Initial discussion

Budget season is a time of excitement for some leaders and managers and stress for others. Capital items are a big budget request for a department or service such as new beds for the Intensive Care Unit (ICU) with all the bells and whistles or a piece of specialized equipment for new procedures performed in your department. However, a budget request for an item or items is a wish list and does not guarantee the approval by the budgeting committee. Making such a request requires research and some understanding from the leader of the financial operating budget. Information that is presented with the request should include if the request is a replacement item or a new purchase, the proposed cost including service, and warranty, expected improvement in patient quality or estimated percentage of increase in service and over what period, what is the expected lifespan of the item along with other concerns of the organization.

Budget Request

My facility needs a new electronic medical record (EMR) system. Our current system, in my opinion, has reached its life span and capabilities. The automated system does not integrate with other systems and although the information technology (IT) team works tirelessly with the server to modernize, perform updates, and add different functionalities to make the system user- friendly, the system remains, antiquated. Advanced EMRs has numerous benefits to the quality and safety of our patients. As well, the many benefits to the users of the system, which has the potential to improve workflow it aid’s in preventing adverse events and has the capabilities to work with other systems to manage care effectively. As stated by Paul Frisch “An intelligent hospital is based on a combination of existing technologies that are designed, set up, and integrated to share back and forth, and ultimately to provide an enhanced level of clinical information, to monitor treatment” (Mertz, 2014).

Strategic Plan

Obtaining information to provide patient-specific care has seen a significant change over the past ten to twenty years, personal health information once kept in a filing system in the medical records department is now located at your fingertips. Data can be located and shared with permission without looking through stacks of paper and making copies. At my facility, our computerized physician order entry (CPOE) is currently a hybrid system, whereas converting to a new EMR system would negate this form of data entry. The current system of computer order entry, as well as written paper orders, has created problems with nurses new to the organization, missing orders, consult not obtained, and specific diagnostic testing delayed because of not seeing the order. Benefits of CPOE include the potential reductions in medical errors, especially adverse drug events (ADEs), and controlling spiraling costs in the health care industry (Muslin, Vardaman, & Cornell, 2014). Advantages additionally to an advanced EMR are integration to other like systems, allowing access to accurate patient information from other care providers, thereby resulting in a more efficient method of care.

Benefits of a New Electronic Medical Record

Preparing the argument to a new EMR system involves the combination of assistance from the IT department, risk management as well as nursing informatics. Providing documentation and time stamps of weekly downtimes related to system problems, as well as the numerous workarounds nursing has created to solve issues are essential to share. Retrieving data from risk management regarding reportable quality nursing service events, as related to the current system of use compared to advanced EMR usage. The use of evidence-based practice (EBP) standards, structured with the EMR promotes decision making by providing nurses with a checklist of intended care delivery, which in turn fosters compliance with practice (Walker-Czyz, 2016).

Replacing an EMR system carries a substantial financial price. Purchase of this magnitude would require months maybe years of research and discussions with different department and vendors, narrowing the decision down to one that offers safety, quality, and innovation as well the financial terms and flexibility deemed appropriate by the budgeting committee. As the healthcare industry shifts to value-based, care, it is essential for healthcare organizations to fully understand the impact capital investment decisions can have on quality and operational flexibility (Jasuta, 2016). (Jasuta, 2016)

Conclusion

Nursing leaders’ budget for items each year, however, as with any institution items are granted on an as determined needed base compared to another request, therefore providing data to back up your claim for an item is essential. Basic knowledge of the organizations capital budget process is vital. Health systems are continually searching for ways to improve and decrease healthcare cost, such as leasing, repairing equipment compared to replacing. Different options of extending the capital budget are taking into consideration, and the most cost-effective and best for the patient, organization, and community are amongst the highest qualifiers.

References

Jasuta, L.O. (2016). Rolling capital: Managing investments in a value-based care world: A rolling approach to capital planning offers healthcare providers flexibility and efficiency, which ultimately improves patient satisfaction and helps control costs. Healthcare Financial Management(6), 82. Retrieved from https://search-ebscohost-com.ezp.waldenulibrary.or…

Mertz, L. (2014). Saving lives and money with smarter hospitals: Streaming analytics, other new tech help to balance costs and benefits. IEEE Pulse, 5(6), 33-36. doi:10.1109/MPUL.2014.2355306

Muslin, I. S., Vardaman, J.M. (2014). Fostering acceptance of computerized physician order entry: Insights from an implementation study. Health Care Manager, 33(2), 165-171. doi:10.1097/HCM.0000000000000011

Walker-Czyz, A.M. (2016). The impact of an integrated electronic health record adoption on nursing care quality. Journal of Nursing Administration, 46(7/8), 366-372. doi:10.1097/NNA.00000000000003