Gap Analysis Plan

Write a 3- to 4-page Gap Analysis Plan that addresses the following:

Introduce the workflow issue you will be addressing in this Assignment. Explain how this workflow issue is tied to EHRs. Identify the specific meaningful use objective(s) related to the workflow issue.

Analyze the workflow issue IOM six aims of care (patient-centered, timely, effective, efficient, equitable, and safe).

List 2–3 goals you have set for your gap analysis and what you hope to accomplish by examining the workflow concern you selected.

Describe your methods of data collection and the individuals you will observe, consult, and/or interview. Include any relevant narrative statements, checklists, interview questions, or other tools you commonly use to collect data in a workflow analysis.

Explain how you will minimize disruption in the workflow during observations and how you will avoid bias as you conduct your gap analysis.

Describe how you will record, quantify, and analyze the data you collect. Explain how you will establish baseline metrics to normalize data from different sources of information.

Illustrate your current-state workflow. Your draft should include your preliminary knowledge about the primary steps and activities within your workflow. In addition, include a swimlane (flowchart) showing who is responsible for each step, and use the appropriate diagramming symbols within your draft. Copy and paste your actual visual model into your paper (rather than providing a link to the model).

Support your plan by synthesizing and integrating at least two outside resources and two of the provided Resources. Include a reference list with APA-formatted citations of the resources you used.

References to use

McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.

Chapter 14, “The Electronic Health Record and Clinical Informatics”

CGI. (2014).

Links to an external site.Health information integration: Using gap analysis to develop relevant solutions

Links to an external site.. Retrieved from https://www.cgi.com/sites/default/files/white-papers/cgi-health-integration-gap-analysis-paper.pdf

LucidChart. (2019). How to make a flowchart

Links to an external site.. Retrieved from https://www.lucidchart.com/pages/how-to-make-a-flowchart

Microsoft Office. (2019). Create a flow chart with SmartArt

Links to an external site.. Retrieved from https://support.office.com/en-us/article/create-a-flow-chart-with-smartart-30f87402-ba3d-48c8-8e9f-a66bcee7e5aa

Gap Analysis Plan

One of the most challenging issues in the process of workflow in healthcare settings is ineffective and error-prone medication administration closely connected with the use of Electronic Health Records (EHR). It manifests in form of frequent drug errors, such as wrong dosages, wrong medications, and omissions. These are often compounded by poorly designed EHR systems that do not support the nursing staff in managing their tasks. This is directly related to Meaningful Use Objectives, mainly on improving patient safety and reducing medication errors. With the added emphasis of clinical decision support and medication reconciliation in Meaningful Use Stage 2 to make certain that medications are timely and appropriately provided, this really does seem like an area that needs major improvement.

Workflow Issue Analysis Using IOM Six Aims of Care

The medication administration workflow problem affects many dimensions of patient care identified in the IOM Six Aims of Care:

1. Patient-centered care: the agitation in EHRs diverts a nurse away from their patients, therefore, less involvement of patients occurs, hence undermining the accuracy of such care.


2. Timely manner: navigating through the EHR system takes time for nurses to complete medication orders, which may lead to late or missed doses that may compromise care.

• Effective: The integration of EHR in clinical workflows could either be effective or be an ineffective use of health information technology and, thus result in medication administration errors (Zayas-Cabán et al., 2021).

1. Efficient: The current workflow makes nurses repeat steps. For example, cross-checking medication orders on multiple screens, which takes longer time meant for more constructive actions.


2. Equitable: Patients with complex needs, or those in rural settings, can often experience poor outcomes, as the administration of medication is inconsistent, seeing that most EHR systems have no flexibility to adapt to these various needs of patients.


3. Safe: The current workflow creates considerable risk for patients via its predisposition to medication errors. Automation through systems, such as the CDS tools part of the EHR, can be enlisted to help reduce these errors but go underutilized (Lachman et al., 2020).

Goals for the Gap Analysis

Objectives of this gap analysis include the following:

1. To identify any inefficiencies or sources of error in the current workflow around medication administration.


2. To discuss the current EHR system based on the Meaningful Use goals with respect to medication safety and clinical decision support.

• To establish actionable strategies in order to enhance workflow through EHR functionalities, optimizing them to timely, accurately, and efficiently administer medications.

Methods of Data Collection

The review of the issues with workflows will be done through direct observation, interviews with the staff, and auditing of the EHR data. Targets for direct observation will include nursing staff, pharmacists, and EHR personnel involved in the process of medication administration (Renjith et al., 2021). Precise tools for data collection will involve:

1. Narrative Statements: It will involve direct observation of staff interaction with the EHR system with an aim of determining the points at which delays or errors are occurring.


2. Checklists: cross-reference the medication orders with records to monitor the accuracy and timeliness of administration.

• Interview questions: Include but are not limited to the following: “What’s most difficult for you when giving medications in the EHR system?” and “How does the interface of the system affect or impact your workflow?”

Minimizing Disruption and Avoiding Bias

To minimize disruptions and avoid bias, I will first be shadowing the staff during less busy hours so that disturbance due to data collection is minimal during the observations. Furthermore, to avoid biased views, I will ensure that observations and interviews are performed on a mixed sample of staff with regard to experience and different shifts. Also, I will seek more objective data provided by the EHR system in order to complement subjective observations and interviews and reduce the possible incidence of personal biases.

Data Recording, Quantification, and Analysis

Qualitative and quantitative data collection approaches shall be employed. The qualitative data shall include some narrative observations of workflow disruptions among other forms, while the quantitative ones will involve such metrics as average time to perform medication administration activities and frequency of medication errors (McGonigle & Mastrian, 2024). In completing the normalizing of the data, several sources must first be derived in order to initially provide base-line metrics through review of historical EHR logs cross-referenced with medication error reports. These will then provide baselines that identify variances and areas of improvement for workflow optimization.

Current-State Workflow and Swimlane Diagram

The current work routine of medication administration includes multiple phases of the process. These include receiving medication orders, verification against EHR, retrieval of the medication, administration to patients, and recording in EHR (Ozkaynak et al., 2022). There are many stages with slow processing because it is not easy to navigate-need for manual cross-checking. Below is a swimlane diagram showing major stakeholders and their responsibilities.

1. Nurse: Prepares and administers medications. They also document actions in the EHR.


2. Pharmacist: Cross-checks and approves the orders that are related to medications in the EHR.

• EHR system: Provides medication order entry, patient allergy checks, and clinical decision support.

Conclusion

In a recap, this paper discusses a thorough analysis of how the current EHR system affects the workflow of medication administration, most especially with reference to Meaningful Use Objectives and IOM Six Aims of Care. With evidence from observation, interviews, and EHR metrics, recommendations that could enhance medication safety and foster the general efficiency of the workflow are outlined. These will help bridge the gaps in practice and subsequently improve patient outcomes, increase staff satisfaction, and reduce medication administration errors Gap Analysis Plan.

References

Lachman, P., Batalden, P., & Vanhaecht, K. (2020). A multidimensional quality model: an opportunity for patients, their kin, healthcare providers and professionals to coproduce health. F1000Research, 9. https://doi.org/10.12688%2Ff1000research.26368.3

McGonigle, D., & Mastrian, K. (2024). Nursing informatics and the foundation of knowledge. Jones & Bartlett Learning.

Ozkaynak, M., Unertl, K., Johnson, S., Brixey, J., & Haque, S. N. (2022). Clinical workflow analysis, process redesign, and quality improvement. In Clinical informatics study guide: Text and review (pp. 103-118). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-93765-2_8

Renjith, V., Yesodharan, R., Noronha, J. A., Ladd, E., & George, A. (2021). Qualitative methods in health care research. International journal of preventive medicine, 12(1), 20. https://www.ijpvmjournal.net

Zayas-Cabán, T., Haque, S. N., & Kemper, N. (2021). Identifying opportunities for workflow automation in health care: lessons learned from other industries. Applied Clinical Informatics, 12(03), 686-697 Gap Analysis Plan