Unit 1 Flashcards
complex adaptive system (CAS)
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
STEEEP
what it is, what it stands for
Principles for redesigning (quality) healthcare (IOM)
Safe Timely Effective Efficient Equitable Patient-centered
ACE Star Model
what it is, what’s a key concept
what are the steps
EBP model
key concept: knowledge transformation
- Discovery research
- Evidence summary
- Translation to guidelines
- Practice integration
- Process, outcome evaluation
What is considered the most rigourous evidence summary?
systematic review
They are a central link between research and clinical decision making
Triad of EBP
EBP is the integration of:
best research knowledge, clinical expertise, and patient preferences
Hierarchy of evidence
Evidence summaries
Hierarchy of evidence
Evidence summaries
RCTs
Non-experimental
Qualitative studies, expert opinion, theory, basic science
NI Standards of Practice
- Assessment
- Diagnose problems and issue identification
- Outcomes identification
- Implementation
5a. Coordination of activities
5b. Health teaching and health promotion
5c. Consultation - Evaluation
Systematic study of algorithmic methods for representing and transforming information, including theory, design, implementation, application, and efficiency
Computer science
Investigates properties and behavior of information, the forces governing the flow of information, and the means of processing information for optimum accessibility and usability
Information science
Set of related interacting parts enclosed in a boundary
System
Characteristics of an open system
and 3 characteristics of one of ^those^ characteristics
- Purpose - why does the system exist?
- Function - how will the system achieve its purpose?
- Structure - systems are structured to perform their fxs
a. boundary
b. environment
c. attributes
Lewin’s Change Theory
Unfreezing, moving, refreezing
Rogers’s Diffusion of Innovation
stages of decision
- Knowledge stage
- Persuasion stage
- Decision stage
- Implementation stage
- Confirmation stage
Rogers’s Diffusion of Innovation
variations of individuals’ responses
Innovator Early adopter Early majority Late majority Laggard
Rogers’s Diffusion of Innovation
organization characteristics that help response
- Centralization
- Complexity
- Formalization
- Interconnectedness
- Organizational slack (uncommitted resources)
Rogers’s Diffusion of Innovation:
perceived attributes of innovation
- Relative advantage
- Compatability
- Complexity
- Trialability
- Observability
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.
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.
Unit / Functional Testing
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.
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).
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.
Hardware Testing
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.
Volume Testing
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.
Security Testing
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.
ARRA-related Meaningful Use testing
eligible providers, hospital organizations, and CAH must test their ability to collect required information and demonstrate that they meet Meaningful Use criteria.
