Assignment: Creating a Flowchart

Assignment: Creating a Flowchart Assignment: Creating a Flowchart Workflow analysis aims to determine workflow patterns that maximize the effective use of resources and minimize activities that do not add value. There are a variety of tools that can be used to analyze the workflow of processes and clarify potential avenues for eliminating waste. Flowcharts are a basic and commonly used workflow analysis method that can help highlight areas in need of streamlining. In this Assignment, you select a common event that occurs regularly in your organization and create a flowchart representing the workflow. You analyze the process you have diagrammed and propose changes for improvement. To prepare: Identify a common, simple event that frequently occurs in your organization that you would like to evaluate. Consider how you would design a flowchart to represent the current workflow. Assignment: Creating a Flowchart Consider what metrics you would use to determine the effectiveness of the current workflow and identify areas of waste. To complete: Write a 3- to 5-page paper which includes the following: Create a simple flowchart of the activity you selected. (Review the Sample Workflow of Answering a Telephone in an Office document found in this week’s Learning Resources for an example.) Next, in your paper: Explain the process you have diagrammed. For each step or decision point in the process, identify the following: Who does this step? (It can be several people.) What technology is used? What policies and rules are involved in determining how, when, why, or where the step is executed? What information is needed for the execution of this step? Describe the metric that is currently used to measure the soundness of the workflow. Is it effective? Describe any areas where improvements could occur and propose changes that could bring about these improvements in the workflow. Summarize why it is important to be aware of the flow of an activity. Assignment: Creating a Flowchart Remember to include a cover page, introduction, and summary for your paper. week_8_flow_chart.jpg usw1_nurs_5051_applicationassignmentrubric__4_.doc walden_best_sample_wk8flowchartassignment6051and_report__1_.docx ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS Evaluation Criteria for Applications and Formal Papers Levels of Achievement Outstanding Performance Excellent Performance Competent Performance Proficient Performance Room for Improvement QUALITY OF WORK SUBMITTED 1. The extent to which work meets the assigned criteria and work reflects graduate level critical and analytic thinking (0-30 Points) 30 to 30 points Assignment exceeds expectations. All topics are addressed with a minimum of 75% containing exceptional breadth and depth about each of the assignment topics 25 to 29 points Assignment exceeds expectations. All topics are addressed with a minimum of 75% containing exceptional breadth and depth about each of the assignment topics 20 to 24 points Assignment meets expectations. All topics are addressed with a minimum of 50% containing good breadth and depth about each of the assignment topics. 16 to 19 points Assignment meets most of the expectations. One required topic is either not addressed or inadequately addressed. 0 to 15 points Assignment superficially meets some of the expectations. Two or more required topics are either not addressed or inadequately addressed. QUALITY OF WORK SUBMITTED: Purpose of the paper is clear (0-5 Points) 5 to 5 points A clear and comprehensive purpose statement is provided which delineates all required criteria. 5 to 5 points A clear and comprehensive purpose statement is provided which delineates all required criteria. 4 to 4 points Purpose of the assignment is stated, yet is brief and not descriptive. 1 to 3 points Purpose of the assignment is vague. 0 to 0 points No purpose statement was provided. ASSIMILATION AND SYNTHESIS OF IDEAS The extent to which the work reflects the student’s ability to- 10 to 10 points Demonstrates the ability to critically appraise and intellectually explore key concepts. 9 to 9 points Demonstrates the ability to critically appraise and intellectually explore key concepts. 8 to 8 points Demonstrates a clear understanding of key concepts. 5 to 7 points Shows some degree of understanding of key concepts. 0 to 4 points Shows a lack of understanding of key concepts, deviates from topics. Criteria 1. Understand and interpret the assignment’s key concepts (010 Points) ASSIMILATION AND SYNTHESIS OF IDEAS 2. Apply and integrate material in course resources (i.e. video, required readings, and textbook) and credible outside resources (0-20 Points) 20 to 20 points Demonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 3-4 course resources to support point of view. 15 to 19 points Demonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 3-4 course resources to support point of view. 10 to 14 points Integrates specific information from 1 credible outside resource and 3 to 4 course resources to support major points and point of view. 3 to 9 points Minimally includes and integrates specific information from 2-3 resources to support major points and point of view. 0 to 2 points Includes and integrates specific information from 0 to 1 resource to support major points and point of view. Assignment: Creating a Flowchart ASSIMILATION AND SYNTHESIS OF IDEAS 3. Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e. video, required readings, and textbook) by comparing different points of view and highlighting similarities, differences, and connections. (0-20 Points) 20 to 20 points Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice. 18 to 19 points Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice. 16 to 17 points Summarizes information gleaned from sources to support major points, but does not synthesize. 14 to 15 points Identifies but does not interpret or apply concepts, and/or strategies correctly; ideas unclear and/or underdeveloped. 0 to 13 points Rarely or does not interpret, apply, and synthesize concepts, and/or strategies. WRITTEN EXPRESSION AND FORMATTING 1. Paragraph and Sentence Structure: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused–neither long and rambling nor short and lacking substance. (0-5 Points) 5 to 5 points Paragraphs and sentences follow writing standards. 5 to 5 points Paragraphs and sentences follow writing standards. 4 to 4 points Paragraphs and sentences follow writing standards 80% of the time. 3 to 3 points Paragraphs and sentences follow writing standards 70% of the time. 0 to 2 points Paragraphs and sentences follow writing standards < 70% of the time. WRITTEN EXPRESSION AND FORMATTING 2. English writing standards: Correct grammar, mechanics, and proper punctuation (0-5 Points) 5 to 5 points Uses correct grammar, spelling, and punctuation with no errors. 5 to 5 points Uses correct grammar, spelling, and punctuation with no errors. 4 to 4 points Contains a few (12) grammar, spelling, and punctuation errors. 3 to 3 points Contains several (3-4) grammar, spelling, and punctuation errors. 3 0 to 2 points Contains many (? 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. WRITTEN EXPRESSION AND FORMATTING 3. The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/intext citations, and reference list (0-5 Points) 5 to 5 points Uses correct APA format with no errors. 5 to 5 points Uses correct APA format with no errors. 4 to 4 points Contains a few (12) APA format errors. 3 to 3 points Contains several (3-4) APA format errors. 0 to 2 points Contains many (? 5) APA format errors. Running head: PHYSCIAN ORDERING 1 Physician Ordering Week 8 Assignment: Creating a Flowchart Mary Student Walden University NURS 6051-x Transforming Nursing and Healthcare through Technology Month Date, Year PHYSICIAN ORDERING 2 Physician Ordering Physician ordering can be a smooth process when performed correctly. In an electronic health records system, physicians are responsible for placing orders within the system. Situations do occur in which cause physicians to give verbal orders to nurse’s, to place into the electronic health records system. Giving verbal orders over the phone may be necessary if patients have health changes that require new medications/orders, but verbal orders should not be given if a physician is able to place them. The process for a physician to give a verbal order includes the physician calling and speaking with a nurse, giving the order, the nurse writing the order, and the nurse entering the order into the electronic health record system. Assignment: Creating a Flowchart The physician then has to sign off on all verbal orders that are written and placed in the computer. If a physician places their own orders, they are able to put them in the patient’s chart electronically which cuts down on errors in transcription. Figure 1. Workflow of Obtaining Verbal Physician Orders Identify Physician by name and title State inquiry and receive order Read back order for verification NO Report inappropriate order to physician, verify correct order, document order, verify with pharmacy, acknowledge order, and carry out order. Is order appropriate? END YES Document order, verify with pharmacy, acknowledge order, and carry out order. PHYSICIAN ORDERING 3 Obtaining Verbal Physician Orders Obtaining verbal physician orders would not be the first choice when using an electronic health records system. Computerized physician order entry (CPOE) was implemented for physicians to place their orders independently in an electronic system. CPOE solves major safety issues that are tied to poor handwriting and orders that are unclear or incomplete (McGonigle & Mastrian, 2012). CPOE can eliminate errors due to the fact that CPOE warns against possible medication interactions, allergies, dose problems, sound alike drugs, and improves communication between pharmacy staff and physicians (McGonigle & Mastrian, 2012). With improved efficiencies, a reduction in health care costs results (McGonigle & Mastrian, 2012). I have chosen to construct a workflow for obtaining verbal physician orders as seen on page 2 of this paper. The first step in the verbal physician order process is to identify the physician by name and title (see Figure 1). This step should be completed only by nurses who are licensed practical nurses (LPN) or registered nurses (RN). Once the nurse has identified the physician by name and title, the next step is to state the inquiry and receive the order. This step must be carried out by the original caller who would be an LPN or RN only over the telephone or in person during verbal communication with the physician. Following obtaining the order, the nurse must then read back and verify the order with the physician. According to Hendrickson (2007), verbal orders should be verified if they do not make sense (p. 628). The physician may get upset that the nurse is taking up their time. Large scale mistakes can occur in a situation where the order was carried through without verification and indeed it was the wrong dose or route, etc. Verifying the order back to the physician is imperative so that the nurse can cover themselves in that they did verify the order in case PHYSICIAN ORDERING 4 something happened. This step may occur in person during verbal communication with the physician or over the telephone. The third step to obtaining the verbal physician order is to determine if the order was appropriate. In this step, the nurse could consult a pharmacist in order to verify medication orders and other physicians/providers to assist in determining orders appropriate. The RN or LPN could utilize medication books, internet sources, or patient education materials within the electronic health record system. If the order is deemed appropriate, the nurse will document the order, verify medications with the pharmacy if not already done, have another LPN or RN acknowledge the order, and finally carry out the order. If the order is deemed inappropriate, the nurse will contact the ordering physician and communicate the inappropriateness of the order, obtain a correct order, verify the new order, document the order, verify the medication orders with pharmacy, have another LPN or RN acknowledge the correct order, and carry out the new order. In order to send the order to the pharmacy, the nurse will enter the order into the electronic system which translates orders to pharmacy where they will then verify medication orders for appropriateness. If the order is appropriate, the pharmacy will verify the order in the electronic system and the order will appear in the patient’s medication record to be acknowledged. Assignment: Creating a Flowchart A second nurse will have to acknowledge the order, next the order is ready to be carried out. The physician will be responsible for signing off on all verbal orders. Policy for Obtaining Verbal Physician Orders Healthcare facilities must have policies in place for nurses to obtain verbal physician orders. Nurses need to be aware of the regulations for obtaining verbal orders (see Figure 1). It is important to educate nursing staff on the steps to obtaining verbal physician orders and interventions to put into place when problems or errors are discovered with the ordering process. PHYSICIAN ORDERING 5 Measuring the Workflow The metric that is currently used to measure the soundness of the workflow on obtaining verbal physician orders would be to investigate incident reports documented by staff finding errors in the ordering process, as well as auditing electronic records to assess errors caused by verbal ordering. The electronic health record would be audited if the patient had any verbal orders. The auditor would know if the patient had verbal orders if the patient had anything written on the physician order within the paper chart. Paper charts are a minimum after an electronic health record system is implemented, but there can still be physicians order during downtime of the electronic health record system or if verbal orders are obtained. The patients with verbal orders can be audited to determine success of the ordering process on the side of nursing, pharmacy, and physicians. Improvements in Obtaining Verbal Physician Orders In order to improve the process of obtaining verbal physician orders, it is important to assess what areas need to be addressed. For example, if there are multiple errors identified during a chart audit, in that the medication doses were unsafe, the facility can update their policy to include that the nurses read back numbers to the physicians digit by digit instead of, for example, stating “16”. The nurse in that situation would read back “one six” (Hendrickson, 2007). In addition to identifying safer read backs for medications, the health care facility could implement a policy so that physicians may only order new medications or patient orders if there is a dire need or in emergencies. One strategy to limiting errors while obtaining a verbal order would be to make sure the nurse is obtaining orders in a place with limited distractions. If there are any areas that need to be assessed within the verbal ordering process, these areas would be identified PHYSICIAN ORDERING 6 during the chart audits or by studying incident reports. From there, the health care facility could make necessary changes to the verbal ordering policy. Summary All in all, CPOE is the safest route to ordering. When CPOE is not available due to the order being emergent or deemed immediately necessary due to the physician being absent from the health care facility, it is appropriate to follow a verbal ordering workflow (see Figure 1). In order to provide a patient with the safest care during new orders, it is imperative to follow the workflow when obtaining verbal physician orders. If nurses follow the correct workflow while obtaining verbal orders from a physician, there is little room for error. Workflows are important to provide safe and quality patient care, reducing costs and increasing financial benefit for the facility (Giles, Harris, & Parker, 2010, p. 92). With little room for error, patients will have less risk for an adverse event while in the health care facility. PHYSICIAN ORDERING 7 References Giles, K., Harris, J., & Parker, L. (2010). Improving margins through a patient access initiative. Healthcare Financial Management, 64(6), 92-96. Retrieved from Walden Library Database. Hendrickson, T. (2007). Verbal medications in the OR. AORN Journal, 84(4), 626-629. McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge. (2 ed., pp. 97-99). Burlington, MA: Jones & Bartlett Learning. … Purchase answer to see full attachment Student has agreed that all tutoring, explanations, and answers provided by the tutor will be used to help in the learning process and in accordance with Studypool’s honor code & terms of service . 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