NURS FPX 6426 Assessment 1: Needs Assessment and Procurement Plan for a Medication Reconciliation Module to Reduce Medication Discrepancies at Discharge

Introduction

Changes in care can lead to medicine crimes that beget adverse drug events and gratuitous readmissions. This assessment does a structured conditions assessment and makes a plan for buying and setting up a medicine reconciliation module (MRM) that works with the sanatorium’s EHR. The thing is to cut down on medicine crimes at discharge by making sure that babysitters are more accurate, their work is more effective, and they communicate better with ambulatory providers. 

Background & Problem Statement

A 30-bed medical-surgical unit reported a 6-month normal of 14 discharge encounters with at least one medicine distinction linked to the post-discharge medicine review, contributing to patient detriment and a phone-heavy workload for case directors. A root cause review indicated that there were problems with fractured documentation across flowsheets, a lack of a structured medicine concession workflow, and limited interoperability with inpatient EHRs. A targeted MRM that supports structured medicine lists, concession workflows, and morals-predicated exchange was chosen as the Swiss way to help. 

Needs Assessment & Stakeholder Analysis

Key stakeholders include bedside babysitters, nurse directors, apothecaries, discharge planners, the IT/EHR team, representatives from primary care conventions, and people in charge of quality and safety, legal, and insulation. We used the following styles: process mapping of the current discharge workflow, a chart examination (for three months), staff focus groups, and a review of guard events related to medicine crimes. Findings: babysitters take an average of 22 beats to attune specifics for each discharge using different notes. Apothecaries observe that 1 in 8 discharges has a deficient medicine history. 

NURS FPX 6426 Assessment 1: Functional & Nonfunctional Requirements

Functional (must-have):

• A single, organized workspace for medicine concession that is part of the discharge process. 
• The list of specifics is automatically filled out from the inpatient medicine administration record (scar) and the admission medicine history. 
• Reconciliation workflow with tasks predicated on places (nurse checks, apothecary reviews, and croaker signs off). 
• Export a standardized discharge medicine summary (HL7/FHIR) to outside PCPs or HIE with delivery and substantiation. 
• interpretation history for examination logging and concession. 

Nonfunctional (should-have):

• inoperative (should have) It should take less than 2 seconds to gain the med list. 
• morals for usability lower than three clicks to reconcile each medicine, and it should work on mobile and tablet bias. 
• Access controls predicated on places and encryption while data is being stored or transferred. 

Market scans & vendor selection criteria

A broad request can set up three types of merchandisers: a native EHR dealer module, a third-party integrated MRM with FHIR support, and a homegrown EHR configuration. The criteria for selection were interoperability (25), usability (20), cost of power (15), dealer support and upgrade path (15), security and compliance (10), and substantiation of clinical effectiveness (15). We decided to use a Request for Offer (RFP) system to compare the total cost, rally workflows, integration trouble, and references. 

Procurement Process (RFI→RFP→Pilot)

1. Find out what capabilities and integration styles are available. 
2. RFP (4 weeks) a fully functional spec, SLAs that need to be met, a timeline for performance, and a pricing model (license integration and periodic conservation). 
3. Rally and Usability Scoring (2 weeks): Script-predicated demonstrations of merchandisers with babysitters and apothecaries on the anterior lines using a standard usability rubric. 
4. Reference checks and point visits (2 weeks). 
5. Three weeks for negotiating the contract and reviewing the law. 
6. The Airman Contract and Procurement Award involves conducting a birdman program with a single dealer on one unit, lasting between 8 and 12 weeks, transitioning from a silent run to an active birdman. 

Business Case & Budget Estimate

The cost of a software license or module, the hours demanded for integration and configuration, training and go-live support, and ongoing conservation (annually). Benefits include an anticipated drop in medicine crimes from 14 to 5 in 6 months, lower readmissions, less work for apothecaries, and fewer callbacks to cases. A conservative 12-month ROI model indicates a revenge period of 18–24 months predicated on fundamental hypotheticals (perceptivity analysis recorded). 

Risk Analysis & Mitigation

• Too many cautions and workflows can be a problem. To correct this, use offered fliers, customizable cautions, and threshold tuning. 
• Interoperability failures require the dealer to show that they can use FHIR/HL7 and the test harness during the birdman. 
• Resistance from clinicians includes frontline babysitters in the selection of merchandisers, offers micro-learning modules, and makes them part of being huddles. 
• Data insulation when necessary: use encryption, part-predicated access, and BAAs. 

Implementation Considerations (high level)

• Gradual birdman 2 weeks of silent mode (for collecting data) and 8 weeks of active birdman with quick PDSA cycles. 
• Training a mix of micro-learning and the super-stoner model. 
• Data governance includes the part of a medicine data slavery, a data dictionary, and regular checks to confirm that the data is correct. 
• Evaluation process, outgrowth, and balancing criteria. 

Evaluation Metrics

• Outcome of discharges with at least one medicine error set up during the post-discharge review (thing ≤ 5 at 6 months). 
• Exercise the median amount of time it takes for a nurse to finish concession (in beats); the chance of discharge summaries transferred and entered within 48 hours. 
• Balancing the amount of time babysitters say they spend on the job and the number of false admonitions and overwrites. 

Conclusion

The swish way to acquire an MRM that cuts down on medicine crimes at discharge is to use a structured procurement process that puts frontline stoners first, prioritizes interoperability and usability, and stages deployment through fliers. Governance, ongoing monitoring, and making concession a normal part of the discharge process are each important for sustainability.