Policy Change Proposal and Implementation Guide
Introduction
Through a dashboard metrics evaluation previously carried out on Mercy Medical Centre, the study was able to bring to light “documentation errors” as an underperforming benchmark in the health facility but with the potential of improving. If adequate attention is directed towards improving this benchmark, then this will definitely result in a widespread positive impact on the health facility’s overall goal of efficient service delivery to its patients. Fortunately, qualitative research was able to bring forth a solution to documentation errors in the medical field. The adoption of electronic medical records (EMR) will buy a milestone do away with documentation errors that often result from the trust of paper records by most physicians. This paper should act as a guide to the affected health facilities on how to effectively integrate this record-keeping method in their operations without causing any disruptions to the normal day to day operations.
The need for creating an organizational policy to address a shortfall in meeting proper documentation practice
The shortfalls an organization faces in meeting proper documentation practice
In order to address documentation errors, health facilities need to adopt the use of electronic medical records (EMR). However, to be able to adjust to this new way of keeping records, a health facility is faced with numerous challenges. They include; the initial financial expenses in purchasing this EMR equipment and the work time spent by physicians to learn about these new machines. The adoption of EMR will incur an organization’s quite a good amount of money from purchasing costs to installation costs to costs in hiring guide tutors if there will a need to do so. Also, the time physicians are supposed to be working, part of it will be spent on learning about these machines.
Why is an organizational policy needed?
A policy will help in the decision-making process, and the management is able to have a breakdown of the costs and benefits of adopting this new record-keeping technique and, on the other hand, the costs and benefits of staying with the old method of record keeping. With a policy in place. the health facilities have a guide to help in implementing this proposed new solution while being aware of the consequences, so the stakeholders are prepared to find solutions to the shortfalls arising due to the needed change.
The costs and benefits of adopting the use of EMR
Just like any other new venture Electronic Medical Records (EMR) comes with higher opening costs. The organization has to spend money and other resources like time in purchasing this EMR machines. The worktime opportunity cost factor incurred by the physician will also be a charge to the organization, as some of the time needed to be working is forgone and spent on learning about the use of these new machines. Since the adoption won’t be an overnight success, benefits show up at a slower rate as the medical officers horn their skills on the use of the machines in their daily record-keeping practices (Miller et al. 2004). The benefits of adopting EMR method is that the record backlog problems experienced by the reorganization will be contained. The EMR will help ease the upload of records and also ease access when needed. This will keep the organization ahead in the game as secondary errors that are bred by a lack of proper record systems will be solved.
The costs and benefits of staying with the old method of record-keeping
The management decision of not adopting the EMR as a record-keeping method means that still the health facility will still be faced by their old challenges associated with not having proper medical record-keeping habits. The secondary problems emanating from inconsistent records will still haunt the organization as well. Alternately, this decision will benefit the organization as no extra cost will be incurred since the management didn’t opt for a new way of documentation.
Ethical, evidence-based strategy to solve documentation errors
According to the World Health Organization (WHO), the United Kingdom recorded over 10% of prescription errors in one year. A similar study carried out in Sweden revealed that there was a medical error rate close to 45%, with 67% of the cases linked to prescription errors (WHO 2016). In its declaration, a lack of clarity in patients’ records within health facilities was the problem. This documentation problem can be solved by an evidence-based approach. It adopts four major implementation procedures that are awareness creation about the new approach, educating people about the program and encouraging them to stay committed, championing for participants to pro-actively take action as an adjusting method and finally the pursue of the program being blended and sustainability stands taken to ensure the programs stay (Cullen et al. 2012).Still, there is uncertainty about the return on investment, but at least it will offer a solution in the long run.
Potential effects of environmental factors on the evidence-based strategy
A potential environmental factor effect would be some physicians proving resistance to fully use the EMR machine but instead be hoping between EMR and paper records (Miller et al. 2004). This will be a problem with the evidence-based process of implementing this method. For the documentation problem to address, EMR should be used solely as the record-keeping tool. As a remedy, the managers should come up with a way of implementing the EMR method that’s enjoyable to the physicians. The use of incentives should also be used to help the process be a success. Incentives can be in the form of financial rewards and public recognition great of best performers (Cullen et al. 2012).
A brief, succinct policy and guidelines to aid the team in implementing the strategy
To realize success, the organization should implement the strategy in consideration of the organization’s ethics. Stakeholders should be consulted to ensure the program runs smoothly. In this case, the management, the physicians, and the financial team should all be in agreement about adopting the method. This will address any ethical conflict arising as the values of all the parties will be put into consideration. As suggested by William Nelson PhD, adopting a bureaucratic justice approach will calm the ethics conflicts (2005).
Back to the evidence-based approach; Awareness creation of the EMR can adopt methods like educating physicians about the advantages EMR has over the paper recording system plus continuously educating them on how to operate the machine. The second evidence-based approach would be to ensure the knowledge base is increasing, and the physicians are committing to the use of the machines. This can be achieved through the filing of the education gaps that come up in the implementation process. The third approach is to endorse action and the integration of the EMR through setting reminders and promoting skill competence by rewarding the best players. The fourth approach is to champion EMR integration and sustained use through peer inspiration and regular celebrating of department achievements (Cullen et al. 2012).
Stakeholders groups to be involved in further development and implementation of the proposed strategy
For the EMR method of record-keeping to be a success, stakeholders need to collaborate in evaluating possible adversaries that the lack of equipment might cause to the organization. For instance, in the case of an emergency, a team unable to attend to an emergency due to lack of proper facilities means they are not adhering to the state CMS Emergency preparedness rules set (Cascardo 2017). Since everyone knows the adversaries of using an outdated method, they will join hands to ensure that the new documentation method becomes a success. The parties involved, from top health facility management to individual physicians will own up the responsibility of making sure that the EMR becomes an accomplishment.
Conclusion
To solve medical documentation errors, the adoption of Electronic Medical Records (EMR) will be a great intervention. Besides the challenges involved in its implementation, with a proper proposal and implementation guidelines in place will surely make it less of a hassle. Solving medical documentation errors will cut down the consequential errors like misdiagnosis and inappropriate prescriptions. This will ensure efficient service delivery to patients while observing ethics and health facilities policies set by the state; this builds a good reputation for healthcare facilities.
References
Cascado, D. (2017). Preparing to Meet the New CMS Emergency Preparedness Rule
Cullen, L. Adams S. L., PhD. (2012). Planning for Implementation of Evidence-Based Practice, Volume 42, Number 4, pp 222-230
Miller, R. H. & Sim, I. (2004). Physicians’ Use of Electronic Medical Records: Barriers and Solutions
Nelson, W. A. Ph.D. (2005). An Organizational Ethics Decision-Making Process
World Health Organization. (2016). Medication Errors, Technical Series on Safer Primary Care