Einbinder / Einbiner / Lorenzi Transforming Health Care Through Information: Case Studies

3rd Auflage 2010
ISBN: 978-1-4419-0269-6
Verlag: Springer US
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 196 Seiten

Reihe: Health Informatics

With the growth of information and focus on Healthcare Informatics, there remains an interest in case studies. In the current field of Health Informatics there is no text that uses case studies to explain the difficulties that occur. . Edited by specialists in the field of Health Informatics, the third edition of Transforming Healthcare Through Information: Case Studies builds upon the specific examples of case studies to exemplify the various phases of introducing technological advancements into healthcare institutions. The new edition includes a section on how to implement Link2care, a system that will allow caregivers of ill patients, to seek reliable and informative online information and support. In addition the cases will be framed under new sections with discussion on new topics in the area of healthcare technology such as quality data management and knowledge management. The case studies described in the third edition will benefit not only the practicing professional but also the instructor and student studying in the field of health informatics.

Nancy Lorenzi, PhD, is a professor of Biomedical Informatics and Assistant Vice Chancellor for Health Affairs at Vanderbilt University Medical Center, Nashville, Tennessee. Joan S. Ash, PhD, is a professor of Medical Informatics and Outcomes Research at the Oregon Health and Science University Medical School, Portland Oregon. Jonathan Einbinder, MD, MPH is Corporate Manager in Quality Data Management at Partners Healthcare System, Wellesley, Massachusetts. Cindy Gadd, PhD is a professor in Informatics at the Vanderbilt University Medical Center, Nashville, Tennessee. Laura Einbinder, MBA is a Consultant at Einbinder & Associates in Medfield, Massachusetts.

Autoren/Hrsg.

Einbiner, Laura

Einbinder, Laura

Lorenzi, Nancy M.

Ash, Joan

Gadd, Cynthia S.

Einbinder, Jonathan

Inhaltsverzeichnis

1;Foreword;6
2;Series Preface;8
3;Acknowledgments;10
4;Contents;11
5;Contributors;13
6;Managing Change;20
7;Back Breaking Work: Implementing a Spine Registry in an Orthopedic Clinic;24
7.1;Background;24
7.2;Implementation;25
7.3;Questions;29
7.4;Epilog;29
7.5;References;30
8;A RHIO Struggling to Form: Will it Get Off the Ground?;31
8.1;Introduction;31
8.2;Organizational Background;32
8.3;Viewpoints;34
8.4;Focus of the Case;38
8.5;Summary;39
8.6;Case Analysis;39
8.6.1;Politics;39
8.6.2;Power;40
8.6.2.1;Stakeholders Satisfaction and Retention;40
8.6.3;Strategic Planning;40
8.6.4;Trust;40
8.6.5;Change Management;41
8.6.6;Leadership;41
8.6.7;Culture;41
8.6.8;Project Management;41
8.6.9;Virtual Teams;41
8.6.10;Communication;42
8.6.11;Motivation;42
8.6.12;Groups vs. Teams;42
8.6.13;Question;43
9;A Rough Ride at the Theodore Roosevelt Cancer Center;44
9.1;Introduction;44
9.2;Organizational History/Background;45
9.3;IT Structure;45
9.4;Focus of the Case;46
9.5;Clinical System Vendor Selection;46
9.5.1;Phase I Implementation: User Resistance and Impact on Phase II;47
9.6;Nursing Documentation – Use of Consultants and Goals/Objectives;49
9.7;Nursing Documentation – Teams, Training, and Implementation Support;49
9.8;Postimplementation Issues;50
9.9;TRCC Evaluation and Project Closing Document;51
9.9.1;Unique Needs of a Cancer Center System;51
9.9.2;Stakeholders’ Points of View – Where Do We Go from Here?;52
9.10;Question;53
9.11;Analysis of Issues and Recommendations;53
9.11.1;Communication Gaps – User Satisfaction Issues;53
9.11.1.1;Recommendations;54
9.11.2;Top-Down Leadership and Decision-Making;55
9.11.2.1;Recommendations;55
9.11.3;Lack of a Unified Vision and Consistently Communicated Motivational Goals;55
9.11.3.1;Recommendations;55
9.11.4;Workflow Redesign and Training Issues Associated with the CDS;56
9.11.4.1;Recommendations;56
9.11.5;Technical Issues with Visionex;56
9.11.5.1;Recommendations;57
9.11.6;Managing Resistance to Change;57
9.11.6.1;Recommendations;57
9.12;Conclusion;57
9.13;Question;58
9.14;References;58
10;Implementation of an Electronic Prescription Writer in Ambulatory Care;61
10.1;Background;61
10.1.1;The OMC Environment;61
10.1.2;OMC Strategic Plan Prioritized ‘Patient Safety First’;61
10.2;RxWriter’s Stakeholders and Team Organization;61
10.3;RxWriter Implementation;63
10.3.1;RxWriter’s Infrastructure and Dependencies;63
10.3.2;Major Features and Accomplishments RxWriter Already Applied;64
10.3.3;Workflow Integration Features;64
10.4;RxWriter Implementation Challenges;65
10.5;Technical Challenges;66
10.6;Political Challenges;67
10.7;Options;67
10.8;Questions;69
10.9;References;69
11;Online Health Care: A Classic Clash of Technology, People, and Processes;71
11.1;Introduction;71
11.2;Initiating and Evaluating Change;73
11.3;Evaluating Change;73
11.4;Initiating Change;74
11.5;Individual Response to Change;74
11.6;Motivation and Role Ambiguity;76
11.7;Change Management;77
11.8;Management and Leadership;79
11.9;Strategic Planning for FutureCare;80
11.10;References;81
12;A Dungeon of Dangerous Practices;86
12.1;Background: A Harmful Event;87
12.2;Organizational Overview;87
12.3;Information Systems Overview;89
12.4;The Problem;90
12.5;Main Issues;91
12.6;Options with Pros and Cons;92
12.6.1;Option 1;92
12.6.1.1;Pros;92
12.6.1.2;Cons;92
12.6.2;Option 2;92
12.6.2.1;Pros;92
12.6.2.2;Cons;92
12.6.3;Option 3;93
12.6.3.1;Pros;93
12.6.3.2;Cons;93
12.6.4;Option 4;93
12.6.4.1;Pros;93
12.6.4.2;Cons;93
12.7;Question;93
12.8;Key Stakeholders for BPOC Planning and Implementation;94
13;Different Sides of the Story;95
13.1;Introduction;95
13.2;The Location;95
13.3;The Actors;95
13.4;The Story;96
13.5;Summary/Questions;96
13.6;References;96
14;Barcode Medication Administration Implementation in the FIAT Health System;97
14.1;Introduction;97
14.2;Methods;98
14.3;Results;99
14.3.1;BCMA Readiness Survey Results;99
14.3.2;Nursing Survey Results;100
14.3.3;Cross-Survey Results;100
14.4;Analysis and Recommendations;101
14.4.1;Strategic Planning;101
14.4.2;Leadership – Integration of the Clinical and Technological Aspects;102
14.5;Recommendations Regarding Leadership;103
14.5.1;Project Management;104
14.5.2;Introduction of Technology into Workflow;105
14.5.3;Culture of Change;106
14.6;Conclusion;107
14.7;References;108
15;H.I.T. or Miss;109
15.1;Emily’s Story;109
15.2;Joanna’s Story;110
15.3;Jim’s Story;111
15.4;Conclusion;112
16;The Implementation of Secure Messaging;118
16.1;Background;119
16.2;Project Planning Stage;119
16.3;User Interface Issues;120
16.4;Policy Issue;122
16.5;Security Issue;122
16.6;Rolling Out to Clinics;123
16.7;Conclusion;124
16.8;Questions;125
16.9;References;125
17;Who Moved My Clinic? Donnelly University Pediatric Rehabilitation: The Wheelchair Clinic;126
17.1;Introduction to Children’s Hospital Pediatric Rehabilitation;126
17.1.1;Background;126
17.1.2;Mission and Goals;126
17.1.3;Available Resources and Services Provided;126
17.2;The Katie Darnell Wheelchair Clinic;127
17.2.1;Introduction;127
17.2.2;Background;127
17.2.3;Wheelchair Ordering Process;128
17.2.4;Patients of the Wheelchair Clinic;131
17.2.5;Change in Location;132
17.2.6;Technology Available;133
17.2.7;Amenities Provided;134
17.3;Team Communication;134
17.3.1;Vendor Representative-Therapist Relationship;134
17.3.2;Therapist-Therapist Relationship;135
17.4;Conclusion;135
17.5;Questions;136
17.6;References;136
18;OncoOrders: The Early Years;137
18.1;Introduction to OncoOrders;137
18.2;Background;137
18.3;Funding;139
18.4;The Whiteboard;140
18.5;Order Assistant;141
18.6;Evaluation;142
18.7;Questions;143
19;Implementing a Computerized Triage System in the Emergency Department;144
19.1;Introduction;144
19.2;The Institution and IT Environment;145
19.3;Triage Basics;146
19.4;Paper-Based Triage Process;147
19.5;Initial Triage IT Development;150
19.5.1;Quill;151
19.5.2;WizOrder;152
19.6;Designing the Current System;153
19.6.1;Analysis of Implementation Aspects;158
19.7;System Evaluation;159
19.7.1;Discussion;159
19.8;References;161
20;Medication Barcode Scanning: Code “Moo”: Dead COW;163
20.1;Introduction;163
20.2;Project Overview;164
20.3;Workstation Deployment and Support;164
20.3.1;Assessment of Needs for the BCMA Project;164
20.4;Procurement;165
20.4.1;Assembly and Deployment;165
20.4.2;Implementation Surprises;165
20.5;Batteries;165
20.6;Scanners;166
20.7;Volume of Equipment;167
20.8;Budget Freeze;167
20.8.1;The Cumulative Effect;168
20.9;Questions;168
21;Project NEED: New Efficiency in an Emergency Department;173
21.1;Introduction;173
21.2;The Pediatric Emergency Department;173
21.3;Case Study Site;174
21.4;Methodology;175
21.5;Results and Discussion;175
21.6;Staff Perceptions Regarding Efficiency and Length of Stay (LOS);176
21.7;Staff Perceptions Regarding New Triage System and New CIS;176
21.8;Staff Perceptions on Bottlenecks;176
21.8.1;Doctors;177
21.8.2;Gathering Laboratory Results;177
21.8.3;Putting Patients in Examination Rooms;177
21.9;Staff Perceptions on Hospital Admissions;178
21.10;Staff Perceptions on Areas for Improvement;178
21.11;Clinical Decision Support Tools;178
21.11.1;Web Based Tools;178
21.11.2;Personalized Order Sets and Prescriptions;179
21.11.3;Management Systems with Robust Patient Tracking;179
21.11.4;Linking CIS with Other Systems;180
21.12;Integrated Laboratory Results;180
21.13;Recommendations;181
21.14;References;182
22;Digital Radiology Divide at McKinly;184
22.1;Background;184
22.2;PACS Overview;185
22.3;Workflow Changes;187
22.4;Motivation;189
22.5;McKinly’s Dilemma;191
22.6;Case Analysis and Conclusions;191
22.7;Question;193
22.8;References;193
23;Index;195