5 Core Competencies In Healthcare

Healthcare is constantly changing with the intention of improving patient care. The Institute of Medicine (IOM) issued a report introducing five core competencies for health professionals, in order to improve the Untied States healthcare system: provide patient-centered care, work in interdisciplinary teams, employ evidence-based practice, apply quality improvement, and utilize informatics (Institute of Medicine of the National Academies, 2003). IOM proposes that if all five core competencies are utilized by health professionals, quality patient care can be achieved. The facility in which this nurse work, is in need of improving their charting system. The facility currently utilizes two different software systems for charting, in addition to

having a paper chart for each patient. Utilizing three different charting systems has and will continue to lead to medical errors, due to miscommunications among the healthcare team. Keller (2016) reported an astounding 1.5 million preventable adverse drug occurrences in the United States each year. More importantly, medical errors are reported to be the third leading cause of death.
Perceived Needs for Improvement
The facility in which this nurse is currently employed, utilizes three different charting systems. One electronic system is used to chart daily patient assessments and medications administered during treatment. Additionally, it tracks the patient’s treatment history, vaccinations and labs, contains the patient’s Kardex and contact information. The second electronic system is used to chart daily nursing notes related to patient care, monthly nursing progress notes, physicians rounding report, and notes from the registered dietician, as well as the social worker. This system also tracks the patient’s treatment history, labs, and contains the plan of care. The paper chart consists of the patient’s health history, written orders from physicians, and medical records from other provider’s office.
The use of multiple systems to track and chart patient health information can lead to ineffective patient care. Utilizing two different electronic charting system and a paper chart can delay patient care as the patients’ complete health information are located in multiple places. Additionally, legibility is often a problem with a written doctors order. Illegible doctors’ notes and orders can result in medical errors that are easily preventable (Keller, 2016). Lastly, access to patient records from those whom are visiting from other facilities is not a possibility. At this time, patient notes, current in-center medications, patient home medications, vaccination report, and dialysis prescription are faxed from the visiting patients current dialysis facility. All the information is then entered manually for the visitor. This process has and can lead to incorrect information being entered into the system, with the patient being put on dialysis with the incorrect prescription and/or the incorrect medication or dose being given to the patient during treatment.
Goals and Barriers to Improvement
As a healthcare company that strive to be the healthcare system of choice and pride itself on continuous improvement, it is crucial for the company to adopt a new charting system in order for quality patient care to be achieve.

There are a number of ways in which patient care can be improved with a facility that utilizes multiple charting systems. The simplest way to provide effective quality care is to implement the EHR. A EHR is an electronic system consisting of a complete patient medical health history of past and current conditions (Keller, 2016; Menachemi & Collum, 2011). In addition, to the patient’s demographic, diagnoses, medications, treatment plans, allergies, laboratory data, immunizations, and test results. EHR decreases medical errors such as misinterpretation of clinical notes, doctors orders, not having access to paper chart that have yet to be filed or has been missed file (Keller, 2016). EHR also allows for quick and easy access to diagnostic test results and patient notes that are needed for patient care. EHR will significantly enhance patient care by reducing the amount of time it takes the healthcare team to retrieve the needed health information to deliver patient care. It will also dramatically reduce medical errors that are associated with the nursing staff manually entering doctors’

orders.
The facility can also choose to adopt a different electronic medical record (EMR) system that can consolidate all three current charting system into one. This system will still provide all the same benefits of the EHR, the only difference would be that the records are central to one facility and can not be access from outside (Keller, 2016; Celia & Rebelo, 2015). Utilizing only one software system can ensure that the healthcare team do not have to access multiple systems to view patient health information. Which in turn, will allow healthcare providers more time to spend with the patient. This in turn can increased patient safety, improved patient satisfaction, and allow for a more efficient patient flow (Celia & Rebelo, 2015).
As with any new changes within an organization, the propose solutions of implementing either the EHR or a new EMR system, is sure to be met with resistance and challenges.

The biggest challenges with integrating a new software system includes the financial cost of acquiring the it and the training that goes with it. Another challenge would be the staff themselves, as many employees can be against change. Al-Abri (2007) reported changes to be a complex and challenging process. Implementing changes are more successful when staffs have a clear vision of why changes are being implemented and how it will impact them directly. For this process to happen, changes need to be communicated in a clear and precise manner to the staff. Moreover, change agents need to be readily available to answer questions and provide reassurance of a positive

change.
Other solutions for improving patient care would be careful and thorough documentations in the right chart and system, following up with doctors on illegible orders, and double checking all orders that are being entered into the system. Another solution is to have either daily emails or a communication book, in which important patient information can be relayed to the team, as well as, where they can go to read the full nursing note on the individuals affected. The biggest challenge with these solutions is time. The facility in which this nurse work is one nurse to 16 patients. With that said, it is the responsibility of the nurse to get all assessments and medications administered. In addition, to ensuring that patients are on the correct dialysis prescription and that all patient care technicians are following policy and protocols. Moreover, the nurse still have to do their daily notes, entered new orders, reviews labs and medications, provide patient education, and so on.
Conclusion
Change is a constant in healthcare, as the goal is to provide efficient and effective patient care to each and every patient. In order to provide quality patient care, it is essential to utilize only one charting system to prevent errors from occurring. Nevertheless, it is crucial that the healthcare team be vigilant when charting and when entering new medications and orders.