Health care regulatory compliance, together with quality management, can be said to be inextricably linked. In that respect, compliance officers should work in partnership with the quality management team. It has to be understood that regulatory compliance is not merely concerned about billing procedures. It has to be described to encompass the delivery of quality services to patients, as well as, residents so as to support claims submission for services offered. In the event, regulatory compliance is viewed via a clinical lens; it will turn out that patient safety happens to be paramount. Therefore, the compliance regulations have to be a vital part of all the healthcare provider’s initiatives aimed at the delivery of quality services (Miller, 2016).
There are diverse quality management tools, which can be utilized as process control techniques for the purposes of supporting compliance efforts.
The primary quality improvement tools that assist healthcare organizations in the generation of ideas, analysis, development, and evaluation of the process, in addition to the collection of data include flowchart or process maps, scatter diagrams, control charts, check sheets, histogram, cause-effect diagram and Pareto diagrams. In this report, the focus is directed on the utilization of flowcharts and scatter diagrams in informing internal policies, procedures, as well as, in decision making within organizations.
Concerning flowcharts, they are simply a picture of the various steps of a particular system within sequential order. The elements that included within the flowchart are such as the actions sequence, decisions which have to be made, the individuals to get involved, services getting into or leaving the process, the timeline of every step and the process measurements (Franklin et al., 2017). Typically, flowcharts are ideal tools of studying a process for improvement, documenting a process and communication to others the manner in which a policy is to be implemented. An example of a flowchart is as illustrated within the diagram that appears below, which indicates the process of undertaking a diagnosis.
egarding scatter diagrams, they are basically a graphic technique used within the analysis of the relationship or connection between two variables. In most cases, two data sets are plotted in the form of dots within a graph. The resultant patterns of how the dots get disperse can greatly assist in determining whether the variables happen to be related. They are usually used in the identification of the probable root causes of the emerging problems. They also assist in establishing objectively of a particular cause and effect turn out to be related upon brainstorming causes, as well as, effects through the use of a fishbone diagram (Deokar & Sarnikar, 2016). Besides, scatter diagrams come in handy within the establishment of whether specific effects that tend to be connected emerge with a similar cause. Most importantly, they are used to test for autocorrelation prior to the construction of a control chart, specifically when in the procedure of developing a quality control policy upon the identification of a certain patient safety issue. The diagram below is an example of a scatter diagram that illustrates the relationship between monthly healthcare linked infection index rates with hand-hygiene:
Plan of Measuring and Managing Performance
There are diverse techniques that can be used in measuring and managing performance in the course of transiting to new EHR (Electronic Health Record) systems. There is a continuous search by healthcare professionals to make quality, as well as productivity better within the workplace. The successful implementation of an EHR system is done with the expectation that improvements with not only productivity but also the quality of work are set to be realized, at least within the course of time (Franklin et al., 2017). In that regard, for purposes of measuring improvements, the concerned healthcare professionals have to establish monitors in addition to developing baseline productivity along with quality standards. The ultimate objective happens to be the realization of the best performances from the respective work teams.
One of the benchmarking techniques that can be used in evaluating the performance of a team while transiting to a new EHR system is productivity standards. The productivity standards assist in assisting the impact of the new EHR system on productivity within the healthcare facility. Within facilities which rely on the fee-for-service income as their basis for compensation, the impact of an EHR on productivity is measured within diverse ways. One of them is the reliance on the raw volume. Within ambulatory, the average daily visits that were recorded prior to the commencement of the implementation of the EHR system are reviewed. A one-month survey can be used so as to calculate the approximated average visits on a daily basis. Then the daily visits upon the introduction of the EHR system are monitored within different periods, which can be within a specific set of days. Such a move offers a sense of dip within productivity (which happens to be common and has the potential of lasting weeks to months (Deokar & Sarnikar, 2016).
On the other hand, the intensity of service can be used to determine the productivity standards. The just mentioned strategy involves reviewing the number of receipts deposited within a specified time interval. However, it has to be noted that the actual deposits are likely to be the ideal measure (Lorenzi et al., 2009). The total receipts are divided by the overall number of visits within the same time period. The resultant figure turns out to be the average dollars being received per visit. A comparison is made between the average dollars being earned per visit prior, as well as, after the commencement of the implementation of the new EHR system. An example of productivity standards chart is as shown below:
The other benchmarking techniques that can be utilized in evaluating performance in the transition to a new EHR system are dashboards. Dashboards are typically data-driven clinical decision making support tools that are utilized in the analysis of data from diverse databases through the use of colour-coded graphical displays that are easy-to-read and quite similar to the automobiles’ dashboards. The dashboards can successfully be utilized in promoting the data-driven making of decisions and improve adherence to the set practice guidelines. There are dashboards that can be put into use to query EHR in order to guide the implementation of the new system. The five fundamental dashboard properties used in querying the EHR systems are such as the visual properties, time focus (real-time, retrospective or predictive), database integration and nature of process monitored (Franklin et al., 2017).
Workflow Concepts of Managing Transition to new EHR System
EHR deployments are associated with drastic paradigm shift with the workflow that lacks a typical change to electronic processes from paperwork. The core objective of EHR systems is the making of real-time information, as well as, documentation management of diverse activities such as patient assessments, medication order history, together with lab results among others, available instantly to every provider to make better patient safety, as well as, outcomes. Nonetheless, the healthcare professionals’ trends within the adoption of technology primarily rely on workflows which support the ideal practices, easy accessibility to the point-of-care documentation, in addition to useful physical work patterns (Deokar & Sarnikar, 2016).
Before the implementation of a new system or procedure, it turns out to be essential to document the present workflows. The just mentioned process will, in most cases identify the present practices, which are suboptimal, and it facilitates the addressing of the high-risk scenarios, as well as, the determination of device strategies. The documentation is utilized in creating momentum together with direction, which supports healthcare professionals through a clear set path of commencement to the conclusion of the transition process (Miller, 2016).
Top-down diagrams and swimlane diagrams are ideal workflow concepts. The top-down diagram can be used to illustrate the EHR system breakdown to its minimal manageable levels. The diagram is utilized within structured programming for purposes of arranging the system modules into a tree. Every module gets featured within a box, and the tree visualizes the connection between the modules. Within the implementation of the EHR system, the top-down diagram can take the form illustrated below:
On the side of swimlane diagrams, which are some type of flowchart, specifications are made on who does what within the EHR system implementation. The swimlane diagram offers clarity, as well as accountability by placing procedure with the vertical or horizontal “swimlanes” of a specific team member. An example of a swimlane is as shown below:
Project Management Techniques
Gantt charts and risk analysis are the project management techniques that will be utilized for the implementation of EHR system in order to ensure not only efficient workflow but also appropriate outcomes (Lorenzi et al., 2009). The Gantt chart will outline the plan for the project, in addition to showing its progress. It will take the bar chart format and will depict the diverse subdivided phases, which have to be completed for the system to be fully implemented and when within the project timeline the featured phases have to occur. It will take the form illustrated below:
Concerning risk analysis, it involves the planning for risk, identifying and assessing risk areas and formulating risk-handling options, monitoring threats to establish how the risks have changes and documentation of the overall risk analysis and management program. The objective of risk analysis is to minimize the likelihood of risk, as well as alleviate risk effects. Failure to carry out risk analysis and make sure that the EHR system is secured from inadvertent or intentional disclosure puts an organization at the danger of facing civil or criminal cases for failure to comply with patient data privacy regulations.
Deokar, A. V., & Sarnikar, S. (2016). Understanding process change management in electronic health record implementations. Information Systems and e-Business Management, 14(4), 733-766.
Franklin, A., Gantela, S., Shifarraw, S., Johnson, T. R., Robinson, D. J., King, B. R., … & Rubio, A. (2017). Dashboard visualizations: Supporting real-time throughput decision-making. Journal of biomedical informatics, 71, 211-221.
Lorenzi, N. M., Kouroubali, A., Detmer, D. E., & Bloomrosen, M. (2009). How to successfully select and implement electronic health records (EHR) in small ambulatory practice settings. BMC medical informatics and decision making, 9(1), 1-13.
Miller, R. J. (2016). Compliance and quality management integration for improved patient services (Doctoral dissertation, Utica College).