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Quality Improvement Initiative: Executive Summary

Introduction

Poor medical reconciliation is a common occurrence in most healthcare settings. With the recent surge in the number of in-patients that unknowingly overstay in the hospital wards, the management embarked on quality improvement (QI) initiatives as part of its strategic plan to improve patient discharge. With lives at stake and specific practice standards to meet, our organization must be held accountable for service delivery excellence. Therefore, we propose implementing a new electronic health record (EHR) system for efficient management of patient data.  

The Purpose of the QI Initiative

The project aims to support the implementation of a new EHR system in the organization. Currently, more than half of patient medical records are managed manually due to the inability of the current system to support the growing number of patients. This has resulted in low hospital discharges as some patients stay beyond the requisite duration. The program also aims to improve hospital discharges by enhancing operational efficiency in terms of handling patient data and performing medical reconciliations.

Target Population

            The program targets in-patients of all age groups and medical conditions. Length of stay (LOS) is a vital indicator for evaluating the efficiency of hospital management, performance, and quality of patient outcomes (Baek et al., 2018). Evidence indicates that patients still struggle to have their voices heard, and with ineffective processes, most have ended up overstaying in hospitals and incurring higher medical charges (Emes et al., 2018). Ensuring shorter LOS and smooth patient transition from the hospital to homes requires proper planning and monitoring from admission until discharge. Moreover, the surge in hospital admissions due to the Covid-19 pandemic revealed an underlying challenge in managing inpatients. This supports the need for efficient medical record-keeping, reconciliation, and communication between healthcare providers, patients, and support teams. 

The Benefits of the Proposed QI Program

It is projected that implementing a new EHR system will be effective in ensuring better healthcare by improving all aspects of patient care such as efficiency, safety, patient-centeredness, effectiveness, and equity.  With enhanced efficiency, healthcare providers will be able to manage inpatients effectively. This includes better and expedient medical reconciliation to reduce LOS and possible crises due to congestion.  Decreased LOS is associated with improvements in treatment outcomes, patient satisfaction, and reduced mortality rate (Baek et al., 2018). EHR implementation is also expected to improve the communication between different healthcare professionals, support staff, and patients, thus ensuring the smooth patient transition from hospital to homes.

On the other hand, shorter LOS will increase bed turnover and reduce the burden of medical fees. In recent instances, patients have complained about being kept for long in hospitals despite their improved conditions, and the majority experienced difficulties in settling the huge medical fees. An internal investigation showed that such instances emanated from poor medical reconciliation and poor communication among different departments. 

Necessary Interprofessional Collaboration to Implement the Program

            Successful implementation of the program in the organization will require effective collaboration between different professionals such as nurses, doctors, clinicians, management, and the technical team. The technical team will design, develop, install and customize the system will all required aspects of the organization. Additionally, they will be responsible for training all the end-users, healthcare providers, and support staff, besides providing the necessary support during system outages. On the other hand, the management and stakeholders will establish the need and viability of implementing such a project. Upon approval, they will provide the necessary support to ensure its successful implementation and use. 

Cost Justification

            Implementation of EHR systems represents a huge economic burden to most hospitals and organizations. According to a recent study, the cost of EHR systems is approximately $162,000 in the initial year and subsequent $85,000 in annual maintenance fees (Palabindala et al., 2016).  Despite the high cost of implementing the project, it is highly beneficial to improve the quality of healthcare, which is the organization’s core mission.  Besides, the proposed project has a great potential of savings significant healthcare costs associated with increased LOS, improper management of patient data, medical errors due to mix-ups in the patient’s records, and potential ethical and legal issues that may arise. This indicates that the cost involved in implementing the program is way lower than the cost associated with covering the consequences of not implementing it.

Project Evaluation

It will be important to evaluate the efficacy of the QI initiative after implementation to establish whether it meets the desired purpose. In doing so, data regarding patient discharge, patient data mix-up, and medical errors will be collected before and after the implementation of the new system. This data will be analyzed and compared to note any difference after implementing the project. An improved medical reconciliation, patient discharge, and treatment outcomes will demonstrate the project’s efficacy in the target group. Additionally, the impact of the program on the operation and management of the organization will be re-evaluated annually.