EHR Project Plan

Based on the EHR Project case described in Module 01, write a 5-6 page project plan draft. This project plan should include the following: •Description of the overall and specific goals for the project, including an explanation of the overall goal and the approximate scope of the project. 

•Description of the organization, and its characteristics and climate in which the project will be deployed. 

•A breakdown of the project lifecycle, explaining what will take place during each phase and who will be involved. This portion needs to demonstrate understanding and application of each of the project lifecycle phases to the Good Apples Group project. What tasks will occur at each stage?

**5-6 PAGES**  Project Case from mod 1 attached

The Good Apples Group EHRS Project

Summary

You are an employee of the Good Apples Group, a healthcare organization which runs MacIntosh Manor Hospital. The CEO of the hospital has made a priority for the hospital to enter the 21st century by converting its operations to an Electronic Health Records System. You have been assigned the role of project manager for this effort, and are therefore responsibility for ensuring that the needs of the hospital have been carefully assessed and that the planning process for bringing an EHRS online is effective.

The Organization

At first glance, MacIntosh Manor Hospital looks like any small town hospital, where the quality of care is certainly modern but the staff and patients still come to know each other and expect a down-to-earth pace. The Good Apples Group, a parent corporation maintaining several local clinics in addition to MacIntosh Manor, has worked hard over the years to maintain that balance of customer service and cutting edge patient care.

MacIntosh Manor Hospital is a 500-bed, critical access hospital in Shiminy, Pennsylvania. It is the largest hospital within 100 miles, and schedules between 22,000 to 26,000 visits a year. MMH provides surgical, medical and acute care, 24-hour emergency room services, outpatient services, health education, behavioral services, and home and hospice care to a primarily suburban region of about 124,000 residents. It employs 2200 people, including 275 physicians, and as a hospital is managed by its own CEO.

MMH’s mission is to provide for the residents of Shiminy high quality services that enhance the quality of life and promote healthy lifestyles for patients, clients, employees, organization and communities. In its community MMH seeks to lead by example through compassionate, caring and comprehensive health care services.

The direction of MacIntosh Manor’s strategic vision change greatly in 2010 when Dr. Phillip Kapp was named CEO of the Good Apples Group and made it clear that his own successes with implementing EHRS and related technologies in healthcare facilities in the Philadelphia area would be the kind of challenge he wished to take on again with MacIntosh Manor Hospital. Kapp formed a strategic planning committee to assess the use of technology and what MMH should implement, and to determine and monitor a migration path.

Around the same time that Dr. Kapp took charge of the Good Apples Group, a federal mandate was issued that hospitals nationwide need to be using electronic medical records by 2015, giving Kapp and the strategic planning committee even more incentive to act quickly. The committee recommended beginning the transition to EHRS immediately and implementing both financial and clinical solutions.

“Creating a ubiquitous and common platform for timely access to clinical information is crucial for patient care and patient safety. By giving physicians and nursing staff access to the information they need at the point of care, we will eliminate unnecessary tests, and reduce patients’ exposure to medical errors and drug allergies.”

Thomas Lytle

Chief Information Officer at MacIntosh Manor Hospital

Key Business Processes

Clinical Decision Support

A key business process to be addressed by the EHRS should be clinical decision support. When staff enter orders electronically, doctors should gain quick access to their patients’ medication history and be provided real-time potential adverse drug event alerts such as drug-drug and drug allergy. “Currently if a doctor adds a medication on paper they won’t necessarily see what other medications their patients are on unless they carefully go back and flip through the paper-based patient record,” noted Sam Guder, Head of Nursing.

Nursing documentation

Nursing admission assessments for inpatient and outpatient care are now a chaotic mess, as each member of the nursing staff has a different level of experience and often prepare records based on best practices at a facility where they had previously worked. Clinicians should be able to view historical patient information, ensuring appropriate and continuous care. Nursing shift assessment should be able to be pulled forward for review or editing prior to being accepted as part of the patient record.

“I can envision using a wireless LAN with laptop computers at each nursing unit to provide access to EHRS at the point of care, reducing the potential for transcription errors, saving everyone’s time, and eliminating lag time between gathering information and entry into the system. Ideally we would want to decrease nursing time for regular and overtime staff from 1.5 hour to 1.0 hour per day per nurse. Admission assessment should be reduced by two minutes per patient and shift assessment by seven minutes,” says a member of the nursing staff interviewed for this project.

Specific Need: Prevention of bedsores, falls and hospital-based infections

Good Apples Group has recently been asked to comply with new patient safety and pay-for-performance standards. Medicare will stop reimbursing hospitals for treating eight “reasonably preventable” conditions patients acquire at hospitals. These conditions include pressure ulcers, better known as bedsores, patient falls and urinary tract infections. We need software that has built-in bedsore and patient fall risk assessments into the electronic nursing assessment, so that if certain elements are documented during the assessment, the EHRS will trigger electronic alerts to clinicians.”

Additional Business Processes

Dr. Kapp has indicated that his experience demonstrates the value of a phased rollout of EHRS software. At one clinic where he had attempted a wholesale overhaul of the clinic’s business practices with an EHRS he saw an immediate decrease in the quality of care, combined with a great deal of swearing from the staff and anger among the facility’s managers. In order to phase in the EHRS carefully, Dr. Kapp has suggested that the following units within the organization be addressed first:

Targeted Organizational Units

· Pharmacy

· Radiology Unit

· Respiratory Therapy

· Food and Nutrition Services

· Mom-Baby and Labor & Delivery

MacIntosh Manor Hospital Organizational Chart

“Many of our physicians are reluctant to adopt EHRS technology if it does not mirror their current workflow,” Dr. Phil Kapp, CEO of the Good Apples Group says. “An intuitive, easy-to-use system is the key to making something work here.”

MacIntosh Manor Hospital at a glance

Beds– inpatient: 500

Number of physicians: 275

Number of nurses: 7000

Annual inpatient visits: 24,480

Annual Emergency Room visits per year: 93,702

Desired Results

• Real-time access to patient data

• Improve quality and continuity of care

• Enhance patient safety

• Enterprise-wide connectivity

• Improve physician recruitment