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NURS 6441
Oak Township Medical Center Case Study
Oak Township Medical Center (OTMC) in Georgia, a 600-bed hospital, has expanded significantly over the past 3 years. In an effort to respond to the increased workload of all hospital staff, the chief information officer (CIO) and the vice president of patient care services (VP-PCS) at OTMC determined the need to analyze hospital processes throughout the organization. The OTMC organizational analysis revealed a number of areas that needed improvement. At the same time, broad changes in regulatory requirements required immediate adjustments in processes. The organizational analysis was conducted across all departments and found the following organization-wide issues:
Quality reviews discovered a hospital-wide medication administration error rate of 20% with some tasks identified as redundant tasks.
Complying with new federal reporting requirements has increased the time needed to complete the medication administration process.
OTMC responded to the problem by purchasing an enterprise-wide healthcare information system (HIS) from Topmost, one of the leading enterprise-software vendors in the country. The functionality of the system directly addresses the medication administration issues found in the organizational analysis. Several modules of an electronic health record system (EHRS) have already been implemented, as shown in the table below. As an employee of Topmost, you are charged with implementing this medication administration system (MAS) for OTMC, the final phase of the EHRS project. This MAS includes an electronic medication administration record (eMAR), Barcode Medication Administration (BCMA), and physical administration of medication. Note: For the remainder of this scenario, this whole process will be referred to as the Medication Administration System (MAS).
Module Implementation Status
Module in the HIS System
Status of Module Implementation
Fully implemented
Partially implemented
In pilot Not yet implemented
ADT (Accounting System) X
Order Entry/Results Reporting OE/RR)
X
Billing and Financials X
Ambulatory and Acute Care Clinical
X
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Module in the HIS System
Status of Module Implementation
Fully implemented
Partially implemented
In pilot Not yet implemented
Documentation System
Laboratory X
Medication Administration System (MAS)
X
Note that the MAS module has not been implemented. The CIO and VP-PCS relate that there are a number of challenges associated with the OTMC HIS program, including the MAS project. One risk is that the initial implementation of the MAS may result in a temporary increase in medication errors. Another risk is that staff resistance to the new workflows and processes brought about by the MAS may cause delays in the completion of the implementation. In meetings with the CIO and VP, they state that the first task is to develop the project charter. The MAS team is assigned specific elements to be included in the project charter: the mission of the project, the problem statement, the project objectives, key stakeholders, milestones, and risks for the project. A new chief medical information officer (CMIO) has been hired. This CMIO does not have the informatics expertise required to lead this critical and large project; however, the CMIO has gained solid experience on small-scale decision-support projects at a former institution while studying informatics in graduate school. The CMIO is looking forward to learning from you. The budget for the MAS project is approved up to $1 million. If more than $1 million is needed to implement the project, the additional expenditure must be justified in a project plan that key stakeholders approve. The software application for the MAS and necessary hardware have already been purchased, but they have not been delivered. You have a timeline of 6 months to complete the MAS project.
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