Country Villa Health Services (California). Facilitated design and implementing plans for clinical decision support tools for targeted clinical areas.  Developed workplan and coordinated with HIT vendor and development team.  Facilitated implementation plan.

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To better understand the HIT readiness in California’s nursing homes, residential care facilities, and community-based service providers, the California HealthCare Foundation (CHCF) supported research to explore the following questions:

1. What is the current state of HIT planning and adoption in long-term care provider settings?

2. How ready are providers to invest in and manage the implementation of HIT?  What are the perceived benefits and barriers?

3. What should providers, policy-makers, and community stakeholders know and do to support HIT adoption and successful use in long-term care?

The findings suggest that HIT implementation has been more a reaction to crisis than a voluntary investment based on an overall strategy or plan.  Overall, long-term care provider readiness for HIT is low. The research identified the following causes: lack of strategic planning, undervaluation of HIT benefits in improving quality, lack of time and HIT knowledge, underestimation of change management needs, and fear of technology.

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CNA and wound nurse documentation/workflow; eMAR/eTAR processes Review current documentation and data requirements, compare against system available: establish plan to communicate and ensure requirements included in product. Workflow redesign: data and information flow, users impacted, communication needs, report/query requirements. Identify customization needs to support workflow redesign: e.g. data, navigation, reports. Develop Rollout Strategy: establish sequence: facility, units, roles, system functionality.

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Gurwin Jewish Geriatric Center. Served as analyst to support evaluation efforts of electronic health record in the nursing home to improve internal operations and communications with hospital ER.

Facilitated system selection to meet organization objectives:  implement EHR to support MD order entry, results reporting, MD and RN note documentation, improve communication across disciplines for early recognition of priority residents, streamline workflow to reduce inefficiencies, and support seamless information flow between long term care facility and hospital.

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Orthopaedics Practice (Durham, North Carolina). Managed project plan, clinical content definition, template development, workflow redesign, and go-live support for EMR implementation in orthopedic practice (services include: orthopedic clinic, rehab medicine, behavioral health, physical therapy; 24 physicians; 9 sites; 250 users).

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Florida International University funded.  Dates:  2008 – 2009.  Project consultant.  Utilize On-Time QI approach to design and trial a new process of detecting depression in nursing home residents:  standardize CNA observations, redesign communication process with social workers, prototype clinical feedback reports.

Learn more about our services:  Process Improvement & Redesign

‘Workflow Analysis of Front-Line Care Practices in Traditional Nursing Homes and Green House Homes’ funded by Robert Wood Johnson Foundation. Publication in JAGS, December 2010.

The principal objective of the study was to conduct an analysis of front-line caregiver daily workflow in skilled nursing settings, including Green House (GH) homes. Specifically,  understand workflow differences between skilled nursing settings related to:

•  front-line caregiver workflow,  CNA workflow in Traditional nursing homes and Shahbazim workflow in The Green House model,
• level of support from various non-nursing departments like food services, housekeeping, and laundry,
• meal process, dining location, meal service, and time spent,
• front-line caregiver level of engagement with residents,
• job stress and satisfaction with workflow of front-line caregivers,

The project has contributed to a detailed and objective understanding of how the front-line workflow in Green House homes compares to traditional nursing facilities.

Learn more about our services: Applied Research

Project Directors for AHRQ funded effort ($1.5 million grant funding) to implement a health information technology (HIT) system with added best-practices decision support modules in six nursing home organizations (15 facilities) and evaluate the impact on care processes, resident health outcomes, and staff efficiency and satisfaction (2004-2008).  Critical components of the HIT implementation strategy include developing standardized data elements, redesigning workflow in preparation for information technology solutions, and use of timely feedback reports.

The successful result of this grant laid the foundation for subsequent AHRQ funding and partnerships with the New York Department of Health, District of Columbia Office of Aging, Quality Improvement Organizations, etc.

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