Maxim Healthcare- System Integration to Streamline Processing

Adrienne Chavis

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The Maxim Healthcare Information Systems Strategic Plan provides an overview of the current information systems environment and a framework for planning. The plan consists of three sections: Preparing for HIMS Design and planning, HIMS Strategic Planning, and Detailed HIMS Planning and Costing. Analyzing the private duty nursing structures strengths and opportunities along with issues including compliance, documentation, system integration and training administration and staff, a set of strategic directions has been devised to guide present and future planning for the next two years. The current goals of Maxim Healthcare Services are to provide comprehensive healthcare services that include home healthcare, companion care, travel nursing, habilitation services, and health information services. While these goals are being met, the current system, processes, and overall functions of the nursing sector can be optimized to align with the mission of the organization: Company Culture and Mission (Maxim Healthcare Services, 1988- 2010)

Maxim Healthcare Services believes that our unique culture is the foundation of our growth. We thrive on the individual character, work ethic, and desire that each of our team members contribute. Our mission is to work together towards a common goal and remain committed to excellence in every aspect of our business model.

Adrienne Chavis

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Maxim Healthcare Services believes that our unique culture is the foundation of our growth. We thrive on the individual character, work ethic, and desire that each of our team members contribute. Our mission is to work together towards a common goal and remain committed to excellence in every aspect of our business model.

Creating Success by Leading and Serving Others

Planning Module I- Preparing for HIMS Strategy Design and Planning After careful review, the HIM assessment has discovered many strengths within the Nursing Department that allow nurses to provide a high level standard of care for home health patients, as well as meet the mission and cultural objectives of the organization. There were also a number of issues that could improve the overall direction of how information is documented, shared, transferred and used for overall decision making in patient care. The main HIS concern within Nursing is the lack of system integration, timely documentation, and lack of technological support for billing purposes. Major mandates impacting Maxim Healthcares nursing efforts include: Accreditation: Complex processes for licensing agencies create challenges in having employees who have both clinical and technology based training. Nursing Workforce Shortage: The supply of registered nurses in the workforce is declining while the demand for nursing care is growing. Due to a number of factors including challenging working conditions, pay, and an

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aging nursing workforce, the number of nurses is not sufficient to meet demand. (Rosseter, 2009) Technology Training: HIM is the link to clinicians, technology designers, and information technology; and is the value-adding bridge between patients health information and payers, government, and regulating agencies. HIM practitioners demonstrate leadership and management of health information in all formats (paper, scanned, or computerized forms), and are a critical component of the electronic health record (EHR) workforce. (Health Information Careers.com, 2010) Nursing staff now need technology based training to actively participate in documentation, compliance, and decision making practices.

Planning efforts will focus on five areas to improve performance, compliance and information structures within the organization. These include: Strength the nursing workforce through learning and encouraging. -Refers to our many teaching/learning activities for those seeking nursing degrees (BSN, MS, or PhD), certificates or other forms of lifelong learning. Contribute to learning resources through technology based training and onsite programs and incentives.

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 Utilize research practices to enhance the organization through skills assessment, grading and feedback and continuing education for software updates and discovery of new knowledge. -This includes internal assessment and feedback, as well as external feedback from vendors, patients and regulators. We will monitor how our new systems benefit stakeholders. Create and test innovations in use of electronic records to streamline paper processes. - As it relates to our on going efforts to the design and implement systems that improve our daily processes by integrating our teaching, research and practice on an interdisciplinary level. This includes technology upgrades and training. Invest in our work environment to attract those choosing to excel - Refers to our focus on growth and learning opportunist for staff associates, faculty and collaborators. We will build recruiting efforts to initiate cross training for staff with both clinical and technology skills that can compete within the new and growing generation of healthcare providers. Build a stronger learning organization with focus on compliance, organizational growth and a commitment to best practices. -Refers to our commitment to being a teaching and learning organization committed to developing healthcare leaders.

Adrienne Chavis

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PLANNING MODULE II - HIMS STRATEGIC PLANNING The current HIS hardware configuration consists of over 1500 computers with various ranges of access and storage. There are currently several hundred attached peripheral devices consisting of PCs, MFPs, and standard printers located within the corporate offices and 48 branch locations. These major applications operate on the HP platform. Nursing notes are scanned through the MFP system and have to be printed for billing processes. This process is outdated and also brings several compliance issues into question. Our vision is to create a user friendly environment that will allow secure transmission of information without compromising the integrity and structure of our current processes. The initial intent will be integration of the current systems to enable users a smoother workflow with timely information for financial and accounting practices. Within these strengthening efforts, we will also construct a system that allows scrubs our data storage for information that is not aligned with proper input and output functions within the system. Regularly scheduled SQL reports will generate red flag issues to be addressed by the IT department. Systems will allow input form nurses for daily notes that include clinical, demographic, and additional care information as needed. Billing staff will be able to securely log- in to access service and code information for billing functions within 24 hours of input.
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Reports will be generated for audit electronically on a weekly basis. The current system utilizes paper functions that will be obsolete within thirty days of implementation. We will begin to phase out manual audits and email transmission of patient information within twelve months. The overall goal is to meet todays compliance standard set by the organization and HIPAA , while increasing the use of rechnology. We will focus on following the guidelines as they relate to our practices:

We anticipate that the DME guidance will contain the seven elements that we consider necessary for a comprehensive compliance program. These seven elements have been discussed in our previous guidance and include: (United States Department of health and Human Services, 1998) The development of written policies and procedures; The designation of a compliance officer and other appropriate bodies; The development and implementation of effective training and education; The development and maintenance of effective lines of communication; The enforcement of standards through well-publicized disciplinary guidelines; The use of audits and other evaluation techniques to monitor compliance; and The development of procedures to respond to detected offenses and to initiate corrective action.
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PLANNING MODULE III - DETAILED HIMS PLANNING AND COSTING We have utilized several workgroups to list the advantages of new system and process implementation through SWOT Analysis:
Strengths and Opportunities as seen by Staff Work Groups Strengths

Variety of programs to meet learning needs of nursing groups and need to be state specific Technology support to meet program needs/ mentoring Financial processes can be streamlined Culture of learning Meeting healthcare market needs through continuing education Expand partnerships within organization between clinical and technology functions Online learning could be as an incentive Find opportunities to engage nurses in the research processes to utilize technology functions regularly Software company agreements to provide staff with clinical experience access to resources available post graduation. Opportunities Collaboration with financial staff- Nurse Managers dont understand financial software information
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Access to multiple databases creates redundancy- delivery systems need improvements. Current processes are outdated and paper based. System has lots of problems, causing frustration and reducing confidence in performance Minimal training for clinical staff on use of the system One of the issues faced with implementing new system changes and processes is the lack of available nurses to operate and move forward with the plan and vision. The shortage is a continuous external threat to the growth of the organization. Several training programs exist; however these training programs are necessary to produce registered nurses, yet many qualified applicants are denied access to the school of their choice because the schools are not adequately funded. These potential students, who are eager to become nurses, are thus denied the opportunity to pursue a career in nursing. This lack of funding of nursing schools contributes, then, to the overall nursing shortage. Until this problem is addressed, the nursing shortage will continue despite the programs offered.
(nursingshortageinfo.com, 2010) As a result, costs will significantly increase for

recruitment efforts. Plan Document

KEY INITIATIVE

Strategies (target areas of directions)

Tactics (action steps)

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Strengthen the nursing workforce through learning

Create online courses Target market for DNP, RN-BSN and Graduate entry candidates Educate clinical practice workforce development through technology based learning Develop transfer of knowledge through Technology education and training and partnerships with other agencies Targeted recruitment of diverse faculty Orientation and faculty development Information technologies advancement

Form nurse development teams for developing quality skills in and technology Provide funding for active learning innovations

Invest in our work environment to attract those choosing to excel

Scale up RN-BSN and BSN online with software partners Generate new endowed scholar/fellowships for continuing education focused in technology

Create and test innovations in nursing & healthcare practice

Develop and disseminate innovative nursing initiatives to enhance efficient and effective health care services Partner with other health care agencies to co-create and test innovative nurse led initiatives Partner with industry to develop new practice decision support products to include software, hardware and equipment

Appoint innovative practice director/coordinator to build academic nursing practice group Engage nurses with background in the financials of healthcare Utilize computer modules for simulation learning

Maxim Healthcare Services can greatly improve their communication, clinical services and compliance performance by integrating their current systems and maintaining and focus on utilizing and electronic systems. Their current process leaves several gaps for non- compliance and error. If the company wants to remain successful, they need to begin to implement changes in software, information systems and security and overall communication functions.

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Bibliography
Ahima. (1997, August). Ahima Body of Knowledge. Retrieved February 14, 2010, from Ahima Body of Knowledge: http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_000073.hcsp?dDocName=bok1 _000073 Health Information Careers.com. (2010). Health Information Careers. Retrieved 02 20, 2010, from Healthinformationcareers.com: http://himcareers.ahima.org/whatishim1.html Maxim Healthcare Services. (1988- 2010, January 22). About Us: Maxim Healthcare Services. Retrieved January 22, 2010, from Maxim Healthcare Serivces Web site: http://www.maximhealthcare.com/about.aspx nursingshortageinfo.com. (2010). Inadequate Funding of Nusing Schools. Retrieved February 20, 2010, from Nursing Shortage: http:www.nursingshortageinfo.com Rosseter, R. (2009, September 28). American Asociation of Colleges of Nursing. Retrieved February 20, 2010, from AACN- Media Nusing Shortage Fact Sheet: http://www.aacn.nche.edu/Media/FactSheets/NursingShortage.htm United States Department of health and Human Services. (1998, August 7). Federal Register. Retrieved February 20, 2010, from United States Department of health and Human Services: oig.hhs.gov/authorities/docs/cpghome.pdf

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