Developing PICO Questions

Developing PICO Questions

Determining the topic of an evaluation is one of the most important steps of the evaluation process. In the process of selecting a topic for evaluation, researchers should reflect on what information needs to be gathered and how it will be used. A PICO question can provide the foundation for this process. The PICO question requires researchers to determine the population to be studied, select the intervention that occurred or will occur (such as a new system), have a baseline with which to compare the evaluation, and finally, have a standard to measure the outcome of the project. Using a PICO question as a guideline helps ensure the evaluation is focused and effective.

In this Discussion, you generate a PICO question that corresponds to the Evaluation Plan Focus you developed last week.

To prepare:

• Develop a PICO question based on the Evaluation Plan Focus Assignment completed last week.
• Reflect on why it is important that this question be answered. Identify the “who cares?” factor.

By Day tomorrow 12/28/2016, write a minimum of 550 words essay in APA format with a minimum of 3 reference from the list provided below. Include the level one headings as numbered below:

1)      Post a summary of key points (evaluation goal, viewpoint, and model) from your Evaluation Plan Focus Assignment.

2)      Post your PICO question. Explain why you developed this question, and why it is important to be considered.

Required Readings

Friedman, C. P., & Wyatt, J. C. (2010). Evaluation methods in biomedical informatics (2nd ed.). New York, NY: Springer Science+Business Media, Inc.

Chapter 3, “Determining What to Study” (pp. 48–84)

This chapter focuses on how to identify the relevant questions to cover in an evaluation and how to ensure that the scope of the question is appropriate. It includes a description of different types of evaluations, including what they specifically focus on and the general type of questions they address.

Gschwandtner, T., Kaiser, K., & Miksch, S. (2011). Information requisition is the core of guideline-based medical care: Which information is needed for whom? Journal of Evaluation in Clinical Practice, 17(4), 713–721.

Retrieved from the Walden Library databases.

This article describes the construction of a comprehensive information source to be used in the development of computerized clinical practice guideline (CPG). The authors emphasize how the information source is designed to meet the informational requirements of anyone developing a CPG for any user group.

Lin, J. W., Chang, C. H., Lin, M. W., Ebell, M. H., & Chiang, J. H. (2011). Automating the process of critical appraisal and assessing the strength of evidence with information extraction technology. Journal of Evaluation in Clinical Practice, 17(4), 832–838.

Retrieved from the Walden Library databases.

The authors of this article explain a study that sought to create and evaluate a system to automatically determine a medical article’s evidence level. The authors describe the accuracy of the system and speculate on the causes of errors.

Swennen, M. H. J., vander Heijden, G. J. M. G., Blijham, G. H., & Kalkman, C. J. (2011). Career stage and work setting create different barriers for evidence-based medicine. Journal of Evaluation in Clinical Practice, 17(4), 775–785.

Retrieved from the Walden Library databases.

This article describes a study that examines how a doctor’s career stage and work setting are related to their perceptions of barriers to practicing evidence-based medicine (EBM). The authors also provide a framework for classifying the identified barriers.

Required Media

Laureate Education (Producer). (n.d.e). PICO question. Retrieved from CDN database. (NURS 6431)

This animation describes the basics of formulating a PICO question. The animation provides an example scenario of effectively generating a PICO question.

Optional Resources

Alliance for Health Reform. (2013). Health Information Technology. Retrieved from http://www.allhealth.org/issues.asp?wi=4

    American Health Information Management Association. Retrieved from http://www.ahima.org/

    Healthcare Information and Management Systems. (2013). Retrieved from http://www.himss.org/

    Kaiser.edu. (n.d.). Health information technology. Retrieved from http://kff.org/health-reform/issue-brief/building-an-information-technology-foundation-for-health/

National Center for Biotechnology Information. (n.d.). Health services/technology assessment texts (HSTAT). Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK16710/

EVALUATION PLAN FOCUS

EVALUATION PLAN FOCUS 1

Evaluation Plan Focus

Student Name

University Affiliations

Date

Professor

Scenario 1:

Your hospital is implementing a new unified acute and ambulatory Electronic Health Record (EHR) system through which patient care documentation will occur. Interdisciplinary assessment forms (including nursing), clinical decision support, and medical notes will be documented in this system. The implementation of the system is anticipated to improve the hospital’s performance in a multitude of areas. In particular, it is hoped that the use of the EHR system will reduce the rate of patient safety events, improve the quality of care, deter sentinel events, reduce patient readmissions, and impact spending. The implementation of the EHR system is also

Introduction

Evaluation plan involves an integral part regarding a grant suggestion providing information aimed at improving a project during the development and implementation. I will participate in the assessment of the scenario system in throughout the project. The scenario includes the hospital that is implementing the new unified as well as the Ambulatory EHR (Electronic Health Record) system that enhances the documentation of patient care. The purpose of the paper is explaining the selected scenario one, explanation of the reasons for selecting it, and summarizing of the research findings on the similar HIT implementations. More so, there is a description of the evaluation viewpoint, and goal guiding the assessment plan and same rationale.

HIT System Selected

The new system to be implemented has various modules that contain interdisciplinary assessment forms, medical notes, and clinical decision support where their documentation is guaranteed. The implementation of the unified system will enhance improved performance of the hospital in several departments. The new EHR system becomes of great importance to the hospital since there is a reduction of medical errors, reduction of the rate of the safety events of each patient, improving the quality of healthcare, deterrence of sentinel events, reduced patients readmissions as well as impact spending. Another reason for choosing the scenario is that the new system will enhance while fulfilling the requirements of meaningful use as stipulated in the HITECH (Health Information Technology for Economic and Clinical Health) Act. Therefore, the need for evaluation regarding the EHR implementation becomes paramount since it will help to identify the associated risks while adjusting the modules required when offering the medication services to the patients (Lanham, Leykum & McDaniel, 2012).

Summary of Research Findings on Similar HIT Implementations

Several evaluations are analogous to the HIT system implementation of the unified system with related differences regarding the outcomes based on the primary goals. For instance, some of the implemented systems fail to meet one hundred percent of the requirements and the expectations. It leads to the need for improving the system to ensure that most of the requirements that it was developed and implemented for have been met. The evaluation regarding several EHRs systems has precisely shown various results as discussed below.

Technology and Patient Care

The critical element regarding healthcare information involves the nursing documentation of the patients’ records. The HIT systems are designed to utilize the literature based on the knowledge related to the quality of care. The established technology enhances improved patient care that has made the nursing work easy and efficient. The EPR (Electronic Patient Record) after the evaluation has proved to be of great significance for the information workflow in the hospital. The use of technology has evidently improved the patient result quality as well as efficiency. The transmission of information electronically reduces medical errors while saving time and related resources. The benefits related to the EHRs in the ambulatory practices are clearly identified to be improved patient care as well as the office efficiency including the potential financial advantages. More so, there are some barriers realized during the implementation of such similar HIT project like costs, resistance to change, the original system uses difficulty and lacking standardization of the products of HER (Board on Health Care Services, 2012).

Patients’ Records Confidentiality

When implementing the HIT systems in the hospital set up, the need to include a module for the transfer of health records to various departments is paramount. However, the information should remain as secret as it would be whenever the patient has his or he papered records while taking them to the departments when asked to produce them. The EHRs transmission has shown to be emphasizing on the need to ensure no sharing of medical information to other parties not directly associated with the patient and without the latter’s approval. However, some disadvantages are identified where a hospital officer may have the access rights to the confidential information of the patients and happen to expose it to other individuals hence denying the patient the right to secrecy regarding medical records.

Clinical Decision Support Systems

The implementation is also aimed at increasing the performance of the hospital with the new technology. According to the evaluation, the previously used CDSS involved the integration of the clinical information systems like the outpatient and inpatient EHRs. The purpose of the implementation includes improving the decision-making process in the hospital hence increasing the quality of healthcare for all patients. The evaluation shows that half of the reviewed systems provided all the appropriate action-oriented, event-driven, and real-time decision support required to initiate the medication interventions. However, there is some feature lacking during the implementation like the ability to provide alternatives for the information provided and analyzed (Levy & Heyes, 2012).

Patient Satisfaction with the System

The EHR system increased the comfort level of the patients. There is a saving of time, an increase in the number of attended patients, patients getting clinical summaries immediately, and subsequent medication reports. After the evaluation, it showed clearly that several patients got satisfied with the services delivery within the hospital with the development and implementation of the system. Reduced clinical information errors proved proper and improved medication hence the need to embrace the system. The system was found to have little technical challenges hence becoming suitable for the healthcare improvement.

Adoption of the HIT System

The system is seen to have faced minimal resistance during its implementation. It is because previous research has proved the system to be of significant benefits when delivering services to the patients. More so, there is reduced medication errors when using the system hence the need to adopt it without resistance. There is the utilization of resources and serving several patients at the same time (Van Gemert-Pijnen et al., 2011).

Describing the Goal and Viewpoint of the Evaluation Plan

The primary goal for the EHR involves improving the healthcare quality based on the patient care documentation. The new system will ensure that the medical recordings are automated leading to minimal or no errors. Proper documentation will provide improved performance of the hospital and related healthcare services. The system is aimed at reducing costs of operations of the hospital while increasing medication benefits for the patients. The patients should be able to have track information of their medication or clinical trend without delay. The system should also coordinate all the departments within the hospital so as to work together in meeting the primary goal of improving the patient care (Bélanger et al., 2012).

Conclusion

The EHRs primary objective of improving the quality of patient care is achieved by ensuring the implementation stage is well analyzed regarding the requirements and the documentation done as a whole. The system should prove to be of great benefit while improving the performance of the hospital. The evaluation should be done at every subtask to ensure the best is regarding the improved quality of healthcare is achieved by the system.

References

Bélanger, E., Bartlett, G., Dawes, M., Rodríguez, G., & Hasson-Gidoni, I. (2012). Examining the evidence of the impact of health information technology in primary care: An argument for participatory research with health professionals and patients. International Journal of Medical Informatics, 81(10), 654–661.

Board on Health Care Services. (2012). Health IT and patient safety: Building safer systems for better care. The National Academies Press: Washington DC. Retrieved from http://www.nap.edu/catalog.php?record_id=13269

Lanham, H. J., Leykum, L. K., & McDaniel, R. R. Jr. (2012). Same organization, same electronic health records (EHRs) system, different use: Exploring the linkage between practice member communication patterns and EHR use patterns in an ambulatory care setting. Journal of the American Medical Informatics Association, 19(3), 382–391.

Levy, S., & Heyes, B. (2012). Information systems that support effective clinical decision making. Nursing Management, 19(7), 20–22.

Van Gemert-Pijnen, J., Nijland, N., van Limburg, M., Ossebarrd, H. C., Kelders, S. M., Eysenbach, G., & Seydel, E. R. (2011). A holistic framework to improve the uptake and impact of eHealth technologies. Journal of Medical Internet Research, 13(4), e111.