. Write a case analysis developing a corrective action plan for Garrison.
2. Use the Guidelines for Writing A Case Study Analysis (attached)
3. In addition to the standard case analysis components within the guidelines, please include the following points:
A. Include a description of the key components of a corrective action plan and project timeline for implementation of the corrective action plan in your proposed solution section.
B. Add a table, chart, flowchart, and so on to illustrate your solutions. Be sure to include high-level tasks to be completed.
C. Include a discussion of what lessons could be learned from the case that could be applied to other settings in your recommendations section.
Format your research paper according to APA guidelines
CASE 10: CONCERNS AND WORKAROUNDS WITH A CLINICAL DOCUMENTATION SYSTEM
Major themes: system implementation; project management
Background Information Garrison Childrens Hospital is a 225-bed hospital. Its 77-bed neonatal intensive care unit (NICU) provides care to the most fragile patients, premature and critically ill neonates. The 28-bed pediatric intensive care unit (PICU) cares for critically ill children from birth to eighteen years of age. Patients in this unit include those with life-threatening conditions that are acquired (trauma, child abuse, burns, surgical complications, and so forth) or congenital (congenital heart defects, craniofacial malformations, genetic disorders, inborn errors of metabolism, and so forth).
Garrison is part of Premier Health Care, an academic
medical center complex located in the Southeast. Premier Health Care also includes an adult hospital, a psychiatric hospital, and a full spectrum of adult and pediatric outpatient clinics. Within the past six months or so, Premier has implemented an electronic clinical documentation system in its adult hospital. More recently the same clinical documentation system has been implemented at Garrison in both pediatric medical and surgery units and intensive care units. Electronic scheduling is to be implemented next.
The adult hospital drives the decisions for the pediatric hospital, a circumstance that led to the adult hospitals CPOE vendor being chosen as the documentation vendor for both hospitals. A CPOE system was implemented at Garrison Childrens Hospital several years prior to implementation of the electronic clinical documentation system, which began in 2010.
Information Systems Challenge A pressing challenge facing Garrison Childrens Hospital is that nurses are very concerned and dissatisfied with the new clinical documentation system. They have voiced concerns formally to several nurse managers, and one nurse went directly to the chief nursing officer (CNO) stating that the ?flow sheets? on the new system are grossly inadequate and she fears using them could lead to patient safety issues. Lunchroom conversations among nurses tend to center on their having no clear understanding of why the organization is automating clinical documentation or what it hopes to achieve. Nurses in the NICU and PICU seem to be most vocal about their concerns. They claim there is inconsistency in what is being documented and lack of standardization of content. The computer workstations are located outside the patients rooms, so nurses generally document their notes on paper and then enter the data at the end of the shift or when they have time.
The system support team, consisting of nurses as well as technology specialists, began the workflow analysis, system installation, staff training, and golive first with a small number of units in both the adult hospital and the childrens hospital, beginning in January 2010. The NICU and PICU did not implement the system until May and June 2010. System support personnel moved rapidly through each unit, working to train and to manage questions. The timeline for each unit implementation was based on the number of beds in the unit and the number of staff to be trained. No consideration was given to staff members prior experience with computers and keyboarding skills or to complexity of documentation and existing work processes.
Although there are sim
