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  • Subject Name : Nursing

Scenario Based Critical Reflection in Healthcare Settings 

Introduction to Electronic Medical Record System in Healthcare Settings

Electronic health records are growing rapidly in popularity in many healthcare setups (Tubaishat, 2019). This has also become an integral part of any efficient healthcare system. However, healthcare professionals should be well-versed to use this methodology to be inculcated in the daily routine. These healthcare professionals can include, nurses, doctors, other medical helpers and so on. The methodology of using electronic health records should be used in a meaningful manner and this will help in getter better outcomes from the application of the same. This method can be used collecting information to track the key clinical conditions, putting in place a care coordination process, report clinical quality measures which can also be useful for collecting public health information etc. (Tubaishat, 2019). An electronic health record system can also be deemed as more calibrated system, which can be used to exchange health related information in a more sophisticated manner. It can also be used for multiple data to be viewed and fed on a common platform. This can include lab reports, e-prescribing, transmitting patient care and summaries, enabling self-management tools and so on. All these elements cumulatively can help in improving overall patient care and that too with efficiency.

There are many other positive features that can be included as a part of key features enabled as electronic health records. The primary factor is the ability to transfer medical records across the various geographical borders. This is very vital from the point of view of enabling complete and accurate information for performing patient care. This is also important from the point of view of patient management and engagement. With mere few clicks the patient’s comprehensive details can be available for the healthcare professional to view from (Atasoy, 2019). This model of maintaining records in a healthcare setting also comes with a lower price and with less labour force involved in the process. With all healthcare professionals able to view and interact with each other through this portal, for patient care and coordination, the system can be deemed as quite efficient and a deliberate model serving its right purpose. This platform also helps in increasing overall patient engagement between the patient and the care provider. By allowing the patients to participate in the process of their individual care, a patient-centred care approach model can be delivering for smooth facilitation of healthcare services (Atasoy, 2019).

Lewis Model of Change

Kurt Lewis proposed a three staged model of planned approach to the organizational structure (Hussain, 2018). This model is bifurcated into three different stages, which helps in simplifying the stages of transitions of organizational process. Change can be a complicated shift of paradigm in any culture. This model helps in establishing equilibrium of stability within the process and thus, ensuring positive outcomes from its. Implementation (Burnes, 2020). The three stages of this model can be used in our given case scenario as follow:

Stage1- Unfreezing- This stage is the first step towards the transition process (Cummings, 2016). This can be quite crucial as well, as it formulates the foundational grounds for improving the process. In the given process the nurse leader is faced with a challenge of improving communication between the healthcare professionals and reducing the chances of errors. The staff has to be acquainted as well, to adapt to the new transitional phase of inclusion of electronic health records in the system. The nurse leader can work along with the team, working on collecting information on their point of view. This can be inclusive of analyzing the team for their readiness and willingness to foster this new change and adapt to the same (Cummings, 2016). The nurse can identify the staff members who can be deemed less willing to the change and can work on one-on-one basis with them. Communication between the team plays a crucial role in this process and will also help in enabling the desired support to the people. The team can also be highlighted upon the positive benefits of including this routine in the working if the system. This will give them an insight to compare with the ongoing process and methods opted for working preferred (Cummings, 2016).

Stage 2- Change- This stage can be deemed as the actual transitional stage, where the transformation in the process takes place (Hidayat, 2020). Before commencing with this step, it should be ensured that all limitations have been very well catered to. The leader nurse can work with her team to carefully plan a proper methodology to be implemented. The insight of the team members can be taken in this step. As the team members will be working with the system on daily basis, their ideas can help in crafting a customized and effective plan to be implemented in the phase. It also important for the nurse leader to clear all underlying doubts and fears of the team members, so that adopting to the new process can be quite smooth (Hidayat, 2020).

Stage3- Freezing- This phase includes movement of a person from an instable stage of transition to a much stable state of equilibrium (Hussain, 2018). The nurse leader can brief the team about the functioning of the system and can help them in accepting this new reform. This can be deemed as the most stable phase of organizational transition. The nurse leader can also award the employees who deliver excellence while adopting this newer method. This will help in ensuring positive reinforcement in the working of the system and will also motivate other employees to do the same. This can also formulate for foundational grounds for developing much stronger and positive policy framework, that can assist in transforming the ways of working completely. In this given case scenario, the direct positive effect will be observed on the improved patient care and coordination.

Leadership Style

The best possible nursing leadership style in this case study can be deemed as the transformational style. Transformational leaders are found to form string relationship within their team. They have the potential to inspire and encourage the people around them to not only act independently, but to act towards attaining a higher goal (Choi, 2016). These leaders can be very effective in developing a greater shell of confidence in their team members. This is also vital from the point of view of promoting overall self-confidence and enthusiasm in the staff members. They are also found to act with great deal of optimism, being a reliable source to look forward to, advocating for the rights of the team members and so on. They can also help the staff members to develop values and behaviors which can be useful for promoting overall benefit of the patient population. These leaders can work in the best possible manner to ensure trust, compatibility, accountability and team performance between the staff members (Giddens, 2018). In situations, that can be deemed as quite challenging for the person, the transformational leader can help the team member in realizing the main organizational goal, thus, motivating them to work towards it. By focusing on a lager and singular goals, which can be enhancing patient care and coordination in this scenario, transformational leadership role stands a winner in the given case scenario. Strategic leadership role can also fit in this situation. However, this leadership role mainly concentrates its’ focus on employee growth and quality goals. They can also help the staff members to get through the transitional phase quite efficiently (Elliott, 2017). Whereas, in this case scenario the transformational role can be observed to be superseding all other leadership roles. With its main focal deviation on improving overall quality of care provided to the patient, the transformational nursing leadership role can be the best choice. This role can help the new members to adapt not only to the changes, but also to the ever-changing dynamics of the overall working of the healthcare system.

Potential Resistance

The two main potential resistance factors for implementation of this system can be affirmed as follow:

  • Lack of computer skills- This can be true for some senior nursing staff. They have been working in a less technical background and rather taking care of the patient through their clinical skill sets. However, various healthcare settings make use of common databases, which requires use of computers, but the use if generally restricted to few professionals. In this given case scenario, the whole medical system functioning will be relied upon the use of medical health records (Al-Rawajfah, 2019). Getting familiar with the working of the system can be a bit challenging for the staff to perform. Good typing skills might also be required, to avoid any typo errors while documenting patient’s details. This is also vital, as the information will be shared through a common platform, amongst a varied group of healthcare professionals.
  • Security related concerns- There is a greater risk of the data being out in the open and being available on multiple servers. This involves more risk to the security and confidentiality parameter of sharing the patient information (Kruse, 2017). With the records being electricized, the data can be hacked easily, leaving the information quite vulnerable and easy to be attained. There is also a grave danger for cybercrimes, involving confidential and private data. This can also be a concern raised as per the codes of ethics of working of the healthcare organizational structure.

References for Electronic Medical Record System in Healthcare Settings

Al-Rawajfah, O., & Tubaishat, A. (2019). Barriers and facilitators to using electronic healthcare records in Jordanian hospitals from the nurses’ perspective: A national survey. Informatics for Health and Social Care44(1), 1-11. https://doi.org/10.1080/17538157.2017.1353998

Atasoy, H., Greenwood, B. N., & McCullough, J. S. (2019). The digitization of patient care: A review of the effects of electronic health records on health care quality and utilization. Annual Review of Public Health40, 487-500. https://doi.org/10.1146/annurev-publhealth-040218-044206

Burnes, B. (2020). The origins of Lewin’s three-step model of change. The Journal of Applied Behavioral Science56(1), 32-59. https://doi.org/10.1177%2F0021886319892685

Choi, S. L., Goh, C. F., Adam, M. B. H., & Tan, O. K. (2016). Transformational leadership, empowerment, and job satisfaction: The mediating role of employee empowerment. Human Resources for Health14(1), 73. https://doi.org/10.1186/s12960-016-0171-2

Cummings, S., Bridgman, T., & Brown, K. G. (2016). Unfreezing change as three steps: Rethinking Kurt Lewin’s legacy for change management. Human Relations69(1), 33-60. https://doi.org/10.1177%2F0018726715577707

Elliott, N. (2017). Building leadership capacity in advanced nurse practitioners–the role of organisational management. Journal of Nursing Management25(1), 77-81. https://doi.org/10.1111/jonm.12444

Giddens, J. (2018). Transformational leadership: What every nursing dean should know. Journal of Professional Nursing34(2), 117-121. https://doi.org/10.1016/j.profnurs.2017.10.004

Hidayat, A. T., Hariyati, R. T. S. H. S., & Muhaeriwati, T. M. (2020). Applicability of lewin’s change management model for optimization management function in nursing delegation between head nurse and team leader: A mini project in Jakarta military hospital. International Journal of Nursing and Health Services (IJNHS)3(4), 471-478. https://doi.org/10.35654/ijnhs.v3i4.68

Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin's change model: A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge3(3), 123-127. https://doi.org/10.1016/j.jik.2016.07.002

Kruse, C. S., Smith, B., Vanderlinden, H., & Nealand, A. (2017). Security techniques for the electronic health records. Journal of Medical Systems41(8), 127. https://doi.org/10.1007/s10916-017-0778-4

Tubaishat, A. (2019). The effect of electronic health records on patient safety: a qualitative exploratory study. Informatics for Health and Social Care44(1), 79-91. https://doi.org/10.1080/17538157.2017.1398753

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