Monday, November 2, 2009: 3:50 PM
Christina A. Kasprisin, EdD, RN
Nursing, University of Vermont, Burlington, VT
Ann Laramee, MS, APRN
Nursing and Cardiology, Fletcher Allen Health Care, Burlington, VT
Marcia Bosek, DNSc, RN
Clinical Ethics, Fletcher Allen Health Care, Burlington, VT
Terry Powers-Phaneuf, BSN, CRRN
Nursing, Fletcher Allen Health Care, Burlington, VT
Learning Objective 1: Discuss use of focus groups as a methodology to identify barriers and facilitators in organizations.
Learning Objective 2: Explain strategies that facilitate implementation of an Electronic Health Record.
The Institute of Medicine reports offer rich evidence that improved clinical efficiencies, patient safety, and quality care outcomes can be promoted by having an effectively structured and implemented Electronic Health Record (EHR). One reason technological innovations fail is due to a lack of attention given to how technological changes will affect the organization. It is imperative that any organization planning such an undertaking ensures that adequate attention is given to identifying the present state of operations and to determine what future work flow processes’ improvements can be made.The transition from mostly paper processes to a fully computerized electronic process is a complex endeavor. In our institution, two patient care areas had successfully implemented an EHR. The Evidenced Based Practice Group designed a study to understand the processes surrounding the prior implementations. The goal was to identify factors that lead to successful implementation and the approach taken to overcome barriers, address expectations, quell fears, and create positive attitudes and perceptions.
A combination of qualitative and quantitative research design was used. Twelve focus groups were held with early implementers. Four themes were identified and validated with surveys sent to the participants. Themes uncovered: “It will take one hundred charts” slogan participants used to realistically communicate expectations. Self-discovery, that each employee needs to be encouraged and facilitated in their individual pursuit of learning about the EHR. Clear processes for using the EHR need to be communicated to prevent “workarounds”. Make the EHR Support a Customer Focused Service.
Following the identification of themes from the focus groups of the early implementers, meetings were held with the EHR leadership team. The themes and recommendations derived from the focus groups provided additional strategies to facilitate the implementation of an institution wide EHR.
Important lessons were learned from within.
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