The case is about Langley Mason Health (LMH), which is in NorthRenoCounty. LMH serves as an 850-square-mile area that encompasses seven different communities. A registered nurse and dietician founded the facility in 1937. Currently, the health system has LangleyMedicalCenter, which is a 317-bed medical and trauma center. It also has MasonHospital, which is a 107-bed community hospital. There are also the Mason Continuing Care Center and Villa Langley, which are two-part skilled nursing facilities. Lastly, there are a home care division, a surgery center, and a behavioral medicine center (Wager, Lee, & Glaser, 2009).
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LMH developed an information technology strategic plan in 2007. The plan aims at empowering health care consumers and physicians to change data into information so as to enable expansion of the services of the clinic as well as to expand electronic business opportunism. The strategic plan also aims at enabling realization of the benefits associated with innovation, exploiting the value of information technology, improving project results, and enabling preparation for the unexpected, among others. However, the health district has insufficient funds for routine maintenance, equipment, and technology for its facilities (Wager, Lee, & Glaser, 2009).
Description of the Current Situation and Major Issues
LMH has come up with a facilities’ master plan in anticipation of an increase in the population of North Reno County. This is also to achieve the seismic requirements of the state. The plan includes establishing a modern-day 453-bed hospital to replace the LangleyMedicalCenter campus. It also aims at building satellite clinics in four communities (Wager, Lee, & Glaser, 2009).
LMH has already finished the implementation of the first phase of its strategic plan. This was the development of a $20 million enterprise wide electronic medical record system. The second phase was the implementation of “computerized provider order entry (CPOE) with decision-support capabilities.” Though the second phase was to end by 2007, it was not possible because of the various challenges experienced in the first phase. This is because LMH lacks a “fully automated pharmacy information system… and Pyxis medication-dispensing systems on all units of the acute care hospitals” (Wager, Lee, & Glaser, 2009). Besides, “computerized discharge prescriptions and instructions” are possible only for clients served from the emergency departments.
The nursing staff proposes the acquisition of smart IV pumps to replace the old pumps in the health system. Smart pumps can reduce medication administration errors and, as a result, reduce patient harm (Wager, Lee, & Glaser, 2009). This change will cost the district half of the available funds for the fiscal year. On the contrary, the company’s chief information officer, Marylyn Moore, suggests adoption of a plan that will enable the adoption of a suite of technologies that might optimize medication safety, costs, and readiness to use the technologies. The director of pharmacy, Paul Robinson, maintains that there is an urgent need for smart IV pumps to ensure the safety of patients. Other people posit that all other suggestions should be stopped in order to give way for the adoption of CPOE (Wager, Lee, & Glaser, 2009).
Thus, the key issues are the adoption of the most appropriate technology that takes into account the cost, patient safety, and readiness to take up the technology.
Moore versus Robinson
Moore suggests exploring and adopting a suite of technologies instead of adopting only smart IV pumps. One advantage of this approach is that it may enable a holistic technological transformation of the health district (Haux, 2010). Such a transformation would ensure the optimum safety of patients. Changing only one technology like the smart pumps will improve only patient safety but not medical order entries, administration of records, pharmacy systems, prescription and instructions, among others. Besides, using the available funds to enable a complete technological transformation will be cost effective in the long run. This approach will also consider the organization's readiness to adopt the technologies. However, the disadvantage of Moore’s suggestions is that it might take a lot of time and bureaucracy to implement the strategy (Robson & Baek, 2009). Such extensions in time may be costly to the safety of patients.
Robinson, on the other hand, posits the need for immediate adoption of the smart IV pumps. The advantage of this action is the immediate assurance of the safety of patients. This is significant because in nursing care, the immediate well being of a patient is extremely crucial (Robson & Baek, 2009). Besides, such an action would not need a lot of time spent for deliberation and planning. However, the disadvantage of the suggestion is its narrowness in approach. Robinson cares only about the safety of patients and not improvements in other areas like computerized service delivery. In the end, the suggestion may be costly as there will be a need for other funds to enable other technological advances of the health district.
As for me, Moore’s suggestion is more appropriate in this case. This is because it will enable holistic realization of patient safety by adopting all the relevant technologies. While Robinson aims at immediate benefits, Moore thinks of a complete overhaul of the system. The benefits of the Robinson’s approach will be still possible when we take up the idea of Moore.
The best way to reach consensus in this issue is to make the two parties rethink their positions. This is possible through highlighting the pros and cons of both positions and coming up with possible solutions (Robson & Baek, 2009). For instance, I would pinpoint the weakness of time in Moore’s decision and ask her to propose a solution. Moore might propose that the strategic planning process and implementation would take a fixed short period. In the case of Robinson, I would encourage him to look at the long-term goals of the health district. This might make him understand the narrowness of his approach. Robinson might then accept Moore’s suggestion and re-evaluate his decision.
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