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Transforming Health Care Through Information: Case Studies.
von: Laura Einbiner
Springer-Verlag, 2009
ISBN: 9781441902696, 199 Seiten
3. Auflage
Format: PDF, OL
Kopierschutz: DRM
Foreword
6
Series Preface
8
Acknowledgments
10
Contents
11
Contributors
13
Managing Change
20
Back Breaking Work: Implementing a Spine Registry in an Orthopedic Clinic
24
Background
24
Implementation
25
Questions
29
Epilog
29
References
30
A RHIO Struggling to Form: Will it Get Off the Ground?
31
Introduction
31
Organizational Background
32
Viewpoints
34
Focus of the Case
38
Summary
39
Case Analysis
39
Politics
39
Power
40
Stakeholders Satisfaction and Retention
40
Strategic Planning
40
Trust
40
Change Management
41
Leadership
41
Culture
41
Project Management
41
Virtual Teams
41
Communication
42
Motivation
42
Groups vs. Teams
42
Question
43
A Rough Ride at the Theodore Roosevelt Cancer Center
44
Introduction
44
Organizational History/Background
45
IT Structure
45
Focus of the Case
46
Clinical System Vendor Selection
46
Phase I Implementation: User Resistance and Impact on Phase II
47
Nursing Documentation – Use of Consultants and Goals/Objectives
49
Nursing Documentation – Teams, Training, and Implementation Support
49
Postimplementation Issues
50
TRCC Evaluation and Project Closing Document
51
Unique Needs of a Cancer Center System
51
Stakeholders’ Points of View – Where Do We Go from Here?
52
Question
53
Analysis of Issues and Recommendations
53
Communication Gaps – User Satisfaction Issues
53
Recommendations
54
Top-Down Leadership and Decision-Making
55
Recommendations
55
Lack of a Unified Vision and Consistently Communicated Motivational Goals
55
Recommendations
55
Workflow Redesign and Training Issues Associated with the CDS
56
Recommendations
56
Technical Issues with Visionex
56
Recommendations
57
Managing Resistance to Change
57
Recommendations
57
Conclusion
57
Question
58
References
58
Implementation of an Electronic Prescription Writer in Ambulatory Care
61
Background
61
The OMC Environment
61
OMC Strategic Plan Prioritized ‘Patient Safety First&rsquo
61
RxWriter’s Stakeholders and Team Organization
61
RxWriter Implementation
63
RxWriter’s Infrastructure and Dependencies
63
Major Features and Accomplishments RxWriter Already Applied
64
Workflow Integration Features
64
RxWriter Implementation Challenges
65
Technical Challenges
66
Political Challenges
67
Options
67
Questions
69
References
69
Online Health Care: A Classic Clash of Technology, People, and Processes
71
Introduction
71
Initiating and Evaluating Change
73
Evaluating Change
73
Initiating Change
74
Individual Response to Change
74
Motivation and Role Ambiguity
76
Change Management
77
Management and Leadership
79
Strategic Planning for FutureCare
80
References
81
A Dungeon of Dangerous Practices
86
Background: A Harmful Event
87
Organizational Overview
87
Information Systems Overview
89
The Problem
90
Main Issues
91
Options with Pros and Cons
92
Option 1
92
Pros
92
Cons
92
Option 2
92
Pros
92
Cons
92
Option 3
93
Pros
93
Cons
93
Option 4
93
Pros
93
Cons
93
Question
93
Key Stakeholders for BPOC Planning and Implementation
94
Different Sides of the Story
95
Introduction
95
The Location
95
The Actors
95
The Story
96
Summary/Questions
96
References
96
Barcode Medication Administration Implementation in the FIAT Health System
97
Introduction
97
Methods
98
Results
99
BCMA Readiness Survey Results
99
Nursing Survey Results
100
Cross-Survey Results
100
Analysis and Recommendations
101
Strategic Planning
101
Leadership – Integration of the Clinical and Technological Aspects
102
Recommendations Regarding Leadership
103
Project Management
104
Introduction of Technology into Workflow
105
Culture of Change
106
Conclusion
107
References
108
H.I.T. or Miss
109
Emily’s Story
109
Joanna’s Story
110
Jim’s Story
111
Conclusion
112
The Implementation of Secure Messaging
118
Background
119
Project Planning Stage
119
User Interface Issues
120
Policy Issue
122
Security Issue
122
Rolling Out to Clinics
123
Conclusion
124
Questions
125
References
125
Who Moved My Clinic? Donnelly University Pediatric Rehabilitation: The Wheelchair Clinic
126
Introduction to Children’s Hospital Pediatric Rehabilitation
126
Background
126
Mission and Goals
126
Available Resources and Services Provided
126
The Katie Darnell Wheelchair Clinic
127
Introduction
127
Background
127
Wheelchair Ordering Process
128
Patients of the Wheelchair Clinic
131
Change in Location
132
Technology Available
133
Amenities Provided
134
Team Communication
134
Vendor Representative-Therapist Relationship
134
Therapist-Therapist Relationship
135
Conclusion
135
Questions
136
References
136
OncoOrders: The Early Years
137
Introduction to OncoOrders
137
Background
137
Funding
139
The Whiteboard
140
Order Assistant
141
Evaluation
142
Questions
143
Implementing a Computerized Triage System in the Emergency Department
144
Introduction
144
The Institution and IT Environment
145
Triage Basics
146
Paper-Based Triage Process
147
Initial Triage IT Development
150
Quill
151
WizOrder
152
Designing the Current System
153
Analysis of Implementation Aspects
158
System Evaluation
159
Discussion
159
References
161
Medication Barcode Scanning: Code “Moo”: Dead COW
163
Introduction
163
Project Overview
164
Workstation Deployment and Support
164
Assessment of Needs for the BCMA Project
164
Procurement
165
Assembly and Deployment
165
Implementation Surprises
165
Batteries
165
Scanners
166
Volume of Equipment
167
Budget Freeze
167
The Cumulative Effect
168
Questions
168
Project NEED: New Efficiency in an Emergency Department
173
Introduction
173
The Pediatric Emergency Department
173
Case Study Site
174
Methodology
175
Results and Discussion
175
Staff Perceptions Regarding Efficiency and Length of Stay (LOS)
176
Staff Perceptions Regarding New Triage System and New CIS
176
Staff Perceptions on Bottlenecks
176
Doctors
177
Gathering Laboratory Results
177
Putting Patients in Examination Rooms
177
Staff Perceptions on Hospital Admissions
178
Staff Perceptions on Areas for Improvement
178
Clinical Decision Support Tools
178
Web Based Tools
178
Personalized Order Sets and Prescriptions
179
Management Systems with Robust Patient Tracking
179
Linking CIS with Other Systems
180
Integrated Laboratory Results
180
Recommendations
181
References
182
Digital Radiology Divide at McKinly
184
Background
184
PACS Overview
185
Workflow Changes
187
Motivation
189
McKinly’s Dilemma
191
Case Analysis and Conclusions
191
Question
193
References
193
Index
195
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