Impact of Clinical Systems on Outcomes and Efficiencies with the Nursing Practice Context
Introduction
The role of efficient and effective health systems in the management of healthcare costs, disease burden, and the provision of universal health coverage can only be appreciated by understanding the construction of clinical systems. Clinical systems entail the utilization of Information Technology and computerized services in the clinical care environment. Information Technology has a significant impact in improving the safety, quality and efficiency of healthcare services. This paper will synthesize and analyze peer-reviewed research articles.
Bergey, M. R., Goldsack, J. C., Robinson, E. J. (2019). Invisible work and changing roles: Health information technology implementation and reorganization of work practices for the inpatient nursing team. Social Science & Medicine, 235(). https://doi.org/10.1016/j.socscimed.2019.112387
The study by Bergey et al. (2019) sought to establish the current acceptance, effectiveness and efficiency of digital technology presently used in nursing care. The authors acknowledge that while digital technologies have extensive opportunities to overcome some of the pertinent challenges in the healthcare sector, there is potential for non-normative, and sometimes unexpected outcomes.
Accordingly, the authors note that adoption of health information technology tends to reconfigure work practices, sometimes at the expense of nurse/patient interactions. Clinical and care delivery systems that encourage nurse-patient interactions can improve the quality of care delivered, which in turn results in overall improved nurse performance. However, in instances where such systems result in work or staffing realignments, then the need to prioritize patient care becomes imperative.
Blijleven, V., Koelemeijer, K., Wetzels, M., & Jaspers, M. (2017). Workarounds emerging from electronic health record system usage: Consequences for patient safety, the effectiveness of care, and efficiency of care. JMIR Human Factors, 4(4), e27. https://doi.org/10.2196/humanfactors.7978
The fast adoption of Electronic Health Record systems (EHRs) has the potential to improve the general way in which medical information is collected, stored, processed and communicated between those involved in the delivery of healthcare services. The study by Blijven et al. (2017) shows that the adoption of Electronic Health Records system results in positive outcomes related to the general safety of the patients through reduced costs, efficiency, and provision of quality services. Therefore, due to these benefits and other state-provided stimulus packages, several healthcare systems in the world have adopted these new clinical systems to provide quality and affordable patient care.
Blijleven et al. (2017) argue that although the adoption rates of these new clinical systems are fast rising, the much-anticipated benefits in the healthcare system are slow. In addition to that, the authors have addressed the often unanticipated and unfavorable outcomes of adopting these new clinical systems with particular emphasis on the adoption of EHRs.
Some of these constraints include the challenges experienced by healthcare providers following poor navigation and difficulties in finding the right choice of system. Many clinical systems are double-edged. Sometimes, these clinical systems may not deliver 100% improved efficiency, but in most cases, they ensure patient safety. For instance, these EHRs have been used by the medical team to override alerts aimed at giving critical medication to a patient as soon as possible.
Gee, P. M., Greenwood, D. A., Paterniti, D. A., Ward, D., & Miller, L. M. S. (2015). The eHealth enhanced chronic care model: a theory derivation approach. Journal of Medical Internet Research, 17(4), e86. https://doi.org/10.2196/jmir.4067
Terminal diseases are costly and emotionally draining to an individual and the community at large. However, when implemented systematically, tested, and well-established using the Chronic Care Model (CCM), their general outcome seems to improve significantly and to be cheaper. The general development of this model alongside its communication protocols, its information management pathways and technology, this time-bound clinical system has created a lot of efficiency in electronic healthcare tools.
Gee et al. (2015) define CCM as a well-defined and comprehensive clinical model that has been validated in the caring of the chronically ill patients. Collectively, it improves the clinical and functional outcomes of the system. Just like other electronic models, this model has the aspect of Self-management support that feeds the patients with clinical knowledge, skills and confidence on how to self-manage their conditions, thus making life easy for the workaround nurses.
Finally, CCM emphasizes on clinical information systems aimed at providing the patients, relatives and clinical team access to data, clinical information, and knowledge on how to improve their health (Gee et al., 2015). This, in its entirety, creates a patient-nurse relationship that at the end increases clinical efficiency, thus saving time and cost. Further, the authors identify three pertinent areas of eHealth that the CCM approach can greatly improve. These include eHealth education focused on critical self-care, establishment of eHealth support that leverages the benefits of virtual communities and the creation of a comprehensive feedback loop to enhance patient-provider interactions.
Hussey, P. A., & Kennedy, M. A. (2016). Instantiating informatics in nursing practice for integrated patient-centred holistic models of care: a discussion paper. Journal of Advanced Nursing, 72(5), 1030-1041. https://doi.org/10.1111/jan.12927
Based on the increasing incidences of chronic illnesses and their costs, the cost of traditional clinical care models in increasingly becoming unsustainable. For this reason, global health systems are looking into technology-enabled solutions capable of supporting a patient-centred clinical model. Informatics models have played a significant role in designing, implementing and use of novel healthcare models.
In their study, Hussey and Kennedy (2016) contend that clinical leaders should recognize and come up with the best and relevant clinical models that will help in creating efficiency and reducing cost in the future transformation of the healthcare industry. The authors thus provoke nurse leaders to focus on developing informatics skills not only to transform the healthcare profession but also to advance the delivery of care.
Hussey and Kennedy (2016) argue that clinical informatics models like EHRs are redesigning healthcare, specifically in the delivery of quality healthcare while significantly cutting down the associated clinical costs. However, to achieve this, it requires focused attention, first from empowering the nurses before the application of the models. To achieve this, the authors suggest assertive promotion and maximization of progressive nursing opportunities, enhanced nursing inclusion and visibility for an inter-professional care delivery model and the development of structured opportunities for building knowledge of informatics among nurses.
Conclusion
Based on the findings from the four articles, a holistic perspective of the clinical system aims at promoting the delivery of quality services by creating efficiency and resource utilization. Globally, the healthcare system is in transition, a factor that renders the traditional models no longer viable. Although not all-new clinical system models have proven viable, especially in relation to improved efficiency and resource utilization, all new clinical models have proven efficiency, are time–saving and are vital in reducing the costs of healthcare.
Arguably, these systems have been integral in improving the general hospital design, implementation of other models and recognition of essential patient-nurse essentials. These novel articles collectively therefore uphold the general concept of how various clinical models improve the quality of health globally.
References
Bergey, M. R., Goldsack, J. C., Robinson, E. J. (2019). Invisible work and changing roles: Health information technology implementation and reorganization of work practices for the inpatient nursing team. Social Science & Medicine, 235. https://doi.org/10.1016/j.socscimed.2019.112387
Blijleven, V., Koelemeijer, K., Wetzels, M., & Jaspers, M. (2017). Workarounds emerging from electronic health record system usage: Consequences for patient safety, the effectiveness of care, and efficiency of care. JMIR human factors, 4(4), 27.
Gee, P. M., Greenwood, D. A., Paterniti, D. A., Ward, D., & Miller, L. M. S. (2015). The eHealth enhanced chronic care model: a theory derivation approach. Journal of medical Internet research, 17(4), 86.
Hussey, P. A., & Kennedy, M. A. (2016). Instantiating informatics in nursing practice for integrated patient-centred holistic models of care: a discussion paper. Journal of Advanced Nursing, 72(5), 1030-1041.