Unit 1

Question 1

complex adaptive system (CAS)

Answer 1

an entity consisting of many diverse and autonomous parts which are interrelated, interdependent, linked through many interconnections, and behave as a unified whole in learning from experience and in adjusting (not just reacting) to changes in the environment. Each individual agent of this is itself one of these

Question 2

STEEEP

what it is, what it stands for

Answer 2

Principles for redesigning (quality) healthcare (IOM)

Safe Timely Effective Efficient Equitable Patient-centered

Question 3

ACE Star Model

what it is, what’s a key concept
what are the steps

Answer 3

EBP model

key concept: knowledge transformation

1. Discovery research
2. Evidence summary
3. Translation to guidelines
4. Practice integration
5. Process, outcome evaluation

Question 4

What is considered the most rigourous evidence summary?

Answer 4

systematic review

They are a central link between research and clinical decision making

Question 5

Triad of EBP

Answer 5

EBP is the integration of:

best research knowledge, clinical expertise, and patient preferences

Question 6

Hierarchy of evidence

Answer 6

Evidence summaries

Question 7

Hierarchy of evidence

Answer 7

Evidence summaries
RCTs
Non-experimental
Qualitative studies, expert opinion, theory, basic science

Question 8

NI Standards of Practice

Answer 8

1. Assessment
2. Diagnose problems and issue identification
3. Outcomes identification
4. Implementation
   5a. Coordination of activities
   5b. Health teaching and health promotion
   5c. Consultation
5. Evaluation

Question 9

Systematic study of algorithmic methods for representing and transforming information, including theory, design, implementation, application, and efficiency

Answer 9

Computer science

Question 10

Investigates properties and behavior of information, the forces governing the flow of information, and the means of processing information for optimum accessibility and usability

Answer 10

Information science

Question 11

Set of related interacting parts enclosed in a boundary

Answer 11

System

Question 12

Characteristics of an open system

and 3 characteristics of one of ^those^ characteristics

Answer 12

1. Purpose - why does the system exist?
2. Function - how will the system achieve its purpose?
3. Structure - systems are structured to perform their fxs
   a. boundary
   b. environment
   c. attributes

Question 13

Lewin’s Change Theory

Answer 13

Unfreezing, moving, refreezing

Question 14

Rogers’s Diffusion of Innovation

stages of decision

Answer 14

1. Knowledge stage
2. Persuasion stage
3. Decision stage
4. Implementation stage
5. Confirmation stage

Question 15

Rogers’s Diffusion of Innovation

variations of individuals’ responses

Answer 15

Innovator
Early adopter
Early majority
Late majority
Laggard

Question 16

Rogers’s Diffusion of Innovation

organization characteristics that help response

Answer 16

1. Centralization
2. Complexity
3. Formalization
4. Interconnectedness
5. Organizational slack (uncommitted resources)

Question 17

Rogers’s Diffusion of Innovation:

perceived attributes of innovation

Answer 17

1. Relative advantage
2. Compatability
3. Complexity
4. Trialability
5. Observability

Question 18

ADT Testing

Answer 18

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.

e.g. The tester will ask registration to admit several new patients. Tester will verify that patient is in correct department, room, and bed, and all data entered during admission are correct. Admissions then will cycle through the various transactions, with the tester validating each change.

Question 19

Unit / Functional Testing

Answer 19

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.

e.g. For a CPOE application, the tester will enter interfaced and noninterfaced orders in the application and follow them through. The tester will verify that order details display appropriately and that orders are received in the ancillary system.

Question 20

Integrated Testing

Answer 20

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).

e.g. The tester will enter different kinds of orders in the CPOE system to interfaced ancillary applications like laboratory, radiology, pharmacy, dietary, and cardiology, and then cycle through all actions that are permitted per user role, including canceling the order, discontinuing the order, modifying the order, holding the order, etc. This also includes testing “unsolicited” orders, orders that originate in an ancillary system. An example of an unsolicited order is when the laboratory system initiates an order in response to the result of a previous order such as performing an HIV Western blot if HIV antibody is positive.

Question 21

Hardware Testing

Answer 21

Includes the capability of hardware interfacing with the EHR such as computers, printers, label printers, barcode printers, tablets, scanners, modems, etc.

e.g.The IT team will test that diet requisitions print in the dietary department, but dietitian consults print to the dietitian’s office at the specific times based on table settings. Another example is that lab labels print in the patient departments for specimens that are collected by the nurse but print in the lab for specimens that are collected by lab personnel.

Question 22

Volume Testing

Answer 22

Stress testing; Systems are built to accommodate the largest number of users accessing the system at the same time with no or minimal reduction in overall performance.

e.g. Early morning physician rounding and early afternoons are typically peak times for accessing the EHR. This type of testing may include asking a large group of students to log on and perform a variety of tasks simultaneously.

Question 23

Security Testing

Answer 23

checks that each provider type is able to perform functionalities specific to the role (entering orders, vital signs, nursing documentation, viewing results, medication reconciliation, etc.) but is prohibited from unauthorized actions, viewing, or access.

e.g. The IT department will validate that nursing assistants have the security to document vital signs, height, weight, I&O, and percentage of meals consumed but not be able to review the chart or enter orders. Another example is that a physician or RN can perform medication reconciliation with a change in the level of care but a nursing assistant cannot.

Question 24

ARRA-related Meaningful Use testing

Answer 24

eligible providers, hospital organizations, and CAH must test their ability to collect required information and demonstrate that they meet Meaningful Use criteria.