Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies
New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.
Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.
In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.
To Prepare:
• Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
• Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
• Identify and select 5 peer-reviewed articles from your research.
The Assignment: (5 pages)
In a 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:
• Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
• Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.

Some Sources:

Skiba, D. (2017). Evaluation tools to appraise social media and mobile applications. Informatics, 4(3), 32–40. doi:10.3390/informatics4030032
( copy and paste the link on google to retrieve the article)

Sample Free Essay
Clinical Systems
Alkureishi, Lee, Webb, and Arora (2018) carried out a study on integrating patient-centered electronic health record training using post-implementation surveys among house staff. The study focused on eliminating a problem among healthcare organizations that rarely train their staff on Electronic Health Records communication practices. The purpose of the study was to create and provide patient-centered Electronic Health Records training for all the new staff. The findings demonstrated that integrating Electronic Health Records communication skills during training is an effective way for trainers to understand the necessary skills. The training helps trainers to cultivate the culture of patient-centered Electronic Health Records use.
The training is necessary to improve the outcomes and efficiencies in the delivery of patient-centered care. It successfully helped the trainees to understand how to utilize technology such as Electronic Health Records to promote health outcomes and patient satisfaction. Alkureishi, Lee, Webb, and Arora (2018) state that “the training helps clinicians to maintain a culture of promoting efficiency while delivering various types of healthcare services” (p. 12). The best practices promote a culture that helps achieve quality care for all patients. For instance, it promotes the efficiency of recording, retrieving, and sharing patient data, which is essential in promoting quality care.
I have learned that it is necessary to provide internal onboarding training to staff to promote standard utilization of the electronic records. The training should be patient-centered to ensure all the clinicians remember to promote the interests of the patients. I have also learned that the training is effective and thus it can be extended to other practitioners such as physicians, nurses and support staff. I have also learned that training is important for the staff since it helps them to understand high-quality patient-centered care.
Mold, Raleigh, M., Alharbi and de Lusignan (2018) also conducted a study on the impact of patient online access to computerized medical records and services on type 2 diabetes. The purpose of accessing medical records is to promote efficiency in the delivery of healthcare. For example, the delivery of primary care and treatment of type 2 diabetes is related to better glycemic control. Therefore, it is regarded as a safe and efficient system that can be deployed in a healthcare facility to eliminate technical barriers and system failures that may hinder adequate self-management of diabetes.
Access to online records improves efficiency and patient outcomes in the delivery of care through convenient access to medical records compared to the laborious paperwork. Online records were also safe from any alteration thus leading to the safe prescription of medication. According to Mold, Raleigh, M., Alharbi and de Lusignan (2018) online medical records “solve various disparities that emerge during treatment such as age, gender, ethnicity, and comorbidities” (p. 18). For instance, comprehensive information showing vital statistics such as blood pressure aided pharmacists in prescribing medication. The easy access to the data on disparities was critical in determining the effective treatment to be provided to patients.
I learned that the delivery of efficient treatment requires easy and convenient access to medical records. The convenient access was crucial in maintaining glycemic control among type 2 diabetes patients. I also appreciated that patient records can be easily recorded and shared in their entirety including disparities such as age, gender, ethnicity, and comorbidities. The comprehensive data helps clinicians to deliver personalized care. I also learned that it is important to support the patients during initial stages after diagnosis to ensure they effectively utilize the online medical records.
A systematic review and narrative synthesis were also carried out by Neves, Carter, Freise, Laranjo, Darzi, and Mayer (2018) on the impact of sharing electronic health records with patients on the quality and safety of care. The purpose of the systematic review was to assess the risks as well as the benefits of various patient-centered interventions including their effectiveness and safety. The findings of the study suggested that access to online electronic health records was vital in improving communication between the provider and the patient. It was also crucial in boosting the satisfaction of patients during the delivery of care.
Providing medical records to patients is vital in improving the safety of care. It improves the efficiency of involving patients in decision-making. Neves, Carter, Freise, Laranjo, Darzi, and Mayer (2018) argue that “the shared decision-making promotes patient satisfaction which is essential during the delivery of healthcare” (p. 21). For instance, telephone consultation boosts the satisfaction of patients since they feel they can access quality care at any time despite their geographic location. The sharing is also necessary since provides customized support and decision-making for all patients.
I learned that electronic medical records foster patient-centered interventions. They also improve the safety and effectiveness that is necessary for boosting patient outcomes. Additionally, I learned that sharing of data among various stakeholders such as physicians and patients was effective in promoting better outcomes. Telephone consultation is also one of the simplest forms of communication between a provider and a patient with the intention of providing treatment. Therefore, I have learned that electronic medical records can be shared through various platforms with the focus of improving patient-centered care.
Tubaishat (2019) on the other hand conducted a qualitative exploratory study on the effect of electronic health records on patient safety. Although previous studies have explored the benefits of electronic medical records in health facilities, few have focused on patient safety. Patient safety involves complete documentation of patient data, elimination of medical errors, and sustainability of the patient data. The conclusions of the study according to Tubaishat (2019) suggest that “it is important to develop systems that promote patient safety” (p. 13). The study recommended that involving nurses in the process could enhance patient safety.
The use of electronic medical data to promote patient safety involves various aspects such as documentation of data and minimization of medical errors. For instance, the documentation is essential since it helps in identifying patients accurately. When the data is not complete nurses may give the medication to the wrong patient leading to severe complications. Additionally, according to Tubaishat (2019) “medical errors are minimized since the data is available to assist in decision-making” (p. 11). For instance, pharmacists can promote patient safety by prescribing the right medication considering the allergic reactions, age, gender and ethnicity of a patient. Therefore, health facilities should invest in designing systems that will be customized to enhance patient safety.
I have learned that although electronic medical records are increasingly being used in healthcare facilities, there is a need to develop systems with specifications that support patient safety. I also learned that involving nurses is critical since they will specify the aspects of a system that they should be incorporated into a system. The customized design will help in improving patient safety due to enhanced levels of safety such as the elimination of medical errors. I also learned that it is necessary to train physicians on how to utilize various systems with the intention of supporting patient safety. For example, decision support systems and artificial intelligence can be used critically to support the safety of patients.
Yanamadala, Morrison, Curtin, McDonald, and Hernandez-Boussard (2016) carried out an observational study on electronic health records and quality of care focusing on mortality, readmissions, and complications. The purpose of the study was to evaluate the relationship between the adoption of electronic medical records and patient outcomes. The findings of the study show that electronic health records play a minimal role than expected in various health facilities. The results of the study also indicated that patients receiving care in health facilities with no electronic medical records received minimal benefits compared to those who were admitted to hospitals without electronic records.
Electronic health records are important in promoting patient safety and effective delivery of care. For example, electronic medical records are effective in reducing the rate of mortality. The reason is that decisions are based on accurate data recorded in the systems. Yanamadala, Morrison, Curtin, McDonald, and Hernandez-Boussard (2016) shows that electronic records also “prevent medical errors which lead to complications and readmissions” (p. 16). The availability of data also enhances decision-making since practitioners have all the necessary data stored in a system. However, the efficiency and patient outcomes should be enhanced through customized development and design of the healthcare systems to ensure maximum benefits.
I have learned that despite the various benefits of electronic medical records, a health facility may miss realizing the benefits if their systems are not customized to certain specifications. It is thus important for a health facility to be careful when they are adopting or designing a system. I have also learned that health facilities should attempt to track the progress they have made after the adoption of the systems, especially on patient safety.

References
Alkureishi, M. A., Lee, W. W., Webb, S., & Arora, V. (2018). Integrating patient-centered electronic health record communication training into resident onboarding: curriculum development and post-implementation survey among house staff. JMIR Medical Education, 4(1), e1.
Mold, F., Raleigh, M., Alharbi, N. S., & de Lusignan, S. (2018). The impact of patient online access to computerized medical records and services on type 2 diabetes: a systematic review. Journal of Medical Internet Research, 20(7), e235.
Neves, A. L., Carter, A. W., Freise, L., Laranjo, L., Darzi, A., & Mayer, E. K. (2018). Impact of sharing electronic health records with patients on the quality and safety of care: a systematic review and narrative synthesis protocol. BMJ Open, 8(8), e020387.
Tubaishat, A. (2019). The effect of electronic health records on patient safety: A qualitative exploratory study. Informatics for Health and Social Care, 44(1), 79-91.
Yanamadala, S., Morrison, D., Curtin, C., McDonald, K., & Hernandez-Boussard, T. (2016). Electronic health records and quality of care: An observational study modeling impact on mortality, readmissions, and complications. Medicine, 95(19).

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