Data Entry Automation Improves Cost, Quality, Performance, and Job Satisfaction in a Hospital Nursing Unit.

OBJECTIVE: An Automated Data Entry Process Technology tool was developed to free nurses from data entry tasks, thus creating time for patient care and other activities associated with improvements in performance and job satisfaction. BACKGROUND: Manually transferring data from patient measurement devices to electronic health records (EHRs) is an intensive, error-prone task that diverts nurses from patient care while adversely affecting job performance and employee satisfaction. METHODS: Performance improvement analytics were used to compare matched sets of manual and automated EHR data entries for 1933 consecutive vital signs records created by 49 RNs and certified nursing assistants in a 23-bed medical-surgical unit at a large tertiary hospital. Performance and quality effects were evaluated via nurses' responses to a postintervention survey. RESULTS: Data errors decreased from approximately 20% to 0; data transfer times were reduced by 5 minutes to 2 hours per measurement event; nurses had more time for direct patient care; and job satisfaction improved. CONCLUSION: Data entry automation eliminates data errors, substantially reduces delays in getting data into EHRs, and improves job satisfaction by giving nurses more time for direct patient care. Findings are associated with improvements in quality, work performance, and job satisfaction, key goals of nursing leaders.

2017 Annual Meeting of the American College of Radiology-Moreton Lecture: Forecasting the Futures of Radiology.

PURPOSE: The traditional forces of change in health care are no longer working as they did in the past. Political gridlock has destroyed Washington's ability to create sensible policy for reforming the medical marketplace, creating chaos for providers. Fortunately, chaos creates opportunity. The idea of creating one's future has never been more relevant and necessary. MATERIALS AND METHODS: Predicting-the science of extrapolating future values from historical data-is not a valid method for looking ahead when causal relationships that explained change in the past are themselves being redefined (the current situation). Forecasting-the art of estimating probabilities of possibilities-is the appropriate method for anticipating futures when causality is being redefined. With its focus on identifying a range of possibilities, forecasting identifies many different outcomes that are simultaneously possible for radiology. RESULTS: Health care's new climate is being shaped by four defining trends: 1) revolution in biological science that is shifting caregivers' mission from acute care to disease management; 2) proliferation of information and communications technologies that are transforming the way care is delivered; 3) end of economic growth in the medical marketplace that is reshaping demand for care; and 4) political dysfunction that forces caregivers and their business partners to develop successful futures on their own. CONCLUSIONS: Radiology 3.0 is nicely aligned with the transformational trends. Staying focused on implementing Radiology 3.0 is supported as the optimal strategy for creating the profession's futures. Diagnostic convergence, establishing a unified diagnostic science with laboratory medicine, is proposed as a complementary initiative.

Automated, wireless, continuous, intelligent, and noninvasive systems for risk management and performance improvement in vital signs monitoring.

Few health professionals need to stay up-to-date on as many different problems and solutions as risk managers do. Consequently, a single solution that resolves several problems at once is really helpful for job performance, especially when it doesn't require duplicating effort in multiple areas. This article summarizes current literature about one such technology that helps risk managers address 3 of today's biggest challenges for healthcare delivery organizations: reducing costs, improving quality, and preventing harm across the continuum of clinical care; ensuring valid and reliable data for healthcare clinical and managerial decision makers; and adopting technologies that improve the medical marketplace.

Nurse practitioners as an underutilized resource for health reform: evidence-based demonstrations of cost-effectiveness.

Healthcare reform in 2009 was motivated by an imperative to reduce the relentless increase in spending on medical care. Many efforts to solve the problem focused on applying proven principles of evidence-based practice and cost-effectiveness to find the least-expensive way to produce a specific clinical service of acceptable quality. This paper combines economic analysis and reviews published literature to show how the goals of healthcare reform can be accomplished by allowing independently licensed nurse practitioners to provide their wide range of services directly to patients in a variety of clinical settings. The paper presents extensive, consistent evidence that nurse practitioners provide care of equal or better quality at lower cost than comparable services provided by other qualified health professionals.

Culture clash: aligning payers and providers for real reform.

Self-imposed cost containment is not part of providers' heritage. The payer business model and its problems are complicated; simplistic reforms won't help. Health reform needs to be refocused on policies that allow providers and payers to align their cultures so that all parties benefit from potential synergies to provide top-quality care as inexpensively as possible.

Medical tourism: wave of the future in a world of hurt?

People look to medical tourism to save money and to get treatments that are not approved or that are not available at home due to political prohibitions. Medical tourism will be affected by the global economic downturn, concern about lower quality of care, and political instability. The international marketplace could be rewarding to American providers, payers, vendors, and other healthcare stakeholders that can efficiently and effectively respond to the current crisis.

Change that's truly different: a productive approach to reform.

Healthcare leaders need to reform the way health care is produced more than the way it is reimbursed. Reform efforts should be directed toward improving performance of the healthcare delivery system. A promising approach to reform would be to impose a formal performance improvement process as a criterion for provider accreditation.