Gap Analysis in Medication reconciliation Grant Invinzor Abejar Walden University GAP ANALYSIS RECONCILLIATION 2 Gap Analysis in Medication reconciliation Gap analysis is a technique that is utilized by most of the organizational managers to determine the size, format and general strategies that are necessary to be followed by the firm to realize its goals. The process of gap analysis is very important, especially to strategic management and planning team. The process will provide very vital information regarding improving the cooperate performance. In summary, the gap analysis tool is very important in measuring whether the set company goals are attainable within a given time frame. Regarding actual analysis, the gap analysis tries to see the difference the current company performance and the actual capability regarding potential performance. In the gap analysis, we focus on the analysis of a health care system. Incomplete medical reconciliation is identified as the gap to be analyzed in the healthcare system. More attention will be a focus on the relationship between the healthcare system and electronic healthcare record system (EHR) to find an explanation on its impact on overall healthcare. There is also need to understand important goals that need to be followed to achieve the reconciliation of this factors to improve service delivery at healthcare. Among the factors to be given consideration include the data collection and the technique to be used during sampling. The process should be very smooth and run in a manner that is acceptable to reduce disruption in the work area. Look at the workflow issues mention. Major explorations are given to incomplete medical reconciliation. According to recent research, it’s evident that errors in the medical field have been responsible for injuries caused by some patients across the world. The increased number of reported medical errors prompted the team to carry out a research and determine GAP ANALYSIS RECONCILLIATION 3 proper methods that be adapted to reduce them. In the research, it was noted that variation exists in the reconciliation process and there is need to undertake very crucial step to improve the process. The medical processes should be smooth and in harmony to improve efficiency and reduce the errors in the system. There exist two steps to be followed in realizing reconciliation of any system or process. The first step in the healthcare system is to create a list that captures all the medication that is being administered to a patient. Secondly, the recorded information should be communicated effectively to next service provider that regards the ongoing health care of a patient. Electronic Health Record is very vital in achieving medical reconciliation process. The EHR is an important tool that plays key role in ensuring the pre-admission medication list process is made easier and faster. The reconciliation process is attained through a series of event that ensures that the process is fully automated and once a record is captured it automatically update to all system. Such good automation of the system sometimes can also experience challenges; it is known that system generated medication record may sometimes have errors, and such considerations must be put in place to ensure that they eliminated. It recommended for users of such system to be very keen when using electronically generated information. There should be a keen follow up to ensure that the information generated by the system truly captures the actual state of the patient. The main goal of the electronic health record is to provide accurate information to medical care personnel so that they can be in a position to make the proper decision regarding steps to follow. To fully realize the medication reconciliation through the utilization of electronic health record system, the very two stages must be followed with the correct procedure applied. A good user-friendly display is recommended, the display should provide data from at least two GAP ANALYSIS RECONCILLIATION 4 reliable sources in a format that will allow their attributes to be also accessible. Such proper provision will ensure that user creates a fully reconciled list invalidating the final information. Goals for Gap Analysis Having realized that there is an existing gap in the medication reconciliation process, it will be very necessary to set goals that will guide us in solving such existing problem. Following the given goals with the acceptable procedure, it will be very useful in realizing the reduction of errors previously encountered. The set goals are 1. Providing reliable care coordination during the process between sites of care. 2. Fasten the decision-making process at the point of care. 3. Make an efficient system that will improve medical personnel knowledge regarding current medication to a patient. By the end of the research, it is expected that various mechanism required to eliminate reconciliation disparities would be widely reviewed. Also during the process various drug identification mode will be considered and efficient mode adopted. Data Collection. To be able to successfully collect data survey method will be applied. The survey technique will ensure accurate data collection and also include all members at different work level in the healthcare sector. The method also will be good in capturing various range of data ranging from demographic and hospital structure. During the survey, some individuals will be interviewed including both staff and patients. 5 GAP ANALYSIS RECONCILLIATION References Bayer, S., Petsoulas, C., Cox, B., Honeyman, A., & Barlow, J. (2010). Facilitating stroke care planning through simulation modelling. Health Informatics Journal, 16(2), 129–143 Campbell, E. M, Guappone, K. P., Sittig, D. F., Dykstra, R. H., & Ash, J. S. (2009). Computerized provider order entry adoption: Implications for clinical workflow. Journal of General Internal Medicine, 24(1), 21–26. Dennis, A., Wixom, B. H., & Roth, R. M. (2015). Systems analysis and design (6th ed.). Hoboken, NJ: Wiley. McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning Current-State Workflow Grant Invinzor R Abejar Walden University Current-State Workflow During the research, the gap analysis report helps to identify the effectiveness of an electronic health record system (EHR-S) and based on the information given it recommends its optimization. The recommendation in the optimization will be very useful in the process of improving healthcare service delivery via the information system. The gaps will be very useful in identifying a workflow that is not up to the standard so that such areas can easily be worked on to improve the overall quality of health service. It is now evident that in improving the health quality at a healthcare facility, there is need to redesign workflow system and the overall practice. To achieve this progress in information and quality delivery, it is recommended that an information and quality departments be created to make delivery of such service better. One of the best technique to adapt when redesigning the workflow is to the renovation of the whole system, especially preventive screening. It is clear that from the newly created workflow, nursing officers in charge will be able to receive preventive screening alert and from such information, he or she can start laboratory procedures without waste of time in waiting for authorization from the physician. Following such procedure at the healthcare facility will help in improving quality and saves a lot of time. Analysis of How The Identified Issues Relate to EHR The agency in charge of disease management is tasked with population-based research of diabetes and proper method to carry out preventions. The information concluded from the research is very useful to diabetes care, disease management health officers, futures populationbased surveillance, guardian and other health providers. However, it is noted that there is no full utilization of electronic health record system across various information system. All the information system including the EHR system, the laboratory information management system, the registry in charge of health, and the quality information department to work together to achieve proper exchange of information in realizing fight against diabetes. Such information system lacking in health organization will force the healthcare system to use standalone information source which in reality is not sufficient to address the health care of a patient. Current State Workflow On the normal days of operation at the health facility, patients come in and their information in captured to the registry by health center clerk. The patient consent is recorded and send to electronic health record system. Then the nurse will examine the patient to obtain the signs which are also keyed into the electronic health record. The physician in charge will examine patient state, and the result is available via electronic health record. After all the information from the patient is obtained, the care manager will communicate with the clinical officer to get guidelines to care for chronic disease though database querying. After all the preliminary tasks have been completed, the physician in the charge request for the HbA1c test through the electronic health record system. The nurse receives the request and obtain blood from the specimen and complete the request by sending the specimen to the laboratory. The laboratory messaging technique will be connected with the electronic health record so that such exchange of information to the laboratory will be realized. The final results from the laboratory are obtained, and if the completion notification shows that the results are normal, then it is the duty of physician in charge to review the case. This may utilize forthcoming HIE alert database, which will communicate the unusual results and support authorization of receipt of the abnormal results by the medical doctor. If the results are normal, the physician converses HcA1c test results to the patient. The manager in charge of patient care will generate a care schedule based on the report from the Hb1c test from the laboratory and the physician in charge will also be responsible in reviewing the care plan as stated. The health information exchange (HIE) system together with the health electronic record system will be utilized in producing a highly accurate report about the patient progress. The disease surveillance report that is standard can be downloaded to guide during the patient care. Lessons Learned. Based on the overall feedback obtain it was agreed that a lot of acronyms should be eliminated if not well defined to avoid complexity. The gap analysis is very important not only in identifying the factors and major reasons for the gap but also good knowledge about the gap background and how to eliminate is very necessary. From this understanding, it is good for a person in charge of gap analysis to have proper information gathering format and ensure that the process runs smoothly to the end with accurate and proper solutions being realized in the process. Conclusion The challenges faced in fighting diabetes has been mainly attributed to the fragmented, duplicative, and unsystematic healthcare systems that put a lot of emphasis on acute conditions and complications than on managing this chronic disease (American Diabetes Association, 2015). The workflow structured in this paper describes a diabetes register office system that changes the way healthcare facility manages patients with diabetes. The implementation of this Diabetic Healthcare will be very useful in coordinating the accountabilities for intervening and monitoring patients in the system with ease. Reference American Diabetes Association (2015). Standards of medical care in diabetes. Retrieved from http://www.diabetes.org/research-and-practice/we-support-your-doctor/clinical-practicerecommendations.html Brokel, J. M. (2009). The infusing clinical decision supports interventions into electronic health records. Urologic Nursing, 29(5), 345–352 Davis-Ajami, M. L., Costa, L., & Kulik, S. (2014). Gap analysis: Synergies and opportunities for effective nursing leadership. Nursing Economics, (1), 17. Glaser, J. (2008). Clinical decision support: The power behind the electronic health record. Healthcare Financial Management, 62(7), 46–48, 50–51. Saba, V. K., & McCormick, K. A. (2015). Essentials of nursing informatics (6th ed.). New York, NY: McGraw-Hill. Revised Workflow Diagram Patient Arrival Nursing and Doctor/Physician Consultation Laboratory Investigation No Patient Treatment and Leaves Medical Services Patient arrives Patient in the system? Nurse available? -Yes Take pulse, blood pressure, weight, urine No No Patient needs to complete paperwork Waiting Room Doctor available? -Yes Patient with doctor No Need follow-up Waiting Room -Yes Make an appointment appointment? No Need medication? -Yes Patient sent to pharmacy OLE Dispense medication No Patient leaves
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