Healthcare Informatics
Discussion: Community Systems, Decision Support, and Public Health
Ashley
Statewide health information exchanges (HIEs) allow the exchange of healthcare information
amongst healthcare professionals in certain regions; clinical decision support systems (CDS) are
the tools and applications that assist the healthcare provider with some aspect of clinical
decision making (Nelson & Staggers, 2018). CDS systems are part of the next frontier for
home health and other related community-based practice settings (Nelson & Staggers, 2018).
Using both up to date HIEs and CDS standards, healthcare providers could be providing the
right information to the right person at the right time and at the right location, CDS systems can
support effective clinical decision making and improve clinical care (Nelson & Staggers, 2018).
Be kind and compassionate to one another, forgiving each other, just as in Christ God forgave
you (Ephesians 4:32). Quality over quantity should always be the healthcare standard. The
core values of community-based clinicians include patient-centered care and services that are of
high quality, efficient, and cost effective (Nelson & Staggers, 2018). The incentivized adoption
of EHRs continues to be at the core of reform initiatives to improve care quality and better
manage care costs, meeting clinical and business needs by capturing, storing, and displaying
clinical information when and where it is needed to improve individual patient care and provide
aggregated, cross-population data analysis (Nelson & Staggers, 2018).
Based off my research, most healthcare offices do not favor the use of CDS. Despite four
decades of substantial evidence demonstrating the ability of well-implemented CDS to improve
practitioner performance and patient outcomes, most commercial EHR systems and healthcare
delivery organizations in the United States have implemented only basic CDS capabilities, such
as alerts for drug-drug interactions and drug allergy contraindications (Nelson & Staggers,
2018). Unfortunately, there are still many barriers to clinical decision support adoption.
Including lack of incentives, implementation challenges, and low HER adoption, to name a few.
References
Nelson, R., & Staggers, N. (2018). Health Informatics: An Interprofessional Approach, 2nd Ed.
St. Loius, MO.: Elsevier Inc.
The Holy Bible, New International Version (NIV). (1973, 1978, 1984, 2011). Biblica, Inc.
Rinell
Community Systems, Decision Support, Public Health
Clinical Decision Support (CDS) systems analyze data which help healthcare professionals
make their clinical decision where the intentions are to improve healthcare delivery. Our
textbook mentions two approaches that the CDS systems use, the first one has healthcare
providers determine what is known about the patient and then presents the best evidence-based
practice options that could be beneficial to the patient, staff and clinicians. The second approach
is using a process of machine learning that presents best evidence based practice option to the
health care provider after the data is analyzed after being entered and compare it to similar
patterns or circumstances that is found in the system (Nelson, R., PhD, RNBC, ANEF, Staggers,
F.A. N., PhD, RN, & FAAN, 2018).
Health information exchange (HIE’s) is national objective where the goal is to improve care
and reduce cost by electronically transferring health information between different health care
organizations. HIE systems are beneficial to both the patient and health care provider because if
a patient seeks care from multiple organizations, their information will be able shared without
any miscommunication because it would go directly from healthcare provider to another. Overall
HIE systems are used to facilitate an exchange of patient information with the reduction of costs
with better quality health care and improved population health (Menachemi, N., Rahurkar, S.,
Harle, C. A., & Vest, J. R. , 2018).
CDS aligns with the goals of rewarding “quality over quantity” in health care reimbursement.
There are several functions and advantages of CDS, some examples are patient safety, clinical
management, cost containment, diagnostics support, patient decision support, workflow
improvement and proper documentation (Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski,
D. C., Fedorak, R. N., & Kroeker, K. I., 2020). Although CDS may seem like a system that is
used for health care providers to deliver care faster and quicker the intentions are focused on
giving high quality care for patients. If you were a patient in the emergency room in excruciating
pain you would hope your health care provider could find out what is wrong with you by getting
the proper information and using your symptoms and data as well. The favor adoption of CDS is
“quality over quantity”, patient safety is seen in CDS by reducing the incidence of medication
errors or prevention of any adverse events. Cost containment is also another function in the
system that is seen by reducing any unnecessary test or duplication of tests, suggesting cheaper
medication and treatment options. The diagnostic support helps health care providers with
diagnostics based on the data, imaging or test results and automate output rest results. Sometimes
new systems can be confusing or hard to trust but CDS and HIEs have been created with the
intent to create a high quality health care experience for patients.
References
Menachemi, N., Rahurkar, S., Harle, C. A., & Vest, J. R. (2018). The benefits of health
information exchange: an updated systematic review. Journal of the American Medical
Informatics Association, 25(9), 1259-1265.
Nelson, R., PhD, RNBC, ANEF, Staggers, F.A. N., PhD, RN, & FAAN (2018). Health
Informatics: An Interprofessional Approach (2nd Edition). Elsevier Health Sciences
(US). https://libertyonline.vitalsource.com/books/9780323402316 (Links to an external site.).
Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I.
(2020). An overview of clinical decision support systems: benefits, risks, and strategies for
success. NPJ digital medicine, 3(1), 1-10.
Financial Analysis and Management in Healthcare
Discussion: Accounting Principles
Erika
Accounting as a whole incorporates three distinct activities – identification, recording and
communication of the economic events of an organization to its users (Weygandt, et al.,
2018). Financial and managerial accounting have very distinct differences between them. To
begin, it is important to have a proper understanding of each type of accounting. Financial
accounting provides general-purpose financial statements or reports (Cleverly & Cleverly,
2018, p. 196). Essentially, this means that financial accounting refers to the aggregation of
information into four, key financial statements: balance sheets, statement of operations,
statement of cash flows and statement of changes in net assets. Financial accounting aids groups
that are both internal or external to the organization in making decisions (p. 196).
Managerial accounting, on the other hand, is mostly concerned with preparing financial
information for specific purposes, usually for users who are internal to the company. In other
words, managerial accounting focuses on internal processes used to help make decisions
regarding the daily operations of a company (Sanderson, 2021).
Key distinctions arise in regards to each accounting types goals, reporting focus, standards and
time period. To begin, the goal of financial accounting is to provide uniformity and
comparability of information (Cleverly & Cleverly, 2018, p. 197). In comparison, managerial
accounting seeks to evaluate current and future trends.
The reporting focus of financial accounting is that of historical financial transactions. With this
focus, financial accounting statements are used to evaluate an organizations efficiency and
provide documented evidence for past decisions made (Gardi et al., 2021). In contrast,
managerial accounting focuses on operational reports, distributed within the company that
determine future periods of financial activity.
The standards between both forms of accounting are quite different. Financial accounting must
rigorously adhere to Generally Accepted Accounting Principles (GAAP) which shape how the
financial statements are structured (Cleverly & Cleverly, 2018). Managerial accounting has less
need for a body of restrictions in the preparation of its material, since the information is mainly
used within the organization.
Finally, the time period of both financial and managerial accounting is different. Whereas
financial accounting creates reports that are filed on an annual basis, managerial accounting can
issue its reports more frequently (Cleverly & Cleverly, 2018). Why? Because the information
managerial accounting provides regarding current and future trends is of most relevance if
managers are able to see the material immediately.
Luke 16:11 states If then you have not been faithful in the unrighteous wealth, who will entrust
to you the true riches? (Crossway, 2016). In this verse, Jesus is asking that if one is
untrustworthy with worldly wealth, how can that person be trusted with the true riches of
heaven? Christians who are faithful, money-managing stewards not only benefit themselves, but
bring glory to the Lord. Proper adherence to accounting principles can aid a believer in
stewarding well the money God has given them.
References:
Cleverley, W., & Cleverley, J. (2018). Essentials of Health Care Finance (8th Edition). Jones &
Bartlett Learning. https://libertyonline.vitalsource.com/books/9781284142808
Crossway. (2016). The Holy Bible: English Standard Version (ESV), Containing the Old and
New Testaments. Crossway Books Publishing. Wheaton, IL.
Gardi, B., Abdalla Hamza, P., Sabir, B. Y., Mahmood Aziz, H., Sorguli, S., Abdullah, N. N., &
Al-Kake, F. (2021). Investigating the effects of financial accounting reports on managerial
decision making in small and medium-sized enterprises. Bawan Yassin and Mahmood Aziz,
Hassan and Sorguli, Sarhang and Abdullah, Nabaz Nawzad and Al-Kake, farhad, Investigating
the Effects of Financial Accounting Reports on Managerial Decision Making in Small and
Medium-sized Enterprises (April 28, 2021). http://dx.doi.org/10.2139/ssrn.3838226
Sanderson. (2021, August 24). What are the differences between financial accounting and
Management Accounting?Bentley University. Retrieved May 31, 2022, from
https://www.bentley.edu/news/what-are-differences-between-financial-accounting-andmanagement-accounting
Weygandt, J. J., Kimmel, P. D., & Kieso, D. E. (2018). Financial and managerial accounting.
John Wiley & Sons.
https://books.google.ca/books?id=r66fDwAAQBAJ&lpg=PR4&ots=O8JLFaw_yN&dq=financia
l%20%20vs%20managerial%20accounting&lr&pg=PR4#v=onepage&q=financial%20%20vs%2
0managerial%20accounting&f=false
Management of Human Resources and Health Professionals
Discussion: Motivational Strategy
Heather
The Turnover primarily results from an unsatisfying and unmotivating work environment. It is
expensive as organizations spend a lot of resources to replace a leaving employee (Cho et al.,
2017). Like other high-pressure professions, nursing requires staff to be motivated to deliver
optimum results. The absence of adequate motivation will lead to low morale, burnout, and high
turnover. Some Expectancy theories provide a framework for executive leaders and nurse
managers to develop motivational strategies to reduce staff turnover. In expectancy theory, the
employees are encouraged to select behavior that has a high potential of resulting in a valued
outcome for the personnel (Chang et al., 2015). The theory has three vital aspects: expectancy,
valence, and instrumentality (Allen, 2011). I propose to develop a motivational strategy for the
nurses applying the expectancy theory. It will involve rewards and recognition for performance
and for selecting the correct behavior.
I will develop a performance-based strategy where nurses will earn a reward and recognition for
their exemplary performance. I will ensure a clear connection between the nurse’s performance
and the rewards. Further, the expected performance shall not be unattainable. Additionally, I will
ensure that the nurses have all the right conditions necessary to attain the performance, including
knowledge and skills and the appropriate working conditions. The nurses should feel that they
have all the tools and know-how to achieve the expected results and gain the reward. They will
be highly motivated and deliver superior results. Highly motivated and focused nurses will
unlikely leave the organization searching for better opportunities (Collini et al., 2017). They will
stay with the healthcare institution for a long time. Motivating the nurses through the expectancy
theory framework will keep them highly motivated, and few will depart from the organization. It
will reduce the turnover rate and the costs associated with it.
References
Allen, J.E. (2011). Nursing home administration. New York: Springer Pub.
Chang, Y., Hsu, P., & Wu, Z. (2015). Exploring managers intention to use business intelligence:
The role of motivation. Behaviour & Information Technology, 34, 273-285.
doi:10.1080/0144929X.2014.968208
Cho, Y., Rutherford, B. N., Friend, S. B., Hamwi, G. A., & Park, J. (2017). The role of emotions
on frontline employee turnover intentions. Journal of Marketing Theory & Practice, 25, 57-68.
doi:10.1080/10696679.2016.1235960
Collini, S. A., Guidroz, A. M., & Perez, L. M. (2015). Turnover in health care: The mediating
effects of employee engagement. Journal of Nursing Management, 23, 169-178.
doi:10.1111/jonm.12109
Research and Evidence Based Practice in Healthcare
Discussion: Evidence-Based Leadership Practices
Steven
Before taking a new job as a leader, I would want to assess a few things. I would want my team
to work as one, with everyone taking some part in decision making. I would also want everyone
to be accountable for their actions. This is what shared governance is. Shared governance models
have been implemented throughout the world, the shared beliefs being that authority over and
involvement in decision making lead to staff autonomy, enhanced perceptions of control over
practice, and, ultimately, greater job satisfaction and staff retention (Hall & Roussel, 2020, p.
172). I would take a step back and observe if everyone is working together, being accountable,
and communicating well and that is how I would know that the shared governance system is
being implemented. The next thing I would assess is the culture, which ties into shared
governance in a way. The thing I would look for are values, job satisfaction, and work ethic. The
culture of an organization starts from the top. In healthcare organizations, nothing plays a more
significant role in shaping organizational culture, improving quality of care, and enhancing
patient safety than leadership (ALFadhalah & Elamir, 2021). If the culture is good, everyone
should be happy and everyone should understand their roles within the organization. Probably
the most important thing to assess in a healthcare organization is the safety of the patients.
Patient safety is defined by World Health Organization (WHO) as ‘the prevention of errors and
adverse effects to patients associated with health care’ and ‘to do no harm to patients (Kuriakose
et al., 2020). Patient safety is determined by good teamwork, competency, and a willingness to
learn new things and learn from mistakes. I would want the reports of any incidents involving
patients to determine if the organization is competent. So then, as we have opportunity, let us do
good to everyone, and especially to those who are of the household of faith (Galatians 6:10,
ESV). Patient safety is all about trying our best and doing whatever we can to help those who
really need our help.
References:
ALFadhalah, T., & Elamir, H. (2021). Organizational Culture, Quality of Care and Leadership
Style in Government General Hospitals in Kuwait: A Multimethod Study. Journal of healthcare
leadership, 13, 243254. https://doi.org/10.2147/JHL.S333933
Galatians 6:10 ESV – – Bible Gateway. (n.d.). Retrieved June 1, 2022, from
https://www.biblegateway.com/passage/?search=Galatians%2B6%3A10&version=ESV
Hall, H. R., & Roussel, L. A. (2020). Evidence-Based Practice: An Integrative Approach to
Research, Administration, and Practice (3rd Edition). Jones & Bartlett
Learning. https://libertyonline.vitalsource.com/books/9781284229356
Kuriakose, R., Aggarwal, A., Sohi, R. K., Goel, R., Rashmi, N. C., & Gambhir, R. S. (2020).
Patient safety in primary and outpatient health care. Journal of family medicine and primary
care, 9(1), 711. https://doi.org/10.4103/jfmpc.jfmpc_837_19
Sarah
When accepting a new position, especially a leadership position, I believe it is important to take
a look at how the culture is surrounding that department. I believe when looking at shared
governance and culture of organization, you can ask the others in leadership that will be working
beside you. I also think you can take a look at meeting minutes and see who is the main go-to for
different issues or topics. I believe when looking at safety of patient care, follow around the staff
working with patients, discuss with them their problems, concerns or praises when it comes to
patient and staff safety.
Unfortunately, there are always going to be issues or ways to improve in healthcare, but I think if
something is functioning well, you can visibly see the effort and change in motion.
A huge advantage I would say that I would have though is being staff prior to being in
leadership. I think at that level, I am able to understand both sides and see how to make position
change that is safe for patients and staff members rather than decisions based strictly on budget
or time.
“Where no counsel is, the people fall: but in the multitude of counsellors there is safety.”
Proverbs 11:14 (King James Version).
References:
The Holy Bible. (n.d.). Bible gateway passage: Proverbs 11:14 – king James Version. Bible
Gateway. Retrieved June 1, 2022, from
https://www.biblegateway.com/passage/?search=Proverbs+11%3A14&version=KJV
Purchase answer to see full
attachment
Recent Comments