NURS 8210 Week 4: System Development Life Cycle

NURS 8210 Week 4 Discussion

HIT Projects and Decision Makers

A nurse leader sought to implement greater security in the children’s wing of the hospital by installing a new alarm and monitoring system. Due to budget constraints, the CNO rejected the proposal, stating that current security methods were sufficient. Shortly after this failed proposal, an individual did in fact breach the children’s wing security and abducted a young child. Thankfully, the child was found and returned to her parents; and the CNO quickly found the money to install the new security system.

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Not all HIT projects have such high-profile stakes. The main takeaway from this example is the importance of getting key stakeholders and decision makers on board when planning a new HIT project.

To prepare:

Bring to mind a HIT project implemented in your organization. Which leaders identified the project? Which stakeholders and decision makers helped moved the project forward?
Consider methods that were used to garner the support of stakeholders and decision makers to move the project forward.

By Day 3 post a cohesive response that addresses the following:

Describe an example of a HIT project implemented at your organization and analyze how that project was identified and moved forward.
Evaluate the impact of key decision makers on moving the HIT project forward.

Read a selection of your colleagues’ postings

By Day 6 respond to at least two of your colleagues in one or more of the following ways:

Ask a probing question, substantiated with additional background information, evidence, or research.
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional research.
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.

Click on the Reply button below to post your response.

NURS 8210 Week 4 Discussion-HIT Projects and Decision Makers SAMPLE

To have more affordable and quality healthcare, disruptive innovations need to take place. It involves using technologies to become more efficient (Townsend, 2013). For healthcare systems to implement new health information technology (HIT) the use of the systems development life cycle is used. The system development life cycle includes five stages, planning, design, implementation, maintenance, and evaluation (Laureate Education, 2011). The purpose of this discussion is to describe a HIT project in my healthcare system and the impact key decision makers made on implementation of the project.

HIT Project

The healthcare system had five regional cancer centers all using the same electronic health record (EHR). The system had been implemented in 2005 and had undergone two upgrades to the system. The maintenance phase in the system development life cycle includes be aware of the new business needs and refining the system to meet those needs (Dennis, Wixom, & Roth, 2012). The physicians were proficient in CPOE and all orders were entered electronically. The cancer center had an outpatient clinic, surgery, infusion center, and inpatient settings all using the EHR. Patients moved between levels of care frequently between levels of care, and the need became apparent that electronic reconciliation of medications needed to be implemented. In the Institute of Medicine’s Report, To Err is Human, recommendations were made for organizations to use CPOE, barcode medication administration and medication reconciliation to increase patient safety and reduce medication errors (To Err Is Human: Building a Safer Health System, 2000). The healthcare system had also implemented bar-cod medication administration but had never moved on to medication reconciliation using the EHR. The project was identified by the physicians within the cancer center. Patient due to their changes of condition was moving from the outpatient to inpatient units. The manual reconciliation for a patient at discharge from inpatient status was taking a physician at least two hours and mistakes were being made due to the manual process. My friend was the director of clinical informatics for the hospital, and the chief hospitalist brought it to his attention. Together they coordinated a meeting with the chief hospitalists and informatics directors at the other four hospitals to gain consensus. The group created an enhancement request to take to the governance committee for information systems. The request was initially denied due to other projects currently prioritized.

NURS 8210 Week 4: System Development Life Cycle

“He who fails to plan, plans to fail.” — Proverb

Whether you are building a house, buying a new software program, or going on vacation, a carefully considered plan may encourage a positive outcome. In health care, planning for the adoption and integration of health information technology systems requires research, analysis, communication, and collaboration. During the planning phase, those leading a health information technology system project must evaluate potential problems related to patient needs, staff workloads, and costs, among other things. Planning frameworks can assist leaders with this task.

This week, you examine a popular planning framework—the Systems Development Life Cycle (SDLC)—as you begin your Major Assessment for this course: investigating a health information technology system or health information application. You also explore how leaders facilitate the implementation of HIT projects and consider strategies for garnering support from key stakeholders and decision makers.

Learning Objectives

Students will:

Analyze how HIT projects are identified and moved forward within an organization
Evaluate the impact of leaders and key decision makers on implementing HIT projects within an organization
Critically analyze the development and implementation of a health information technology system or application /li>

Photo Credit: [JGI/Tom Gril]/[Blend Images]/Getty Images

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Course Text: Ball, M. J., Douglas, J. V., Hinton Walker, P., DuLong, D., Gugerty, B., Hannah, K. J., . . . Troseth, M. R. (Eds.) (2011). Nursing informatics: Where technology and caring meet (4th ed.). London, England: Springer-Verlag.

Chapter 17, “Disruptive Innovation: Point of Care”

This chapter uses real-world integration examples to illustrate the visions and challenges that characterize Smart Point of Care systems.

Course Text: American Nurses Association. (2008). Nursing informatics: Scope and standards of practice. Silver Spring, MD: Author.

“Standards of Nursing Informatics Practice” (pp. 67-79)

This excerpt presents the specific measurement criteria found within each nursing informatics standard.

Madsen, M. (2010). Knowledge and information modeling. Studies in Health Technology and Informatics, 151, 84-103.

Retrieved from the Walden Library databases.

Within this article, the overall design models of information systems are linked to the metastructures, data, information, knowledge, and wisdom.

Peleg, M. (2011). The role of modeling in clinical information system development life cycle. Methods of Information in Medicine, 50(1), 7-10.

The author of this article discusses the role of conceptual modeling in health information technology systems and how it has been an effective component of system development.

Philip, A., Afolabi, B., Adeniran, O., Oluwatolani, O., & Ishaya, G. (2010). Towards an efficient information systems development process and management: A review of challenges and proposed strategies. Journal of Software Engineering and Applications, 3(10), 983-989.

Retrieved from the Walden Library databases.

This article examines the phases and methodologies found within the Systems Development Life Cycle (SDLC), and proposes a framework for establishing the crucial roles that participants must play during the SDLC.

Szydlowski, S., & Smith, C. (2009). Perspectives from nurse leaders and chief information officers on health information technology implementation. Hospital Topics, 87(1), 3-9.

Retrieved from the Walden Library databases.

Qualitative research is used in this article to examine the trends, goals, outcomes, barriers, and mistakes that hospital leaders may experience when implementing health information technology systems.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Transforming nursing and healthcare through technology: Systems analysis. Baltimore, MD: Author.

Note: The approximate length of this media piece is 11 minutes.

The presenters in this week’s media presentation outline the stages involved when implementing a new technology system..

Optional Resources

Burgess, L., & Sargent, J. (2007). Enhancing user acceptance of mandated mobile health information systems: The ePOC (electronic Point-Of-Care Project) experience. Studies in Health Technology and Informatics, 129(Pt 2), 1088-1092.

Discussion: Welcome to the Week 4 Discussion area!

Post your responses to the Discussion based on the course requirements.

Your Discussion postings should be written in standard edited English and follow APA guidelines as closely as possible given the constraints of the online platform. Be sure to support your work with specific citations from this week’s Learning Resources and additional scholarly sources as appropriate. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct. Initial postings must be 250–350 words (not including references).

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 4 Discussion Rubric

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Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 4 Discussion

Assignment: Application 3: Health Information Technology Project [Major Assessment 5]

In previous Discussions and Applications, you have explored various aspects of health information technology systems: the historic development of HIT, how data flows across HIT systems, and standards and interoperability requirements including specific terminologies used in your practice setting. In this Application Assignment, you will have the opportunity to further develop your analysis skills by closely examining the implementation of a health information technology system. As a doctorally prepared nurse, you may find yourself in the position of leading a HIT project team; to be an effective leader and move health information technology projects forward in your organization, you must be able to logically and critically analyze the many aspects and challenges of implementing such a system and then present your insights in a succinct and professional manner. This exercise provides an opportunity to hone those skills.

Carefully review the project requirements below and plan your time accordingly. Be sure to refer to the standards of nursing informatics practice as you develop this Application, which serves as your Major Assessment for this course.

To prepare:

Investigate a health information technology system or health information technology application in your area of interest. The health information technology system/application may be in any setting where health care information is developed or managed. You may choose your system or application from any organization or virtual environment.
- Examples of health information technology systems or health information technology applications that are acceptable include but are not limited to:
  - Consumer health applications
  - Clinical information systems
  - Electronic medical record (EMR) systems in hospitals or provider offices
  - Home health care applications
  - School health applications
  - Patient portal/personal health record
  - Public health information systems
  - Telehealth (i.e., from facility to home)
  - Simulation laboratories
  - Health care informatics research and development centers
Discuss your proposed health information technology system/application with your Instructor before proceeding with your final selection. You may visit a health care organization in person or virtually in order to make your final choice about the health information technology system or health information technology application of interest.
Choose the best strategy to gain information about your selected information technology system/application. Some ways to gather information include virtual visits; vendor demonstrations; on-site visits; interviews via face-to-face, phone, or teleconference. You must conduct at least one interview for this project.
Complete a literature search to gather information about your selected information technology system. You may also need to review related scholarly articles to help answer the questions presented below.

NOTE: In your submitted report, do not share proprietary information, personal names, or organization names without permission.

To complete:

Your deliverable is a 12- to 15-page scholarly report, not counting the title page or references. A successful report should leave the reader with confidence in understanding the answers to all the questions listed below. Graphics may be used to illustrate key points.

Organization Information

Briefly describe the health information technology system/application and the organization type (hospital, clinic, public health agency, health care software company, government health information website, private virtual health information site, etc.).
Is the health information technology system/application clinical, administrative, educational, or research related?
What were the key reasons for the development of this health information technology system/application, i.e., what made the organization believe this system/application was needed? How did this organization determine those needs? Did the organization use specific tools to conduct needs assessments, staff opinions, or workflows?
How did the organization determine that this specific system/application could fulfill its predetermined needs?
Who manages this health information technology system/application and where are they located within the organization’s administrative structure?

Information System Application Design and Development

Many health care systems have multiple independent entities that work together toward the common goal of providing high-quality care. How did—and do—the various stakeholders make decisions related to this health information technology system/application? Were the end users involved in the development of this health information technology system/application?
How are individuals trained to use the health information technology system/application?
How are security issues addressed? How does this health information technology system/application support a legally sound health care record?
Where did initial funds for this health information technology system/application come from?
Who manages the budget for this health information technology system/application?
Have organizational or political issues impacted the ongoing funding for this health information technology system/application?
What are the arrangements for planned or unplanned downtime?
How are health information technology system/application upgrades scheduled or planned?
How has the health information technology system/application changed in response to health care reform and related legislation?
What suggestions could you make regarding changes needed to support health care reform and related legislation?

Innovative Aspects of the System

How does the health information technology system/application utilize technology innovations?
What technology innovations would you recommend for this organization? What innovations presented in this course, or found through your own research, could this organization benefit from?
What innovations could further promote evidence-based practice and efficiency within this organization?

End Product

Your report is a scholarly paper and needs to include a minimum of 10 citations from peer-reviewed journals. Every statement made in a scholarly report must be supported by a reference. Be very cautious when stating your opinion, or using terms suggesting absolute facts, or values, as these must be supported by references. Note that textbooks, including the course texts, are composed of information cited from other sources (see the reference section in the course textbooks). With this in mind, there should be an adequate number of appropriate references (a minimum of 10). Please note that primary sources are to be used. Peer-reviewed journal articles should make up the bulk of your references (90%). If referring to a book, be sure to include all information in APA style, including specific page numbers when necessary. Note that an article referred to in a book is a secondary source. More on this topic is available in the APA Publication Manual and in the Walden Writing Center. See also “Policies on Academic Honesty” listed at the Walden website.

A superior paper demonstrates breadth and depth of knowledge, and critical thinking appropriate for doctoral level scholarship. The report must follow APA Publication Manual guidelines (6th edition) and be free of typographical, spelling, and grammatical errors. This Application is the Major Assessment for this course. You will submit this document by Day 7 of Week 9.

By Day 7 of Week 9

Final Report: 12- to 15-page scholarly report is to be submitted.

Health Information Technology Project Evaluation

Program LO: 3

3: Educator / Consultant

DNP Essential: 4

4: Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care

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ASSIGNMENT PROMPT

Target

5 points

Acceptable

3 points

Unacceptable

1 point

Score/Level

Abbreviated Research Proposal Paper

Part 1: Information on Organization

(5 points)

Program LO: 3

DNP Essential: 4

Exemplary quality.

Content is of a professional portfolio quality; addresses every major subsection in the assignment description of health information technology system/application and the organization type; key reasons for development of this health information technology system/application; management and administrative structure of health information technology system/application using advanced critical thinking skills; does not summarize or paraphrase the content of the literature review, rather demonstrates content mastery using examples and/or personalized reflections about the content of the literature review; demonstrates an applied level of understanding through personalized reflections about the content area. Excels in meeting expectations for graduate level work.

Fully meets expectations for LO 3

Fully meets expectations for Essential 4

Well-developed, good quality work. Content is of a professional portfolio quality; addresses at least 80% of the major subsections in the assignment using adequate critical thinking skills; includes some summarizing or paraphrasing of literature review; demonstrates content mastery using examples and/or personalized reflections about the content of the literature review; demonstrates an applied level of understanding through personalized reflections about the content area. Fully meets expectations for graduate level work.

Meets expectations for LO3

Meets expectations for Essential 4

Superficially developed, unacceptable quality.

Content needs substantial revision for it to be of a professional portfolio quality; addresses less than 50% of the major subsections in the assignment using weak critical thinking skills; consists primarily of a summary of main ideas from the literature review; does not demonstrate an applied level of understanding. Lags behind expectations for graduate level work.

Insufficient to meet expectations for LO 3

Insufficient to meet expectations for Essential 4

Part 2: Information System Application: Design

(5 points)

Program LO: 3

DNP Essential: 4

Exemplary quality.

Content is of a professional portfolio quality; addresses every major subsection in the assignment clearly and succinctly addresses how stakeholders worked together to design and fund the system application including a detailed description of who manages the budget, and any organizational or political challenges that impacted the initial or ongoing funding of the system/application and how these challenges were addressed using advanced critical thinking skills; does not summarize or paraphrase the content of the literature that supports this section, rather demonstrates content mastery using examples and/or personalized reflections about the content of the literature; demonstrates an applied level of understanding through personalized reflections about the content area. Excels in meeting expectations for graduate level work.

Fully meets expectations for LO3

Fully meets expectations for Essential 4

Well-developed, good quality work.

Content is of a professional portfolio quality; addresses at least 80% of the major subsections in the assignment using adequate critical thinking skills; addresses how stakeholders worked together to design and fund the system application including a description of who manages the budget, and any organizational or political challenges that impacted the initial or ongoing funding of the system application and how these challenges were addressed; includes some summarizing or paraphrasing of literature that supports this section; demonstrates content mastery using examples and/or personalized reflections about the content of the literature; demonstrates an applied level of understanding through personalized reflections about the content area. Fully meets expectations for graduate level work.

Meets expectations for LO 3

Meets expectations for Essential 4

Superficially developed, unacceptable quality.

Content needs substantial revision for it to be of a professional portfolio quality; addresses less than 50% of the major subsections in the assignment using weak critical thinking skills; consists primarily of a summary of main ideas from the literature that supports this section; does not demonstrate an applied level of understanding. Lags behind expectations for graduate level work.

Insufficient to meet expectations for LO 3

Insufficient to meet expectations for Essential 4

Part 3: Information System Application: Implementation

(5 points)

Program LOs: 3

DNP Essential: 4

Exemplary quality.

Content is of a professional portfolio quality; addresses every major subsection in the assignment; identifies key security issues and provides a detailed description on how the issues have been addressed; provides an in-depth portrayal of management of health information technology system, including quality of health care records, training of users, and planning for downtime and scheduled updates; includes a thoughtful analysis of system changes in response to health care reform/legislation and well-reasoned recommendation of additional changes needed using advanced critical thinking skills; does not summarize or paraphrase the content of the literature review, rather demonstrates content mastery using examples and/or personalized reflections about the content of the literature review; demonstrates an applied level of understanding through personalized reflections about the content area. Excels in meeting expectations for graduate level work.

Fully meets expectations for LO 3

Fully meets expectations for Essential 4

Well-developed, good quality work.

Content is of a professional portfolio quality; addresses at least 80% of the major subsections in the assignment using adequate critical thinking skills; identified security issues and described how they have been addressed; provides an overview of management of health information technology system, including quality of health care records, training of users, and planning for downtime and scheduled updates; describes system changes in response to health care reform/legislation and recommendation of additional changes needed; includes some summarizing or paraphrasing of literature review; demonstrates content mastery using examples and/or personalized reflections about the content of the literature review; demonstrates an applied level of understanding through personalized reflections about the content area. Fully meets expectations for graduate level work.

Meets expectations for LO 3

Meets expectations for Essential 4

Superficially developed, unacceptable quality.

Insufficient to meet expectations for LO 3

Insufficient to meet expectations for Essential 4

Part 4: Innovative Aspects of the System

(5 points)

Program LO: 3

DNP Essential: 4

Exemplary quality.

Content is of a professional portfolio quality; addresses every major subsection in the assignment; provides a succinct description of the role of innovation in the health information technology system/application and thoughtful recommendations for additional use of innovations using advanced critical thinking skills; does not summarize or paraphrase the content of the literature review, rather demonstrates content mastery using examples and/or personalized reflections about the content of the literature review; demonstrates an applied level of understanding through personalized reflections about the content area. Excels in meeting expectations for graduate level work.

Fully meets expectations for LO 3

Fully meets expectations for Essential 4

Well-developed, good quality work.

Content is of a professional portfolio quality; addresses at least 80% of the major subsections in the assignment; provides a description of the role of innovation in the health information technology system/application and recommendations for additional use of innovations using adequate critical thinking skills; includes some summarizing or paraphrasing of the literature review; demonstrates content mastery using examples and/or personalized reflections about the content of the literature review; demonstrates an applied level of understanding through personalized reflections about the content area. Fully meets expectations for graduate level work.

Meets expectations for LO 3

Meets expectations for Essential 4

Superficially developed, unacceptable quality.

Needs substantial revision to be worthy of a professional portfolio; addresses less than half the major subsections in the assignment using weak critical thinking skills; consists primarily of a summary of main ideas from the literature review; does not demonstrate an applied level of understanding. Lags behind expectations for graduate level work.

Insufficient to meet expectations for LO 3

Insufficient to meet expectations for Essential 4

Part 5: End Product

(5 points)

The majority of references are from scholarly journals, support the topic well, and are current. All sources are peer reviewed. Minimum of 7 citations used. Paper stays within page requirements. APA format is used correctly throughout.

Report leaves the reader with confidence in understanding the informatics system; graphics are used to illustrate key points.

Excels in meeting expectations for graduate level work.

Most references are from scholarly journals and support the topic. Most references are fairly current. All sources are peer reviewed. Minimum of 7 citations used. The paper stays within page requirements. APA format is used with minimal errors.

Report leaves the reader with confidence in understanding the informatics system; graphics are used to illustrate key points.

Meets expectations for graduate level work.

References are not sufficient or are mostly from the lay literature or out of date. Sources identified are a combination of peer reviewed and nonpeer reviewed. Fewer than 7 citations used. The paper is either too long or too short. Weak writing quality and/or little evidence of correctness of APA format.

Report does not leave the reader with confidence in understanding the informatics system; graphics are minimally used or not used to illustrate key points.

Work lags behind expectations for graduate level work.

Health Information Technology Project Assignment:

Write a 12- to 15-page (plus references) paper that includes the following:

Organization Information (5 points)

Briefly describe the health information technology system/application and the organization type (hospital, clinic, public health agency, software company, government health information website, private virtual health information site, etc.).
Is the health information technology system/application clinical, administrative, educational, or research related?
What were the key reasons for development of this health information technology system/application?
Who manages this health information technology system/application and where are they located within the organization’s administrative structure?

Information System Application: Design (5 points)

Many health systems have multiple independent entities that work together toward a common goal of providing health care. How did the various stakeholders work together to make decisions related to this health information technology system/application? Were the end users involved in the development of this health information technology system/application
How was this health information system/application initially funded?
Have organizational or political issues impacted the ongoing funding for this health information technology system/application?
Who manages the budget for this health information technology system/application?

Information System Application: Implementation (5 points)

How are security issues addressed; how does this health information technology system/application support a legally sound health care record?
How are individuals trained to use the health information technology system/application?
What are the plans for planned or unplanned downtime?
How are health information technology system/application upgrades scheduled or planned?
How has the health information technology system/application changed in response to health care reform and related legislation?
What suggestions could you make regarding changes needed to support health care reform and related legislation?

Innovative Aspects of the System (5 points)

How are technology innovations being used in the health information technology system/application?
What technology innovations could you recommend for this organization?

End Product (5 points)

The paper is 12- to 15-page report.
The report leaves the reader with confidence in understanding the informatics system.
Graphics are used to illustrate key points.
The report is a scholarly paper and includes a minimum of 7 citations from peer-reviewed journals.
Appropriate APA format is used.

*Note: Up to 5 points (20%) may be deducted for grammar and APA style errors.