the health facility. As such, the weekly status meeting held for the first phase of the project was key in helping the team members have an idea regarding the planning of the project (Kerzner, 2022). It is also important to note that the project leader used the weekly meeting sessions to encourage every team member to accomplish their goals and fulfill their roles without looking to anyone for guidance. Inspiration and encouragement were key as members tried to always do better and better.

Every project requires appropriate and accurate documentation, as the information documented can be used as appropriate to improve various aspects of the project and for future reference (Kerzner, 2022). As such, it was decided that documentation become a key aspect of the project in general and the weekly status meetings. It is important to note that the project leaders have always spearheaded the documentation of various phases and the weekly status meetings. The project leader has been assigning various individuals on a need-to-need basis to formulate the required documentation. All three phases and associated activities have all been having documentation, and such documentation has been a key source of references and a resource for improving performance. Therefore, the planning, implementation, and evaluation phases and their associated activities all had their documentation.

Attending the weekly status meetings is vital since everyone gets to have a grasp of the update of the project, new communications, and the current project plans. It may not be enough to communicate to the absent members whatever has been discussed during the weekly status meeting, underlying the importance of attending the meetings as appropriate (Kerzner, 2022). Therefore, it is also important to evaluate if individuals have been attending the weekly status meeting as it should be. It is important to note that the project leader communicated to every team member at the beginning of the project why it would be key to attend the meetings. In addition, individuals had a weekly reminder to inform them of the following weekly status meetings, and they were encouraged to timeously send their apologies in case they would not make it to attend the meetings. The implication is that the strategies put in place acted as a source of the push for the team members to attend the status meetings. After the status meetings, the project leader would then follow up with emails, and everyone would be sent an email, irrespective of whether they attended the meeting or not to let them know of all that was discussed in the meeting. This ensured that there was adequate communication and connection between the team members and the project leader.

It is important to have a communication plan that can help drive the communication activities in the project. As such, the project leaders ensured that there were established communications channels which were then made active and two-way. This motivated the project team to feel part of the project and actively participate in the project as appropriate. As such, the communication plan which was formulated earlier was helpful in guiding the communication during the project implementation.

Approval and Documentation of Change (Change Management Plan)

This small nursing informatics project for the organization took the approach of a change process which led to the creation of a change management plan earlier in the project. As such, it is key to explore if every change was approved and documented (Kerzner, 2022). The change focused on using informatics to improve patient outcomes connected to patient discharge. The suggested changes impacted the system’s data and functionality. As such, the changes were allowed by the organization, and every stage of change was also documented for future reference.

 

Risk Identification, Prioritization, and Assignment of an Owner for the Development of a Mitigation Plan (Risk Management Plan)

The existence of risk can lead to the failure of project implementation if the risks are not identified, prioritized, and mitigated. Therefore, as part of the project, various risks were successfully identified. For example, it was noted that there could be a substantial risk to patient data security and privacy. The project depends on private patient data which must be protected from unauthorized access and theft. Patient data can also be a subject of illegal sharing, which may lead to the whole project violating the HIPPA rules and the established organizational guidelines (Mbonihankuye et al.,2019). Therefore, patient data needs to stay secure, private, and confidential. The implication is that appropriate mitigation plans should be formulated to help overcome such risks.

To fulfill their HIPAA responsibilities, healthcare providers must ensure that their patients’ personal information is kept private. Patients’ private information is protected from disclosure. Therefore, the EHR employs measures such as a firewall, system-wide phishing, and antivirus software applications to protect patient data from intrusion. The health informatics nurse has reported significant decreases in the use of social security numbers for patient identification (Morkisch et al., 2020). By its very nature, such a system will facilitate the spread of sensitive data. To prevent unauthorized access to patient information, it is recommended that the application used to view charts be closed when it is no longer in use. However, these precautions alone are not enough to guarantee the safety and privacy of patients’ records. This is because there are numerous parties involved, including patients, insurance providers, government agencies, pharmaceutical organizations, and others who may infringe upon patients’ right to privacy.

Summary and Lessons Learned

The purpose of this small nursing informatics project is to streamline the discharge decision making process by the interdisciplinary team utilizing data analytics at Riverside University Health System (RUHS). Therefore, the project focused on improving patient care outcomes related to discharge by enhancing discharge decisions and eliminating wrongful discharges. Therefore, the small nursing informatics project was implemented according to the major phases. The evaluation also forms a critical part of a project life cycle since, through it, the project team can establish whether the project’s goals and objectives have been met. It also helps to explore how efficacious the methods applied were. A complete evaluation will be possible when the results of the project are out. However, the process used in the phases has proved to be successful.

There were also lessons learned, what went well and what can be adjusted. Throughout the project, there was a harmonious collaboration between the team members, which led to a more effective way of implementing the project. Therefore, almost every activity was completed according to the scheduled timelines. However, some resistance was experienced among the stakeholders, who felt that the project would be costly and that there was no guarantee that it would work. The project manager took time and talked to the individuals to obtain their buy-in. A key lesson learned was that open and effective communication is key in any project, as the success of the project depends on it.

 

 

 

 

References

Abdilahi, S. M., Fakunle, F. F., & Fashina, A. A. (2020). Exploring the extent to which project scope management processes influence the implementation of telecommunication projects. PM World Journal, IX9(5), 1-17.

Ford, D. N., & Lyneis, J. M. (2020). System dynamics applied to project management: a survey, assessment, and directions for future research. System Dynamics: Theory and Applications, 285-314. https://doi.org/10.1007/978-1-4939-8790-0_658

Jeanmonod, D., & Jeanmonod, R. (2018). Overcrowding in the emergency department and patient safety. Vignettes In Patient Safety2, 257.

Mbonihankuye, S., Nkunzimana, A., & Ndagijimana, A. (2019). Healthcare data security technology: HIPAA compliance. Wireless Communications and Mobile Computing2019, 1-7. https://doi.org/10.1155/2019/1927495

Moran, K. J., Burson, R., & Conrad, D. (2019). The doctor of nursing practice project. Jones & Bartlett Learning.

Morkisch, N., Upegui-Arango, L. D., Cardona, M. I., van den Heuvel, D., Rimmele, M., Sieber, C. C., & Freiberger, E. (2020). Components of the transitional care model (TCM) to reduce readmission in geriatric patients: A systematic review. BMC geriatrics20(1), 1-18. https://doi.org/10.1186/s12877-020-01747-w

Müller, R., Drouin, N., & Sankaran, S. (2019). Modeling organizational project management. Project Management Journal50(4), 499-513. https://doi.org/10.1177/8756972819847876

Kerzner, H. (2022). Project management case studies. John Wiley & Sons.

Skivington, K., Matthews, L., Simpson, S. A., Craig, P., Baird, J., Blazeby, J. M., … & Moore, L. (2021). Framework for the development and evaluation of complex interventions: gap analysis, workshop, and consultation-informed update. https://doi.org/10.3310/hta25570

Suhanda, R. D. P., & Pratami, D. (2021). RACI matrix design for managing stakeholders in project case study of PT. XYZ. International Journal of Innovation in Enterprise System5(02), 122-133. https://doi.org/10.25124/ijies.v5i02.134

Wells, S., Tamir, O., Gray, J., Naidoo, D., Bekhit, M., & Goldmann, D. (2018). Are quality improvement collaboratives effective? A systematic review. BMJ Quality & Safety27(3), 226-240. http://dx.doi.org/10.1136/bmjqs-2017-006926

 

 

 

 

 

 

 

 

 

 

Appendix

Appendix I – SWOT Analysis

Appendix II – Scope

Appendix III – Charter

Appendix IV – Gap Analysis

Appendix V – Work Breakdown Structure

Appendix VI – Gantt Chart

Appendix VII – RACI Chart

Appendix VIII – Communication Plan

Appendix IX – Change Management Plan

Appendix X – Risk Management Plan

 

 

 

 

 

 

 

 

 

 

 

 

 

I – SWOT Analysis

Strengths (S) Weaknesses (W) Opportunities (O) Threats (T)
·         The facility’s revenue will increase, and its growth will be accelerated by the implementation of EHR. Additionally, it will increase health satisfaction and help care teams to make effective discharge decisions.

 

·         EHR – Clinical Analytics enables the tracking of treatment within the organization. As such, the effectiveness of the treatment and discharge can be achieved.

 

·         The system will deliver highly accurate risk stratifications and operationalize them to enhance discharge planning with data-driven recommendations personalized for every patient.

  • EHR-Clinical Analytics project supports information sharing between the medical team, the patients, and their surrogates. This improves the provision of care as treatment plans are shared with members of the family. Besides, the system allows the reconciliation of medication tools, and this prevents errors that arise from the use of wrong medications upon discharge (Morkisch et al., 2020).

 

·         Updating the existing EHR to include clinical analytics may cause a loss of both existing and new data and this can alter the effectiveness of the system.

 

·         Finances can be lost due to failure to track the lost data.

 

·         The required update can cause financial chaos. It can encounter technical interruptions leading to delays in the payments of individual therapists. Thus, the health record department can be forced to use third parties in making payments to their staff.

·         To improve the facility’s and the EHR’s efficacy and efficiency. Possibility to foster the development and proficiency of a data-driven discharge decision process. ·         The other competitors will have more patients and employees because of the subpar standardization of the nursing informatics patient discharge process. Consequently, ineffective discharge decision-making could lead to the organization’s financial woes and the failure of its aims.

 

 

 

 

 

 

 

 

II – Scope

PROJECT SCOPE
PROJECT NAME Use of Data Analytics to Improve Discharge Decisions at Riverside University Health System – Arlington Campus
MISSION STATEMENT The system will help the care team to better predict when to release patients and how to best manage their post-discharge care by organizing discharge planning on precise patient risk stratifications.
MEASURABLE OBJECTIVES Thorough risk analysis that empowers care teams to make data-driven choices regarding additional clinical tests, follow-up appointments, check-ins to ensure adherence to lifestyle changes, choosing the best aftercare facilities, or deciding whether the patient isn’t ready for transfer and extending their hospital stay is the goal of the project.
JUSTIFICATION An in-depth clinical data analysis in risk predictions is required to make effective discharge decisions for patients. This will allow the care team to consider variables such as the likelihood that a patient will be readmitted within the next 30 days as well as the estimated cost or length of readmission.
IMPLEMENTATION STRATEGY A Clinical Analytics system build on a cloud system with the capability to vertically integrate advanced analytics platforms for healthcare
MEASURE OF SUCCESS ·         System must be able to predict and track patient data efficiently

·         System must be able to effectively stratify patients into highly accurate risk categories

·         System must be able to integrate highly accurate readmission analysis with precise cost and length of stay predictions.

 

 

 

 

 

III – Charter

PROJECT CHARTER
PROJECT NAME Using Data to Improve Discharge Decisions
PROJECT DESCRIPTION/PURPOSE The purpose of this small nursing informatics project is to streamline the discharge decisions making process by the interdisciplinary team utilizing data analytics at Riverside University Health System (RUHS).
PROJECT STAKEHOLDERS ·         Psychiatrists

·         Nurse Leaders/Management (Chief Nursing Officer, Nurse Managers, Charge Nurses)

·         Staff Nurses

·         Nurse Educators

·         Case Managers and Social Workers.

·         IT

PROJECT OBJECTIVES ·         Increase the organization’s revenue by reducing the Length of Stay (LoS) and re-admission rate.

·         To enhance discharge planning with data-driven recommendations that are personalized for every patient.

·         Increase health satisfaction and help the care team to make effective discharge decisions.

PROJECT TIMELINE 6 Months

 

 

 

 

 

 

 

 

IV – Gap Analysis

  Risk Severity
NEGLIGIBLE

Small/unimportant; not likely to have a major effect on the operation of the event

MARGINAL

Minimal importance; has an effect on the operation of the event but will not affect the event outcome

CRITICAL

Serious/important; will affect the operation of the event in a negative way

CATASTROPHIC

Maximum importance; WILL affect the operation of the event in a negative way

Probability

 

 

 

LOW

This risk has rarely been a problem and never occurred

LOW (2) MEDIUM (3)

 

MEDIUM (6) HIGH (9)
MEDIUM

The risk will MOST LIKELY occur at this event

LOW (2) MEDIUM (7) HIGH (9) EXTREME (11)

 

HIGH

The risk WILL occur at this event, possibly multiple times, and has occurred in the past

MEDIUM (3) HIGH (8) HIGH (10) EXTREME (12)

 

V – Work Breakdown Structure

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VI – Gantt Chart

Implementation Steps Estimated Duration 
Assessment of the feasibility of the EHR program at the selected facility 1 week of 1st month
Identification of a multidisciplinary team to address the anticipated change 2 weeks
Introduction of the EHR program at the health facility 2 weeks
Review of Reports on Compliance 1 week
Complete assessment of compliance 2 weeks
Pilot a report with adequate data 3rd Month
Validate Data 3rd Month
Accept to use reports/implementation strategies 3rd Month
Create Report Strategies 3rd Month
Ensure Implementation of Strategies are carried out 4th month
Development of a Plan for the Implementation of new strategies at the hospital 5th Month
Monitor Implementation 5th Month
Review EHR Program As required
Sustain the Effort 6th Month

 

 

 

 

 

 

VII – RACI Chart

  ROLES  
Roles & Responsibilities Matrix

 

 

Leader

 

Nursing Staff

 

Allied Health Staff

 

Medical Officer

 

Nurse Educator

 

Nurse Informaticist

 
Assessment of the feasibility of the EHR program at the selected facility R C C C C C  
Identification of a multidisciplinary team to address the anticipated change R A C C C C C  
Introduction of the EHR program at the health facility R A I I I I I  
Review of Reports on Compliance R A I I I C I  
Research Review & Dissemination I I I I I R A  
Complete assessment of compliance R I I I R A I  
Pilot a report with adequate data C I I I C I R A R A  
Validate Data R A I I I I I  
Accept to use reports/implementation strategies A R R R R I  
Create Report Strategies R A I I I I I  
Ensure Implementation of Strategies are carried out R A I I I I I  
Development of a Plan for the Implementation of new strategies at the hospital R A I I I C I I
Monitor implementation of new strategies at the hospital R A I I I I I  
Monitor Implementation R A I I I I I  
Review EHR Program R A     C I      
Sustain the Effort R A C I C I C I C I C I  
R = Responsible for completion of task or deliverable  
A = Accountable for completion and approval of the task  
C = Consulted by those responsible for advice and expertise  
I = Kept updated on progress and notified when tasks are completed.  

VIII – Communication Plan

Communication is an integral aspect of the success of a given project as it provides the fuel for the effective management of programs. Based on this premise, the adoption of EHR at RUHS will include a communication plan in order to fast-track project activities (Spatar et al., 2019). An approach in the management of communication in the facility varies on three considerations. The first aspect inclines to the people who need to be informed about the project activities. In the dissemination of information about the EHR, priority in communication will be given to the top executives and project sponsors (Fraczkowski, Matson & Lopez, 2020). The group owns the project and every activity undertaken by the organization need to be concisely addressed to these senior stakeholders. Team members and employees are as well informed about the project so that they own up program activities to realize intended outcomes.

The second perspective of communication fate inclines to the type of information to be communicated to the stakeholders. The RUHS’s top executives will be informed about the status of the project in terms of finances in addition to variances in program cost and time (Vichitkraivin & Naenna, 2021). Functional managers, on the other hand, will need to know information about employees, project schedules and time so as to establish accountability. However, details about communication demands will not only be achieved through the recording of meetings and progress notes but also through assessing problems and the success of RUHS’s EHR program activities.

However, communication at the facility will also take into account the schedule matrix in terms of the right time to disseminate information. Essentially, daily, weekly, bi-weekly, and monthly communication will be achieved based on project conditions and the urgency of programs for Mercy Medical Center. Memos will be sent weekly to constantly remind employees and other stakeholders about their role in ensuring that the facility realizes its intended goals.

 IX – Change Management Plan

Change management in the healthcare sector presents a host of challenges to professionals due to complexities in handling the entire process. And yet even better frameworks may be implemented, and organizational changes can culminate in confusion, insecurities, and anger among healthcare professionals. Nursing leaders at RUHS are therefore challenged to use their competencies to implement changes that do not inculcate negativism, disinterest, and stagnation to jeopardize the progress of the facility. While many organizations vouch for the benefits of planning to guide practice, nurse leaders are challenged not to look at the superficial aspects of the planning process (Spatar et al., 2019). An aspect of consideration for nurse leaders is to implement strategic planning which entails a systematic and organized process to address both the current and future progress of RUHS. While strategic planning is expensive and has the potential to uncover hidden conflicts, it establishes an explicit framework for organizational development. Most importantly, it encourages participation and professional commitment within the continuum of care. However, as a nurse leader, strategic planning in change management involves sharing the vision with all the stakeholders and demonstrating effective leadership toward the goal. Even though unintended challenges can impede the change, the nurse leader is obliged to establish organizational strategies to manage the obstacles and develop suitable initiatives to deal with resistors (Fraczkowski, Matson & Lopez, 2020). Most importantly, the development of team culture and empowerment of professionals foster a suitable environment for change implementation at RUHS.  Clinicians, middle managers, nurses, and other cadres of health need to be involved not only in the change formulation but in the entire approach of implementation.

At RUHS, change management will be initiated by the lead nurse manager within the facility. The management strategy will take into account the aspect of a team approach in care and facilitated communication in the preliminary implementation plan (Vichitkraivin & Naenna, 2021).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

X – Risk Management Plan

One of the notable aspects of the EHRs system is security. In ensuring the safety to the information disseminated in the EHRs, the nurse leader identifies various security protocols. To protect the information on patients the facility enforces all the regulations defined by the HIPAA (Sarabdeen. and Moonesar, .2018). The HIPAA obligations require that privacy protections of information about the patients are guaranteed. Disclosure of data about the patients is restricted. Accordingly, the EHR uses a firewall, system-wide phishing, and antivirus software applications to restrict unauthorized access to patient information. Considerably, the health informatics nurse reports on the lack of use of SS numbers to identify patients (Morkisch et al., 2020). The use of such a system will encourage information leakage. Intrinsically, all users using the patient charts are advised to close the application when not in use to limit unauthorized access. Despite these measures, maintaining the security and integrity of patients’ information remains a challenge. This is due to the presence of various stakeholders such as insurance companies, governments as well as pharmaceutical agencies, and patients who may violate the privacy protocols of the patients.

 

 

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