Staging for the Future: Validating Enhancements in the EHR in a Simulated Environment
Start Date
5-19-2012 1:00 PM
End Date
5-19-2012 1:15 PM
Description
Successful implementation of the electronic health record (EHR) hinges on the development of a user interface that not only supports but enhances workflow processes at the point of care. Ideally, this requires end user validation of the design to ensure it meets workflow processes. Typically this occurs in validation session held away from actual patient care delivery settings. Off unit software validation is limited when trying to match the EHR system design with real life end user workflow at the bedside. The Department of Nursing and Information Systems at ThomasJeffersonUniversityHospitalhas collaborated with the School of Nursing Simulation Center to test EHR design using realistic clinical scenarios within its learning lab. The EHR design is tested while nurses perform patient care in high fidelity simulation lab, thereby providing rich feedback to the interdisciplinary clinical teams on how the EHR supports workflow processes. The perceived ease of use, perceived potential usefulness, and the task-technology fit measures were used to obtain nurse feedback3. The tools have been tested for reliability and validity and are used in the information technology domain4.
This method of EHR validation is far superior to the traditional methods of utilizing classroom type settings off of the clinical unit. The use of live patient actors (Standardized Patients), human simulators (Sim Man, IStan, Noelle), and task trainers (molded torsos, IV infusion arms, etc.), provides for EHR validation that is close to real life. This method of validation is being used to improve electronic clinical documentation. Nurses can actually see and interact with the software design before it goes live on the nursing units. As an example, order sets for post-operative patients were developed and integrated within the EHR to enhance preparation for the clinical rotations. Interacting with evidence-based order sets added a level of richness and complexity to the software validation, not possible in traditional settings. The Future of Nursing: Leading Change, Advancing Health, released by the Instituteof Medicinein 2010 suggests that “Schools of nursing, in collaboration with other health professional schools, should design and implement early and continuous interprofessional collaboration through joint classroom and clinical training opportunities.”7 Addressing this recommendation, faculty members, in conjunction with the hospital information technology experts, are validating software design using real life clinical scenarios in simulated environments. This approach will lead to the development of EHR modules that more closely match the needs of evidence-based practice and workflow.
References
1. Johnson, Stetson, Bakken. Development and Evaluation of Nursing User Interface Screens Using Multiple Methods. Journal of Biomedical Informatics 42(6): 1004-1012. 2009
2. Jeffries PR. A framework for designing, implementing, and evaluating simulations used as teaching strategies in nursing. Nursing Education Perspectives. 2005; 26(2), 96-103.
3. DavisF. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly, 13(3), 319-340. 1989.
4. Davis, Bagozzi, Warshaw. User Acceptance of Computer Technology: A Comparison of Two Theoretical Models. Management Science, 35(8), 982-1003, 1989.
5. Rauen C. Using simulation to teach critical thinking skills: you can’t just throw the book at them. Critical Care Nursing Clinics ofNorth America. 2001; 13(1), 93–103
6. The Essentials of Baccalaureate Education for Professional Nursing Practice. American Association of Colleges of Nursing, Essential VI: Interprofessional Communication and Collaboration for Improving Patient Health Outcomes. October 20, 2008.
7. InstituteofMedicine. The Future of Nursing: Leading Change, Advancing Health.Washington,DC: The National Academies Press; 2010.
8. Hager M. Enhancing Interactions between Nursing and Medicine: opportunities in Health Professional Education.New York: Josiah Macy, Jr. Foundation; 2001:11–34.
Staging for the Future: Validating Enhancements in the EHR in a Simulated Environment
Successful implementation of the electronic health record (EHR) hinges on the development of a user interface that not only supports but enhances workflow processes at the point of care. Ideally, this requires end user validation of the design to ensure it meets workflow processes. Typically this occurs in validation session held away from actual patient care delivery settings. Off unit software validation is limited when trying to match the EHR system design with real life end user workflow at the bedside. The Department of Nursing and Information Systems at ThomasJeffersonUniversityHospitalhas collaborated with the School of Nursing Simulation Center to test EHR design using realistic clinical scenarios within its learning lab. The EHR design is tested while nurses perform patient care in high fidelity simulation lab, thereby providing rich feedback to the interdisciplinary clinical teams on how the EHR supports workflow processes. The perceived ease of use, perceived potential usefulness, and the task-technology fit measures were used to obtain nurse feedback3. The tools have been tested for reliability and validity and are used in the information technology domain4.
This method of EHR validation is far superior to the traditional methods of utilizing classroom type settings off of the clinical unit. The use of live patient actors (Standardized Patients), human simulators (Sim Man, IStan, Noelle), and task trainers (molded torsos, IV infusion arms, etc.), provides for EHR validation that is close to real life. This method of validation is being used to improve electronic clinical documentation. Nurses can actually see and interact with the software design before it goes live on the nursing units. As an example, order sets for post-operative patients were developed and integrated within the EHR to enhance preparation for the clinical rotations. Interacting with evidence-based order sets added a level of richness and complexity to the software validation, not possible in traditional settings. The Future of Nursing: Leading Change, Advancing Health, released by the Instituteof Medicinein 2010 suggests that “Schools of nursing, in collaboration with other health professional schools, should design and implement early and continuous interprofessional collaboration through joint classroom and clinical training opportunities.”7 Addressing this recommendation, faculty members, in conjunction with the hospital information technology experts, are validating software design using real life clinical scenarios in simulated environments. This approach will lead to the development of EHR modules that more closely match the needs of evidence-based practice and workflow.
References
1. Johnson, Stetson, Bakken. Development and Evaluation of Nursing User Interface Screens Using Multiple Methods. Journal of Biomedical Informatics 42(6): 1004-1012. 2009
2. Jeffries PR. A framework for designing, implementing, and evaluating simulations used as teaching strategies in nursing. Nursing Education Perspectives. 2005; 26(2), 96-103.
3. DavisF. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly, 13(3), 319-340. 1989.
4. Davis, Bagozzi, Warshaw. User Acceptance of Computer Technology: A Comparison of Two Theoretical Models. Management Science, 35(8), 982-1003, 1989.
5. Rauen C. Using simulation to teach critical thinking skills: you can’t just throw the book at them. Critical Care Nursing Clinics ofNorth America. 2001; 13(1), 93–103
6. The Essentials of Baccalaureate Education for Professional Nursing Practice. American Association of Colleges of Nursing, Essential VI: Interprofessional Communication and Collaboration for Improving Patient Health Outcomes. October 20, 2008.
7. InstituteofMedicine. The Future of Nursing: Leading Change, Advancing Health.Washington,DC: The National Academies Press; 2010.
8. Hager M. Enhancing Interactions between Nursing and Medicine: opportunities in Health Professional Education.New York: Josiah Macy, Jr. Foundation; 2001:11–34.
