C790 Nursing Informatics (WGU), Unit 8 taxonomies, Unit 1 & 2 Define Health Informatics and theoretical Foundations/models, Unit 3, Unit 4 system Development Life Cycle., Unit 5 Project Management, Unit 7. Standardized Taxonomies, Unit 8 Taxonomies. Verified Masterpiece. Rated A+

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C790 Nursing Informatics (WGU), Unit 8 taxonomies, Unit 1 & 2 Define Health Informatics and theoretical Foundations/models, Unit 3, Unit 4 system Development Life Cycle., Unit 5 Project Mana... gement, Unit 7. Standardized Taxonomies, Unit 8 Taxonomies. Verified Masterpiece. Rated A+ goal of EBP is improvement of systems and microsystems within healthcare, with these improvements based on science STEEEP principles The Institute of Medicine (IOM) expert panel issued recommendations for urgent action to redesign healthcare so that it is safe, timely, effective, efficient, equitable, and patient-centered (S) in STEEEP Safe-Avoid injuries to patients from the care that is intended to help them. (T) in STEEEP Timely-Reduce waits and sometimes harmful delays for both those who receive and those who give care. (E) in STEEEP Effective-Provide services based on scientific knowledge to all who could benefit, and refrain from providing services to those not likely to benefit. (E) in STEEEP Efficient-Avoid waste, including waste of equipment, supplies, ideas, and energy. (E) in STEEEP Equitable-Provide care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status. (P) in STEEEP Patient-centered Provide care that is respectful of and responsive to individual patient preferences, needs, and values, and ensure that patient values guide all clinical decisions. ACE Star Model of Knowledge Transformation Advancing Research and Clinical Practice through Close Collaboration (ARCC) Model of Evidence-Based Practice in Nursing and Healthcare Johns Hopkins Nursing Evidence-Based Practice Model and Guidelines Iowa Model of Evidence-Based Practice Stetler Model of Research Utilization FOCUS: EBP, research use, and knowledge transformation processes DESCRIPTION: Direct a systematic approach to synthesizing knowledge and transforming research findings to improve patient outcomes and the quality of care Address both individual practitioners and healthcare organizations Focus on increasing the meaningfulness and utility of research findings in clinical decision making Promoting Action on Research Implementation in Health Services (PARiHS) Vratny and Shriver Model for Evidence-Based Practice Pettigrew and Whipp Model of Strategic Change Outcomes-Focused Knowledge Translation Determinants of Effective Implementation of Complex Innovations in Organizations Ottawa Model of Research Use FOCUS: Strategic and organizational change theory to promote uptake and adoption of new knowledge DESCRIPTION:Trace mechanisms by which individual, small group, and organizational contexts affect diffusion, uptake, and adoption of new knowledge and innovation Premise is that interventions, outcomes evaluations, and feedback are important methods to promote practice change Collaborative Model for Knowledge Translation between Research and Practice Settings Framework for Translating Evidence into Action Knowledge Transfer and Exchange Canadian Institutes of Health Research Knowledge Translation within the Research Cycle Model or Knowledge Action Model Interactive Systems Framework for Dissemination and Implementation FOCUS: Knowledge exchange and synthesis for application and inquiry DESCRIPTION: Structure ongoing interactions among practitioners, researchers, policy-makers, and consumers to facilitate the generation of clinically relevant knowledge and the application of knowledge in practice All parties are engaged in bidirectional collaboration across the translation continuum Knowledge Transformation (Ace Star Model) is defined as the conversion of research findings from discovery of primary research results, through a series of stages and forms, to increase the relevance, accessibility, and utility of evidence at the point of care to improve healthcare and health outcomes by way of evidencebased care. Ace Star Model These five points are discovery research, evidence summary, translation to guidelines, practice integration, and evaluation of process and outcome clinical practice guidelines (CPGs) The IOM defines clinical guidelines as "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. usability 1.Increased user productivity and efficiency 2.Decreased user errors and increased safety 3.Improved cognitive support human factors is "the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data and methods to design in order to optimize human well-being and overall system performance." In healthcare, human factors might concern the design of a new operating room to better support teamwork and patient flow. ergonomics used interchangeably with human factors by the HFES in Europe but in the U.S. and other countries its focus is on human performance with physical characteristics of tools, systems, and machines i.e. power drill fitting in hand Human-computer interaction (HCI) is the study of how people design, implement, and evaluate interactive computer systems in the context of users' tasks and work usability is often used interchangeably with HCI when the product is a computer but usability also concerns products beyond computers. Usability is also more focused on interactions within a specific context or environment for a specific product. Formally, the ISO defines usability as the extent to which a product can be used by specific users in a specific context to achieve specific goals with effectiveness, efficiency, and satisfaction. allows users to achieve goals joint cognitive systems imply that information is shared or distributed among humans and technology. This framework is useful for examining teamwork in healthcare where team members work together on patient care Health Human-Computer Interaction (HHCI) Framework Humans or products can initiate interactions. The information is processed through either the product or the humans according to characteristics. The recipient then reacts to the information; for example, a healthcare provider could read and respond to email from a patient or a product might process interactions after the "enter" key is pressed. Iterative cycles continue as humans behave and products act according to defined characteristics. Goals and planning are implicit within the tasks displayed in the framework. discount usability methods reduce the number of required users in usability projects and to use early design prototypes. These methods offer economies of time, effort, and cost and can be completed at any point in the systems life cycle. Two common techniques are heuristic evaluation and think-aloud protocol. Heuristic evaluations compare products against accepted usability guidelines to reveal major and minor usability issues. think-aloud protocol also involves a small number of users and has them talk aloud while they interact with a product. Users voice what they are trying to do, indicate where interactions are confusing, and provide other thoughts about the product during interactions. This allows a detailed examination of the specified tasks, in particular to uncover major effectiveness issues. used in conjunction with other techniques task analysis generic term for a set of more than 100 techniques that range from a focus on cognitive tasks and processes (called cognitive task analysis) to observable user interactions with an application (e.g., a systematic mapping of team interactions during a patient code). Task analyses are systematic methods that are used to understand what users are doing or required to do with a product by focusing on tasks and behavioral actions of the users and products. These methods provide a process for learning about and documenting how ordinary users complete actions in a specific context. Methods of task analysis include the following: •Interviews •Observations •Shadowing users at their actual work sites •Observing users doing tasks •Conducting ethnographic studies or interviews focused ethnographies concentrate on individuals' points of view, their experiences and interactions in social settings, rather than on just the actions of those individuals During observations, detailed descriptions are generated with an emphasis on social relationships and their impact on work. Usability Questionnaires System Usability Scale (SUS)- industry standard, 10-scale Questionnaire for User Interaction Satisfaction (QUIS)-computer system or application assessed Purdue Usability Testing Questionnaire-100 open ended questions Software Usability Measurement Inventory (SUMI)- Exploratory Test conducted early in the systems life cycle after requirements are determined. These tests are conducted on very basic or preliminary designs or redesigns where few resources have been committed to programming the product. The objective of an exploratory test is to assess the effectiveness of emerging design concepts informal Assessment Test conducted early in or midway through the development of a product application. After the organization and general design are determined, this kind of test assesses lower-level operations of the application, stressing the efficiency goals of the product (versus effectiveness) and how well the task is presented to users. conducted whens system partially developed validation test completed later in the systems life cycle using a more mature product. This type of test assesses how this particular product compares to a predetermined standard, benchmark, or performance measure. Comparison Study can conduct comparison studies at any point in the systems life cycle but they are more commonly done to compare an existing design with a redesign or an early prototype with a more mature product. The major objective of this usability test is to determine which application, design, or product is more effective, efficient, and satisfying Steps for Conducting Usability Tests 1) define a clear purpose 2) assess constraints 3) Use an HCI framework to define pertinent components. 4) Match methods to the purpose, constraints, and framework assessment. human factors The complex interactions among multiple users, products, and environments with varying characteristics in health information technology is referred to project is a planned undertaking, with a beginning and end that produces a well-defined result or product. information system development project a planned undertaking that produces a new information system predictive approach to the SDLC assumes that the development project can be planned and organized and that the new information system can be developed according to the plan useful for building systems that are well understood and defined. company may want to convert its old networked client/server system to a newer Web-based system that includes a smartphone app. In this type of project, the staff already understands the requirements very well, and no new processes need to be added traditional (70s-90s) adaptive approach to the SDLC is used when the system's requirements and/or the users' needs aren't well understood. In this situation, the project can't be planned completely. Some system requirements may need to be determined after preliminary development work. (late 90s-today) project initiation (predictive) In predictive approaches, there is a group of activities that identifies the problem and secures approval to develop a new system Project planning (predictive) In predictive approaches, there is a group of activities that identifies the problem and secures approval to develop a new system map out the project's overall structure analysis (predictive) focuses on discovering and understanding the details of the problem or need. The intent here is to figure out exactly what the system must do to support the business processes design (predictive) focuses on configuring and structuring the new system components. These activities use the requirements that were defined earlier to develop the program structure and the algorithms for the new system implementation (predictive) includes programming and testing the system. deployment (predictive) involves installing and putting the system into operation. phases of the system development project (predictive) project initiation, project planning, analysis, design, implementation, and deployment support phase (predictive) includes the activities needed to upgrade and maintain the system after it has been deployed. The support phase is part of the overall SDLC, but it isn't normally considered part of the initial development project waterfall model (predictive) the phases of the project flow down, one after another. This model assumes that the phases can be carried out and completed sequentially. After a project drops over the waterfall into the next phase, there is no going back rigid planning, doesn't work very well interative approach (adaptive) Using iterations, the project is able to adapt to any changes as it proceeds. Also, parts of the system are available early on for user evaluation and feedback, which helps ensure that the application will meet the needs of the users. overlapping phases is adaptive because with each iteration's analysis, design, and implementation, modifications can be made to adapt to the changing requirements of the project incremental development related concept to interative SDLC based on an iterative life cycle basic idea is that the system is built in small increments may be developed within a single iteration or it may require two or three iterations. As each increment is completed, it is integrated with the whole "grown" in an organic fashion gets into user's hands faster walking skeleton based on interative approach provides a complete front-to-back implementation of the new system but with only the "bare bones" of functionality. gets into user's hands quickly system development methodology provides guidelines for every facet of the system development life cycle. model representation of an important aspect of the real world abstraction people abstract (separate out) an aspect that is of particular importance to them. tool software support that helps create models or other components required in the project. integrated development environments (IDEs) sets of tools that work together to provide a comprehensive development and programming environment for software developers visual modeling tools tools that help analysts create and verify graphical models and may also generate program code technique a collection of guidelines that specify a method for how to carry out a development activity or task Sometimes, a technique applies to an entire life cycle phase and helps you create several models and other documents. How do methodologies, models, tools, and techniques fit together? A methodology includes a collection of techniques that are used to complete activities within each phase or iteration of the system development life cycle. The activities include the completion of a variety of models as well as other documents and deliverables. Like any other professionals, system developers use software tools to help them complete their activities Agile development a guiding philosophy and set of guidelines for developing information systems in an unknown, rapidly changing environment compliments adaptive approaches Agile modeling a philosophy about how to build models, some of which are formal and detailed, others sketchy and minimal ""Manifesto for Agile Software Development" four values ▪ Value responding to change over following a plan ▪ Value individuals and interactions over processes and tools ▪ Value working software over comprehensive documentation ▪ Value customer collaboration over contract negotiation chaordic a term used to describe adaptive projects because they are chaotic yet ordered Agile Modeling (AM) a guiding philosophy in which only models that are necessary, with a valid need and at the right level of detail, are created The Unified Process (UP) is an object-oriented system development methodology defines a complete methodology that uses UML for system models and describes a new, adaptive system development life cycle. In the UP, the term development process is synonymous with development methodology. UP Phases inception, elaboration, construction, and transition Inception Phase (UP) develop an approximate vision of the system, make the business case, define the scope, and produce rough estimates for cost and schedule usually one iteration Elaboration Phase (UP) define the vision, identify and describe all requirements, finalize the scope, design and implement the core architecture and functions, resolve high risks, and produce realistic estimates for cost and schedule usually several iterations Construction Phase (UP) iteratively implement the remaining lower-risk, predictable, and easier elements and prepare for deployment several iterations Transition Phase (UP) complete the beta test and deployment so users have a working system and are ready to benefit as expected one or more final iterations UP discipline a set of functionally related activities that combine to enable the development process in a UP project disciplines include: business modeling, requirements, design, implementation, testing, deployment, configuration and change management, project management environment Extreme Programming (XP) an adaptive, Agile development methodology an attempt to take the best practices of software development and extend them "to the extreme. characteristics: Takes proven industry best practices and focuses on them intensely Combines those best practices (in their most intense forms) in a new way to produce a result that is greater than the sum of its parts XP Core Values communication- documentation, verbal discussion (open and frequent) simplicity- techniques to reinforce this principle and make it a standard way of developing systems feedback- Feedback on functionality and requirements should come from the users, feedback on designs and code should come from other developers, and feedback on satisfying a business need should come from the client courage- XP practices are designed to give developers the courage to "do it right." XP Practices (12) planning-focuses on making a rough plan quickly and then refining it as things become clearer. testing- two major types of tests: unit tests, which test the correctness of a small piece of code, and acceptance tests, which test the business function pair programming- divides up the coding work. First, one programmer might focus more on design and double-checking the algorithms while the other writes the code. Then, they switch roles simple designs-accomplishes the desired result with as few classes and methods as possible and that doesn't duplicate code refactoring the code- revising, reorganizing, and rebuilding part of a system so it is of higher quality owning the code collectively- everyone is responsible for the code continuous integration- embodies XP's idea of "growing" the software. Small pieces of code— which have passed the unit tests—are integrated into the system daily or even more often. on-site customer- embodies XP's idea of "growing" the software. Small pieces of code—which have passed the unit tests—are integrated into the system daily or even more often. system metaphor- s unique and interesting approach to defining an architectural vision. It answers the questions "How does the system work?" and "What are its major components?" And it does it by having the developers identify a metaphor for the system. small releases- point at which the new system can be turned over to users for acceptance testing and even for productive use. forty-hour week and coding standards- set the tone for how the developers should work. XP system development approach three levels: system (the outer ring), release (the middle ring), and iteration (the inner ring). occur once during each development project Scrum the objective of which is to be quick, agile, and intense and to go the entire distance focus is primarily on the team level social engineering that emphasizes individuals more than processes and describes how teams of developers can work together to build software in a series of short mini-projects Software is developed incrementally, and controls are imposed empirically—by focusing on things that can be accomplished. product backlog product backlog a prioritized list of user requirements used to choose work to be done in a Scrum project Scrum organization three main organizational elements that affect a Scrum project are the product owner, the Scrum master, and the Scrum team or teams. product owner the client stakeholder for whom the system is being built scrum master the person in charge of a Scrum project—similar to a project manager scrum team small group of developers—typically five to nine people—who work together to produce the software sprint a time-controlled mini-project that implements a specific portion of a system daily meetings with the Scrum team to report issues time boxing weaknesses of agile process: requires meaningful stakeholder participation Agile cannot define what will be delivered at the end of a project. Agile requires a strong team of process subject matter experts. No "Scrum Master" role. Unlike with software development teams, in healthcare there is likely no one who is coaching the team on Agile practices, such as defining work in iterations. This is where a subject matter lead role, sponsor, or even project manager will need to lead. The team needs to function at a high level, and thus requires experienced team members with high levels of demonstrated professionalism. project management organizing and directing other people to achieve a planned result within a predetermined schedule and budget. oversight committee clients and key managers who review the progress and direct the project Level of formality or ceremony the rigor of holding formal meetings and producing detailed documentation Agile Project Management a way of balancing flexibility and chaos: how to be agile and flexible while maintaining control of the project schedule, budget, and deliverables. agile time frame-difficult to create/maintain project schedule cost estimates are difficult to make, especially with a project in which the requirements are expected to change throughout. project manager controls cost quality management: each iteration has a deliverable. testing spread throughout project, also process evaluations of each iteration system vision document (SVD) a document to help define the scope of a new system business benefits the benefits that accrue to the organization; usually measured in dollars (part of SVD) system capabilities the required capabilities of a new system; part of a System Vision Document (part of SVD) cost/benefit analysis process of comparing costs and benefits to see whether investing in a new system will be beneficial net present value (NPV) the present value of dollar benefits and dollar costs of a particular investment break-even point the point in time at which dollar benefits offset dollar costs payback period the time period during which the dollar benefits offset the dollar costs tangible benefit a benefit that can be measured or estimated in terms of dollars intangible benefit a benefit that accrues to an organization but that can't be measured quantitatively or estimated accurately project dashboard allows all types of project information to be posted and viewed by Web browsers project iteration schedule the list of iterations and use cases or user stories assigned to each iteration detailed work schedule the schedule that lists, organizes, and describes the dependencies of the detailed work tasks Work Breakdown Structure (WBS) the list or hierarchy of activities and tasks of a project; used to estimate the work to be done and to create a detailed work schedule Gantt chart a bar chart that portrays the schedule by the length of horizontal bars superimposed on a calendar critical path a sequence of tasks that can't be delayed without causing the entire project to be delayed retrospective a meeting held by the team at the end of an iteration to determine what was successful and what can be improved Core Process 1 the objective of which is to identify the business need and to get the project initiated. These activities include: ▪ Identifying the problem ▪ Extending the project approval factors ▪ Performing risk and feasibility analysis ▪ Reviewing with the client and obtaining approval Tall Man Lettering mixed case lettering ie NiFEDipine scope creep occurs when requirements are added after the initial project is defined and those added requirements are substantial enough to affect the project timeline. Best of Breed implementation of EHR involves reviewing several vendors for their "best" module or application, such as an admission, discharge, and transfer (ADT) system or emergency department module. Then multiple modules are purchased from different vendors to create a full suite of functions. Integrated Health System an electronic health record system that includes a suite of modules to support care. It is typically easier to install and easier to support and usually has a similar-looking user interface across modules, which helps users to learn the EHR more quickly. Systems Life Cycle SLC Analyze: The existing environment and systems are evaluated. Major problems and deficiencies are identified using informal or formal methods. A needs assessment is developed. Gaps are noted and current capabilities and limitations are outlined. Initial user and system requirements are formulated. •Plan: The proposed system is planned comprehensively. Planning includes strategic levels, such as whether the system will be developed internally, purchased and tailored, or designed and developed jointly with a vendor. •Develop or purchase: At this stage either the system is purchased or the new system development begins. New components and programs are obtained and installed. For vendorsupported solutions, extensive tailoring occurs. •Test: At this stage extensive testing occurs just before Stage 5 and "go" or "no go" decisions are made about deadlines. Toward the end of this phase, marketing and communication efforts are accelerated to make users aware of the impending change. •Implement or go-live: The system is implemented using a selected method best suited to the organization and its tolerance for risk. User training is completed. •Maintain and evolve: Once the system has been formally acknowledged as passing user acceptance testing, typically at 90 or 120 days after go-live, it enters a maintenance phase. •Evaluate: Activities in each phase are assessed for their quality and effectiveness. workaround a method used to circumvent a problem without solving it ADT Testing ADT testing involves testing for every possible type of ADT transaction used in the organization for inpatients, outpatients, serial patients, and preadmits. These transactions include admit; discharge; transfer; cancel admit; cancel discharge; cancel transfer; change beds, rooms, or departments; merge accounts; etc. Unit Testing and functional testing Unit testing is a very basic type of testing where the tester runs through the basic functionalities and features of an application. It is a high-level cursory walk-through of the application. The goal is to identify deviations from the expectations and to correct these unexpected results. The tester will not test every order or documentation field but will need to test every possible scenario. integrated testing Integrated testing tests the transmission of messages between all systems such as the healthcare information system, laboratory, radiology, pharmacy, dietary, cardiology, etc. This test includes testing all bidirectional order messages and results going across the interface(s) ARRA-related Meaningful Use testing With the introduction of Meaningful Use, eligible providers, hospital organizations, and Critical Access Hospitals (CAH) must test their ability to collect required information and demonstrate that they meet Meaningful Use criteria. big bang go live occurs when all applications or modules are implemented at once. This approach is favored by vendors and facilities conducting large upgrades phased go live both paper and electronic environments exist at the same time within the healthcare institution; however, the existence of both paper and electronic environments forces the clinician to use different work flows in patient units that have implemented the system than in units that have not, potentially creating safety concerns. ten key principles relevant to successful clinical systems integration. Comprehensive Services across the Continuum of Care, Patient Focus, Geographic Coverage and Rostering, Standardized Care Delivery through Interprofessional Teams, Performance Management, Information Systems, Organizational Culture and Leadership, Physician Integration, Governance Structure, and Fina [Show More]

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