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Developing an Implementation Plan

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Developing an Implementation Plan

The economic initiative proposed at the health care facility is the upgrade to the Electronic health records (EHR) system. The Introduction of EHR at the healthcare facility will lead to an increase in the rate of service delivery. EHR will lead to a reduction in long patient queues at the facility. This will enable healthcare providers to offer timely healthcare services to all patients. Patient treatment outcomes will improve due to the prompt initiation of therapy. Furthermore, EHR will reduce the cases of adverse drug effects and allergies because it will avail patient’s personal health information (Kharrazi et al., 2018). This is important to the patients and health care facility because the expenses of managing allergies and side effects will be reduced.

A cost-benefit analysis of the economic initiative revealed that EHR is economically viable. This paper discusses the implementation plan EHR. The implementation plan entails a budget for expected costs and earnings over the first five years. The plan also contains a timeline for rolling out the initiative. Furthermore, the plan explains how the initiative can remain viable in the face of environmental changes.

Budget for the Proposed EHR System

The budget has been created based on the assumption that the EHR system will be implemented by December 2021. The budget contains revenue and expenditure costs for the first five years of operation of EHR. The years included in the budget are 2022 to 2026. The expected capital cost of the initiative is approximately $ 360,000. The capital cost will be invested in the acquisition of software, hardware, implementation, and the initial training of staff.

It is approximated that software costs for each healthcare provider are $1,500. Software cost estimation for all health care providers at the health facility is $100,000. EHR hardware costs are approximately $6,500 per office with three healthcare providers (Reis et al., 2017). Hardware costs for the entire healthcare facility are approximately $120,000. The approximated implementation costs of the EHR are $3,300 per healthcare provider (Reis et al., 2017). The total estimate of the implementation cost is $80,000. The other costs incurred in the current year are maintenance and staff training. It is estimated that the costs are $30,000 each.

The capital cost of $360,000 will be raised by taking a bank loan and using the healthcare facility’s savings. The savings of the healthcare facility will account for $190,000 of the capital cost. The healthcare facility will take a bank loan of $160,000 to supplement the estimated capital cost. The assumption is that the loan will be repaid within five years, and the interest rate is 5 percent annually. Therefore, the loan repayment will be $40,000 per annum.

The projected revenue per annum is calculated based on the estimated increase in the number of patients served per day. The EHR will increase the number of patients served daily by approximately 300. The patients will receive consultation services, during which they are required to pay a service fee. The fee ranges from $90 to $120 based on the service being sought. However, there is uncertainty about whether all of these patients will pay for medications, medical equipment, and laboratory services. Furthermore, there is uncertainty on whether the estimated increase in the number of patients will be achieved daily. The approximation in the increase in the revenue is set at $ 200,000, $ 400,000, $650,000, $ 900,000, and $ 1,100,000, respectively, for the five years.

The budget reveals that the EHR system is economically viable and will earn a cash surplus within the first five years. The cash surplus is calculated by subtracting the sum of non-operating expenses and total operating payments from total operating receipts. Based on the budget, the total cash surplus within the first five years is approximately $ 2,330,000.00 (see Appendix for the details on the 5-year budget for the EHR system).

Implementation Plan

Implementation of the plan will begin by setting up a timeline required to roll out the EHR system. It is assumed that the healthcare facility’s management will take two months to approve the initiative. Loan application and approval will take place within one month after approval of the initiative. The acquisition of software and hardware will take place within one month after loan approval. The installation of hardware and software will occur within two months. Staff training will take place within two months, after which the initiative will be implemented. The entire rollout process will take eight months, from May 2021 to December 2021.

Internal and external stakeholders are key to the successful implementation of the EHR system. The internal stakeholders include healthcare providers (nurses, physicians, pharmacists, dieticians) and the management of the healthcare facility (van Offenbeek & Vos, 2016). Healthcare providers are important in the implementation process because they deal directly with the patient using the EHR. Regular training of healthcare providers will take place to ensure that they are equipped with the required skills. Skillful use of EHR is key to increasing the rate of service delivery and reducing the long queues of patients. Furthermore, regular training will help minimize anticipated EHR breakages and failure. This will lead to a reduction in maintenance costs of the EHR system. The management of the healthcare facility is in charge of overseeing the training process.

Key external stakeholders in the implementation process are the patients. Healthcare providers using the EHR system will be required to provide holistic patient care. This refers to the type of care that focuses on the patient as a whole to fulfill their needs (Frisch & Rabinowitsch, 2019). Patients’ needs can be spiritual, emotional, physical, cultural, or economic. The fulfillment of patients’ needs is key to retaining them and receiving their referrals at the facility. Holistic care and the increased rate of service delivery by EHR will ensure that patients are content with the healthcare facility.

The rollout will be conducted ethically and culturally equitably by upholding the principles of healthcare ethics. The principles include autonomy, non-maleficence, beneficence, and justice. Autonomy refers to the right of the patient to make decisions regarding their treatment. Justice refers to upholding fairness during health care delivery (Jamshed et al., 2015). Non-maleficence advocates for doing no harm to the patient. Beneficence is a principle that requires healthcare providers to practice to benefit patients (Gillon, 2015). Justice will ensure that patients from different ethnicities and cultural backgrounds are not discriminated against. The four ethical principles are essential for the successful rollout of the plan.

To ensure that the desired service improvements of EHR are on track during and after implementation, regular assessments will be made. The desired improvement is to increase the rate of service delivery and reduce the long patient queues. These outcomes have a positive economic impact on the facility. After the assessment, feedback will be provided to staff on the progress of their service delivery. The assessment will include the number of patients served per day and the level of satisfaction of patients with the services. After assessment and feedback delivery, staff will be trained to provide better services. Staff will be required to raise any concerns with the use of the EHR. The necessary measures will be taken to ensure that all of their grievances are solved. This will enable staff to deliver the desired quality of services using EHR.

Areas of uncertainty revolve around loan approval. The bank loan required by the health facility is $160,000. It is estimated that the loan will be approved within one month after the approval of the initiative. Delays in the approval of the loan can lead to changes in the proposed schedule of the implementation plan.

Impact of the Proposed Initiative

Implementation of the EHR system will lead to an increase in the rate at which services are delivered to patients. This is expected to reduce the traditional long queues witnessed at the facility. It is estimated that EHR will lead to an increase in the number of patients served per day by 300. In addition to increasing organizational revenue, the introduction of EHR will have a significant impact on other aspects of the care settings. The anticipated increase in the number of patients will increase the workload on all departments of the facility.

Healthcare workers will have to deal with more patients per day. This is a negative effect because overwhelmed healthcare providers cannot discharge their services effectively. It can lead to the occurrence of medication errors or misdiagnoses (Gardner et al., 2019). This will be mitigated by gradually increasing the number of healthcare workers over the first five years. The increment will be done based on the number of patients being served at the facility per day. The aim is to increase the healthcare provider-patient ratio, reduce burnout of the caregivers and maintain quality service delivery to patients.

The increased service delivery is likely to increase workloads in other departments, such as the laboratory section. This will be addressed similarly to the anticipated overwhelming of healthcare providers. Laboratory personnel will be increased gradually over the five years. This hiring process will ensure that the increased workload does not strain the existing personnel. The management will perform regular assessments to determine the need to purchase extra laboratory equipment to avoid straining the existing resources. These interventions will ensure that the problem of increased workloads is mitigated.

EHR will also impact aspects of care delivery in a positive way. It is expected to increase patients’ satisfaction levels with service delivery. An increase in the rate of service delivery and a reduction in long queues of patients will ensure that patients’ needs are addressed promptly. Prompt care improves treatment outcomes. Better treatment outcomes will increase patients’ trust in the services offered at the facility. Such patients are likely to visit the facility in the future or make referrals to the facility. This is important because it gives the healthcare facility an economic advantage.

Strategies to Deal with Dynamic Environmental Forces

The environmental risks to the economic initiative are the other two healthcare facilities within a three-mile radius of the facility. The two healthcare facilities have an established EHR system. Patient queues reported at these facilities are shorter than those currently witnessed at this facility. They are a risk to the economic initiative because patients are most likely to prefer to visit them due to their faster rates of service delivery.

Competition from these facilities can be addressed using various strategies. Staff training will take place weekly. The training will aim at equipping staff with the appropriate skills needed to serve the patients effectively using the EHR. This training is expected to minimize potential delays caused by the inability to use EHR. Regular training is expected to expedite the adaptation to the new system. This will lead to the fulfillment of the expected increase in service delivery by EHR. Patient queues are expected to decrease significantly to the extent of serving 300 more patients per day. In addition to regular training of staff, hardware and software maintenance will be done quarterly. This maintenance will help to avoid the possibility of breakdowns and the associated timewasting and slow service delivery. The two strategies will give the healthcare facility a competitive advantage.

Staff will be expected to uphold evidence-based practice and healthcare ethics when serving patients. Evidence-based practice ensures that the best treatment plans are selected (McDermott-Levy et al., 2018). Healthcare ethics such as justice and autonomy will make patients feel appreciated and part of the treatment process. These strategies will be used to complement regular staff training and hardware and software maintenance. By implementing these strategies, the healthcare facility will have a competitive advantage over its competitors.

Conclusion

The budget of the EHR reveals that the initiative is economically viable. Both internal and external stakeholders, such as patients, are key to the successful implementation of EHR. EHR will impact other aspects of health care. Some of the impacts include an increase in workloads for the healthcare providers and other departments of the facility. To ensure that EHR remains viable in the face of dynamic environmental forces, regular staff training, maintenance, and evidence-based practice will be upheld.

References

Frisch, N. C., & Rabinowitsch, D. (2019). What’s in a Definition? Holistic Nursing, Integrative Health Care, and Integrative Nursing: Report of an Integrated Literature Review. Journal of Holistic Nursing, 37(3), 260–272. https://doi.org/10.1177/0898010119860685

Gardner, R. L., Cooper, E., Haskell, J., Harris, D. A., Poplau, S., Kroth, P. J., & Linzer, M. (2019). Physician Stress and burnout: the impact of health information technology. Journal of the American Medical Informatics Association, 26(2), 106–114. https://doi.org/10.1093/jamia/ocy145

Gillon, R. (2015). Defending the four principles approach as a good basis for good medical practice and therefore for good medical ethics. Journal of Medical Ethics, 41(1), 111–116. https://doi.org/10.1136/medethics-2014-102282

Jamshed, N., Ozair, F., Sharma, A., & Aggarwal, P. (2015). Ethical issues in electronic health records: A general overview. Perspectives in Clinical Research, 6(2), 73. https://doi.org/10.4103/2229-3485.153997

Kharrazi, H., Gonzalez, C. P., Lowe, K. B., Huerta, T. R., & Ford, E. W. (2018). Forecasting the maturation of electronic health record functions among US hospitals: Retrospective analysis and predictive model. Journal of Medical Internet Research, 20(8), 1–11. https://doi.org/10.2196/10458

McDermott-Levy, R., Leffers, J., & Mayaka, J. (2018). Ethical Principles and Guidelines of Global Health Nursing Practice. Nursing Outlook, 66(5), 473–481. https://doi.org/10.1016/j.outlook.2018.06.013

Reis, Z. S. N., Maia, T. A., Marcolino, M. S., Becerra-Posada, F., Novillo-Ortiz, D., & Ribeiro, A. L. P. (2017). Is there evidence of cost benefits of electronic medical records, standards, or interoperability in hospital information systems? overview of systematic reviews. JMIR Medical Informatics, 5(3). https://doi.org/10.2196/medinform.7400

van Offenbeek, M. A. G., & Vos, J. F. J. (2016). An integrative framework for managing project issues across stakeholder groups. International Journal of Project Management, 34(1), 44–57. https://doi.org/10.1016/j.ijproman.2015.09.006

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Question 

Developing an Implementation Plan

PART 3 of 3 (Order #1 – 39146, Order #2 – 39147)
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OVERVIEW:
Develop a 6–7-page implementation plan for the initiative you proposed in Assessment 1. Include a budget for material, staffing, and capital costs over the first five years of the initiative, as well as projected earnings. In addition, include a timeline, an organizational impact analysis, and an explanation of the effects of environmental changes on the initiative.

Note: Each assessment in this course builds upon the work you have completed in previous assessments. Therefore, you must complete the assessments in the order in which they are presented.
____________________________________________________________________________
RESOURCES:

Budget Development:

Strategy Development and Implementation:

Cost Effectiveness:

Economic Evaluation:

_________________________________________________________________________
ASSESSMENT INSTRUCTIONS:
Develop a thorough implementation plan for the economic initiative you proposed in Assessment 1. Your plan must include a budget for material, staffing, and capital costs over the first five years of the initiative, as well as projected earnings. In addition, include:

REQUIREMENTS:
The requirements for your implementation plan, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, be sure to note the requirements for document format and length and for supporting evidence.

  1. 1. Create a budget for expected costs and earnings over the first five years of your proposed initiative.
    • What are the expected material, staffing, and capital costs of your proposed initiative over its first five years?
    • What are the projected earnings for your organization or care setting over the first five years of your economic initiative?
    • How does this budget take into account the findings and feedback you received on your business case?
    • What assumptions are you basing your budget on?
  2. 2. Create an implementation plan for your proposed initiative that enables achievement of quality or service improvements in an ethical and culturally equitable way.
    • Did you create a timeline for the rollout?
    • How will you work with relevant stakeholders to ensure that your economic initiative is implemented successfully and sustained?
    • How will you ensure that the rollout is conducted in an ethical and culturally equitable manner?
    • How will you ensure that the desired quality or service improvements your economic initiative will achieve are on track during and after implementation?
  3. 3. Analyze the impact of your proposed initiative, once implemented, on other aspects of your organization or care setting and ways in which negative impacts could be mitigated.
    • What other aspects of your organization or care setting may be positively or negatively impacted by the implementation of your proposed initiative?
    • How will these other aspects of your organization or care setting be affected? (For example, increased workload on a testing department, borrowing of staff hours from another part of the care setting, or better communication with the community.)
    • How could you mitigate at least some of the negative effects on other aspects of your organization or care setting?
  4. 4. Explain your strategies for ensuring that your proposed initiative can remain a viable asset to the organization or care setting in the face of dynamic environmental forces.
    • What are the environmental risks to your economic initiative?
    • How could your initiative, or aspects of it, still be a viable benefit to your organization or care setting if the environment shifts in unpredictable ways?
    • What strategies would you propose implementing to keep all, or a portion of, your initiative a viable net benefit to your organization or care setting?
  5. 5. Justify the relevance and significance of the quantitative and qualitative economic, financial, and scholarly evidence you used throughout your plan to support your recommendations.
    • How is the evidence relevant to your organization or care setting?
    • How is the evidence relevant to your proposed economic initiative?
    • How does the evidence illustrate a solution that has been successful in the past?
    • How does the evidence illustrate that a recommendation is the best course of action for your situation and organization or care setting?
  6. 6. Write concisely and directly, using active voice.
    • Proofread your document before you submit it to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your implementation plan.
  7. 7. Adhere to the rules of grammar, usage, and mechanics.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like: SEE ATTACHED

Additional Requirements:
Your assessment should also meet the following requirements:

  1. 1. Format: Format your implementation plan using current APA style. *7TH EDITION* Be sure to include:
    1. A title page and references page. An abstract is not required.
    2. A running head on all pages.
    3. Appropriate section headings.
  2. 2. Length: Your implementation plan should be 6–7 pages in length, not including the title page and references page.
  3. 3. Supporting evidence: Cite 3–5 authoritative and scholarly resources to support your implementation plan. Be sure that your sources include specific economic data.
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