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67 Cards in this Set

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Lack of project manager
Identify the project management mistake illustrated in each of the following scenarios:



A small physician practice acquired EHR software. The vendor was contracted to conduct the software installation. One of the physicians spent the weekend prior to the vendor coming on site installing the hardware. On the day the vendor arrived, a nurse was asked to sit with the vendor and explain the office's clinical processes. After the first week, a member of the IT department at the hospital was asked to assist the office because the portal to the hospital was not working correctly. At the end of the second week, the office manager was fired because two prescriptions faxed to the local pharmacy did not get received.

Lack of project management software
A small hospital has been implementing an EHR project for over six months. The chief information officer has just requested additional funding for a consultant because the project is behind schedule and the vendor is going to charge extra for overtime. It is impossible to determine precisely how far behind the project is or how much the cost difference would be between hiring the consultant and using vendor overtime.
Lack of sponsorship
A large hospital is planning for an EHR, but wants to ensure it has adequate source systems in place to support it. Each of the ancillary departments has a separate information system and each has claimed that the product is the best on the market and that the vendor has promised that the system will interface with any EHR on the market.
Lack of ownership
The IT department of an academic medical center has created a project management office (PMO) in order to help manage the many projects relating to implementing an EHR that have been underway for a few years already. After a few months, the chief information officer is concerned that many tasks the PMO was expected to perform have not been accomplished. In addition, the chairs of the domain teams continue to work independently and directly with the vendor
Lack of priority
A community hospital recently signed a contract for an EHR. The steering committee has now split up into respective domains, so that nurses are working on medication administration, physicians on order entry, HIM on document management, patient financial services on revenue cycle, etc. When the nurses were ready to implement medication administration, however, they found that they could only implement part of the process because the pharmacy had not yet completed its unit dosing project.
Has no clear beginning and end
An EHR is more like a program than a project because the EHR:



(-Has a high cost


-Has no clear beginning and end


-Represents a change


-Requires great attention to detail)

Must demonstrate leadership skills
Which of the following is true concerning an EHR project manager?



(-Most commonly chairs the EHR steering committee


-Must demonstrate leadership skills


- Not a member of the EHR steering committee -Plays an inactive role on the EHR steering committee)

Communicate with users frequently to educate and alleviate concerns
A key strategy to gain user involvement in an EHR is:


(-Assign as many users as possible to committees


- Avoid discussing the EHR with users until close to go-live


-Communicate with users frequently to educate and alleviate concerns


-Require each user to take a course in the EHR being implemented from the vendor)

Reduced the hassle factor for physicians
Qualitative
We are reducing medication errors through a closed-loop medication administration process
Qualitative
Mrs. Jones did not have to have surgery after I found a medication to help her condition
Anecdotal
We have had a 25% reduction in transcription staff through attrition
Quantitative
Earning an incentive for use of EHR
Revenue increases or contribution to profit
Eliminating paper warehousing costs
Cost savings or cost avoidance
Keeping patients well in a managed care environment
Revenue increases or contribution to profit
Reducing nurse overtime due to less time required to document
Productivity improvement
Eliminating manual chart abstraction for quality reporting
Cost savings or cost avoidance
Patient-centered medical home
An approach to providing comprehensive primary care in partnership with patients and other providers is:



(-Care coordination


-Case management


-Consumer empowerment


-Patient-centered medical home)

Support the organization's strategic goals and objectives
Benefits described for an EHR must:



(-Address the functionality of the EHR acquired


-Reflect budget and timeline within the EHR project plan


-Support the organization's strategic goals and objectives


-Track with other organization's achievements))

Support the practice of evidence-based medicine
Which of the following would NOT be a realistic goal for an electronic document management system?



(-Enable workflow to multiple persons


-Enhance access to health information


-Reduce storage costs


-Support the practice of evidence-based medicine)

EHR will decrease transcription expense by 50% within one year
Which of the following is a SMART goal?



(-EHR improves patient satisfaction scores


-EHR should significantly reduce our medication errors


-EHR will save time because information will always be accessible


-EHR will decrease transcription expense by 50% within one year)

Attainable
The "A" in SMART goal refers to:



(-Accurate


-Active


-Always


-Attainable)

Improved clinical decision making
Which clinical benefit describes the ability to make data available at the bedside that identifies a potential medication contraindication?



(-Better access to clinical information


-Enhanced documentation


-Improved clinical decision making


-Tailored patient education)

Coordinated interventions for populations with conditions in which patient self-care efforts are significant
Disease management refers to:



(-Clinical decision support enabling reminders for coordinating a patient's care across the continuum


-Coordinated interventions for populations with conditions in which patient self-care efforts are significant


-Public health process to control the spread of infectious disease


-Utilization review focused on reducing high-cost health conditions)

Benefits Portfolio
can include both monetary and qualitative benefits, but qualitative benefits must be quantified to be supported
SCODF typing model
Starters, Creators, Overseers, Doers, and Finishers
5 Stages of Group Development
Forming, Storming, Norming, Performing, Adjourning
Forming
stage where personal relations are characterized by dependence on other group members for guidance and direction
Storming
stage characterized by competition and conflict in personal relations
Norming
stage where group members demonstrate cohesion and are engaged in active acknowledgement of all members' contributions
Performing
stage where the team geniunely solves problems leading toward optimal solutions
Adjourning
stage that terminated the tasks and members disengage from the group's relationships
Gantt Chart
used to illustrate project tasks, phases, milestones, and their start, end and completion dates
Change Management
the movement of an organization from its current state to some future and it is hoped more effective state
Quantifiable Benefits
are tangible. described by a numeric representation
Anecdotal Benefits
difficult to quantify in any manner and are described by specific examples of events that occurred or were avoided when the EHR was used.
SMART
Specific, Measurable, Attainable, realistic and time based
- Physician champion
Who is often sought out as a person who could take on responsibility for encouraging physician adoption of an EHR in a hospital?
- Cost-benefit feasibility study
The use of what tool would provide both the monetary and qualitative benefits to help build a business case to gain a CEO's support for an EHR project?
- Communicate with users frequently to educate and alleviate concerns
A key strategy to gain user involvement in an EHR is what?
- It has no clear beginning or end
An EHR implementation is more like an ongoing program than a project because an EHR implementation..?
Which of the following is a characteristic of a project (in comparison to a program?)
Project:

-Many short, performed once


-Defined pathway-Dependencies among activities


-Single, well-defined goal-Defined start/end, intense pressure


-Fixed costs avoid overruns


-Vision


-Boundaries of project


-Continual assurance tests


-Variable, multidisciplinary


-Matrix




Program:


-Variable, performed a lot


-Repetitive-Independent or possible pass-off


-General Objectives


-Ongoing, pressure ebbs and flows


-Budget, focus on profit and loss


-Mission


-Limitations of authority/responsibility


-Quality improvement projects


-Dedicated


-Line and staff

- Volunteers from various departments (domain teams)
EHR steering committees are largely comprised of what?
- Executive management
Who is typically NOT a member of an EHR steering committee?
- Operations Management
Pat currently is the director of an HIM department and as a line manager has a preference for having direct reporting relationships, has a great talent for attention to detail, but is uncomfortable with conflict, and is somewhat nervous when having to give presentations to executive leadership. What role might Pat best play in the EHR project?
Which of the following is true concerning an EHR project manager?
- They support the steering committee

- responsible for overseeing project completion


- strong leadership skills


- provide compelling direction


- build trust


- manage conflict


- use influence to get things done

- Written and oral communication are a given but the art of listening is possibly more important.
Which of the following forms of communication may be most important for an EHR project manager?
- Judgment
The best Myers-Briggs personality type for an EHR project manager to seek out in individuals who might be assigned to test the effectiveness of an EHR implementation would be what?
- Creators
An individual who generates good ideas but may not succeed in carrying them out may be described in the SCODF typing model as a...?
- Getting members to move to a problem solving mentality. Listening and conflict management techniques are essential.
A project manager who recognizes that a team is undergoing the "storming" stage of group development might find which aid helpful to move forward?
- Convert from "meeting" to "doing" and focus on creating a document
A project manager who finds that "nothing happens once the meeting ends", should consider what?
- Collecting judgment or belief, not necessarily 100% agreement
What does Consensus mean?
- Influencing
A project manager often has to use what skill to get others to accomplish actual work- "to get the job done"- on a project?
Which of the following does a project manager NOT need to possess?
- Leadership

- Communication


- Team building


- Negotiation


- Problem solving


- Influence

- Planning process
In which phase of an EHR project's life cycle is a migration path developed?
The "monitoring and controlling processes" aspect (or phase) of an EHR project's life cycle is what?
- Are often considered to be the project management functions of communication, team management, procurement, time management, risk management, integration, and configuration management. - It happens at phase start and continues until phase finish.
- Critical path
In a work breakdown structure, the sequence of tasks in which no slack can be tolerated is referred to as what?
- Configuration management
What is the name given to the formal process of tracking every request for change in a system, determining its impact on other elements of the project or the system, obtaining the necessary authorization for the change to be made, keeping track of the change in the event a future action is dependent on understanding what has been changed, and then carrying out the change with the necessary resources?
Which of the following is an example of a milestone?
- A milestone is an important checkpoint or interim goal for a project; has no duration in time associated with it. - In project management, the event that marks the completion of a set of tasks, or a phase, such as the fact that all computers have been installed or a negotiated contract has been signed
Which of the following is inherently an EHR project risk?
- Risks refers to the probability that a threat will exploit vulnerability and do harm - Tasks being delayed, causing cost overrun and project delays
- Gantt chart
Which tool is used to illustrate project tasks, phases, and milestones, and their start, end, and completion dates?
- (3) Get the vision right (page 126) or Normative-reduction (from online source)
Which change management strategy would be described by the following statement: "People are social beings and will adhere to cultural norms and values. Change is based on redefining and reinterpreting existing norms and values, and developing commitments to new ones."
- Not creating a strong enough sense of urgency
Which of the following is NOT a good long-term tactic for managing change?
- Leave takers
A physician who announces his or her plan to avoid using the EHR by retiring before the EHR will be used in the office is demonstrating which of the following forms of resistance?
- Establishing start and end dates for each task.
Which of the following is an important element in getting the project performed "on time?"
?? Maintaining Technology (Using old technology) Pg 130
???Because IT personnel seldom experienced or encouraged it in the past, some members of IT departments may still be expected to resist _______ _______ during EHR implementations.
- 12 examples here: http://www.cio.com/article/2391872/project-management/12-common-project-management-mistakes--and-how-to-avoid-them.html
Be prepared to recognize typical project management mistakes, while reading several short EHR implementation scenarios.