Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies
New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.

Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.

In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.

To Prepare:

Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
Identify and select 5 peer-reviewed articles from your research.
The Assignment: (4-5 pages)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.
Comments / Note
Clinical Systems Improve Outcomes and Efficiencies
Clinical systems are useful in the healthcare sector to boost patient outcomes, reduce medical errors, and enhance patient follow-up. Research studies have indicated that there is a significant positive relationship between clinical systems and patient outcomes. The reason is that they enhance efficiency in terms of decision making, accurate diagnosis, and reduction of medical errors (Kruse & Beane, 2018). Various hospitals in different countries across the world including America, Germany, Denmark, Australia, and Canada have adopted clinical systems or Health Information Technology. Systematic reviews or studies on the impact the clinical systems indicate that they boost health outcomes. The studies below indicate the research that has been carried out previously on the impact of clinical systems in boosting the quality of care.
Bowles, Dykes and Demiris (2015), compiled an article on the use of health information technology to improve care and outcomes for older adults. The article was propelled by one of the transformative policies including Health Information Technology for Economic and Clinical Health (HITECH) Act. The issue was that effective use of Electronic Health Records could improve health outcomes for older patients with suffering from pressure ulcers and falls. The article shows that risk assessment and utilization of evidence-based methods would enhance the treatment of older patients. Clinical systems would also be essential in providing decision support interventions and appropriate remote monitoring of patients. The scholars conclude that clinical systems can be used to improve the quality of health outcomes. For example, the scholars indicate that older patients suffering from stroke can be monitored from a remote location. The telecare has been found to reduce the burden of family members, enhance efficiency in providing outcomes and still remain cost-effective. I have learned from the article that nurses can utilize health records to improve the quality of care. I have also learned that a nurse informaticist can help in synthesizing information from health records to improve the delivery of quality care. Therefore, informaticists should seek to utilize data or information to support other health providers in the provision of treatment.
Hessels, Flynn, Cimiotti, Bakken, and Gershon (2015), carried out a study on the impact of health information technology on the quality of patient care. The objective of the study was to examine the relationship between Electronic Health Records and the satisfaction of hospitalized patients. The study utilized secondary data to carry out a cross-sectional study. It comprised of 854,258 adult patients from 70 hospitals in New Jersey. The results of the study indicated that the adoption of Electronic Health Records was essential in improving the quality of care, improving patient satisfaction and improving nursing working improvements. For example, adoption of Electronic Health Records indicated that it led to enhanced communication from the registered nurses, clean and quiet environment, efficient explanation of medications and plans to discharge a patient. I have learned that data in a health facility can be synthesized and used to improve patient outcomes. The reason is that it will show the various gaps such as disconnect between nurses and patients, which will be fixed eventually. Healthcare providers who do not rely on data to make clinical decisions can make fatal medical errors since they do not check the facts before providing treatment.
Hoque et al. (2017) carried out a systematic review on the impact of clinical registries on quality of patient care and clinical outcomes. The systematic review was based on the notion that Clinical Quality Registries (CQR) are used to enhance the quality of care, describe treatment pattern, provide feedback, and benchmark performance. The objective of the systematic review was to examine the impact of CQR on patient outcomes, mortality rate and cost of healthcare. The review focused on various electronic databases including Google Scholar, MEDLINE, EMBASE, CINAHL, and CENTRAL. Out of the 75 articles identified, 17 of them were selected for the review. The systematic review concluded that sixteen out of 17 articles indicated that health outcomes improved upon adoption of CQR. For example, the American Heart Association has adopted the registries and indicated that they are helpful. Additionally, CQR has been adopted in Sweden, Germany, Australia, and Canada to improve health outcomes for patients suffering from acute stroke. I have learned that registries are established in hospitals to monitor and improve the quality of care. They are also used as a basis for epidemiological research, which also enhanced patient care.
Kruse and Beane (2018) carried out a systematic review of how health information technology continues to show a positive effect on medical outcomes. The purpose of the systematic review was to analyze the existing literature on the impact of Health Information Technology on health outcomes. The peer-reviewed articles were obtained from CINAHL and MEDLINE. 37 articles out of 3636 articles were considered for the review. The results of the study indicated that a majority of the articles indicate there is a significant impact of Health Information Technology on health outcomes. For example, Health Information Technology has been adopted in Germany, Switzerland, and Denmark and results have indicated positive significant influence on health outcomes. I have learned that hospitals can rely on Health Information Technology to analyze data, monitor patients and make health predictions. I have learned that the adoption of information systems in clinical settings will help manage tones of data that is useful in enhancing the quality of care. The reason is that tones of data cannot be managed manually. However, with the use of clinical systems, it is easy to analyze data and find connections that improve clinical decisions.
Pinsonneault, Addas, Qian, Dakshinamoorthy and Tamblyn (2017), carried out a natural experiment on integrated Health Information Technology and the quality of patient care. The study focuses on the importance of fragmenting healthcare delivery. The natural experiment revealed that the adoption of Health Information Technology is essential in detecting and managing health problems. The early detection and intensive management of health issues is necessary for improving patient outcomes. According to the study, the adoption of clinical information systems is also crucial in eliminating medical errors and enhancing continuity of care. The information provided by the health technological systems is essential since it is accurate and thus assists health providers in making accurate decisions. For example, the study shows that patients who were handled using the integrated information systems had better patient outcomes due to accurate diagnosis and consistent follow-up compared to patients in the control group. The natural experiment involved a matching set of 15,626 outpatients and a similar number in the control group. I have learned that Health Information Technology is useful in making clinical decisions and improve patient outcomes. I have also learned that fragmented care is an efficient delivery system.

References
Bowles, K. H., Dykes, P., & Demiris, G. (2015). The use of health information technology to improve care and outcomes for older adults. Research in Gerontological Nursing, 8(1), 5-10.
Hessels, A., Flynn, L., Cimiotti, J. P., Bakken, S., & Gershon, R. (2015). Impact of health information technology on the quality of patient care. On-line journal of nursing informatics, 19.
Hoque, D. M. E., Kumari, V., Hoque, M., Ruseckaite, R., Romero, L., & Evans, S. M. (2017). Impact of clinical registries on quality of patient care and clinical outcomes: A systematic review. PloS one, 12(9), e0183667.
Kruse, C. S., & Beane, A. (2018). Health information technology continues to show a positive effect on medical outcomes: Systematic review. Journal of medical Internet research, 20(2), e41.
Pinsonneault, A., Addas, S., Qian, C., Dakshinamoorthy, V., & Tamblyn, R. (2017). Integrated health information technology and the quality of patient care: A natural experiment. Journal of Management Information Systems, 34(2), 457-486.

Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies
This literature review examines five peer-reviewed research studies that demonstrate how various clinical systems positively impact patient care outcomes and healthcare efficiencies. The adoption of technologies like electronic health records, clinical quality registries, and integrated health information systems allows providers to deliver higher quality, more coordinated care.
Bowles, Dykes and Demiris (2015) compiled an article exploring how health information technology (HIT) can enhance outcomes for older adults, such as those with pressure ulcers or at risk of falls. The researchers found HIT tools like electronic health records, decision support, and remote patient monitoring systems allow for more effective risk assessment, treatment, and family/caregiver support. This study provides an example of how clinical systems improve the quality of care dimensions for vulnerable patient populations.
Hessels, Flynn, Cimiotti, Bakken, and Gershon (2015) conducted a cross-sectional study of over 850,000 hospital patients which revealed the implementation of electronic health records significantly improved quality of care dimensions like nurse communication, room cleanliness, medication explanations, and discharge planning. This research demonstrates the positive impacts of electronic medical records on important aspects of the patient experience during hospitalization.
Hoque et al. (2017) performed a systematic review of 17 studies and found 16 indicated clinical quality registries improved health outcomes for conditions like acute stroke. Registries aid epidemiological research and enhance provider performance monitoring. This review establishes that clinical registries provide benefits like benchmarking that drives better outcomes.
Kruse and Beane (2018) analyzed 37 articles in their systematic review, with the majority demonstrating positive health impacts from technologies like those adopted in Germany, Switzerland, and Denmark. This study supports the notion that health information technologies, when properly implemented, lead to measurable benefits.
Pinsonneault et al. (2017) presented a natural experiment matching over 15,000 outpatients, finding integrated health IT systems allowed for earlier problem detection, better management, and reduced medical errors compared to conventional care methods. This research provides strong evidence that integrated clinical systems support timelier, higher quality care compared to fragmented delivery approaches.
In summary, the literature consistently shows clinical systems improve efficiencies and patient outcomes through tools such as electronic records, decision support, remote monitoring, quality registries, and integrated technologies. When properly implemented, these tools enhance care quality dimensions, catch issues earlier, and allow performance benchmarking. This research affirms the value of clinical leaders exploring health information technology strategies informed by existing evidence. Overall, these five peer-reviewed studies establish that various clinical systems, when adopted appropriately, positively impact important outcomes and make healthcare delivery more efficient.
Bowles, K. H., Dykes, P., & Demiris, G. (2015). The use of health information technology to improve care and outcomes for older adults. Research in Gerontological Nursing, 8(1), 5-10.
Hessels, A., Flynn, L., Cimiotti, J. P., Bakken, S., & Gershon, R. (2015). Impact of health information technology information technology information technology on the quality of patient care. On-line journal of nursing informatics, 19.
Hoque, information technology on the quality of patient care. On-line journal of nursing informatics, 19.
Hoque, D. M. E., Kumari, V., Hoque, M., Ruseckaite, information technology on the quality of patient care. On-line journal of nursing informatics, 19.
Hoque, D. M. E., Kumari, V., Hoque, M., Ruseckaite, R., Romero, L., & Evans, S. M. (2017). Impact of clinical registries information technology on the quality of patient care. On-line journal of nursing informatics, 19.
Hoque, D. M. E., Kumari, V., Hoque, M., Ruseckaite, R., Romero, L., & Evans, S. M. (2017). Impact of clinical registries on quality of patient care and clinical outcomes: A systematic review. PloS one, 12(9), information technology on the quality of patient care. On-line journal of nursing informatics, 19.
Hoque, D. M. E., Kumari, V., Hoque, M., Ruseckaite, R., Romero, L., & Evans, S. M. (2017). Impact of clinical registries on quality of patient care and clinical outcomes: A systematic review. PloS one, 12(9), e0183667.
Kruse, C. S., & Beane, A. (2018). Health information technology continues to show a positive effect on medical outcomes: Systematic review. Journal of medical Internet research information technology continues to show a positive effect on medical outcomes: Systematic review. Journal of medical Internet research, 20(2), e41.
Pinsonneault, A., Addas, S., Qian, C., Dakshinamoorthy, V., & Tamblyn, R. (2017). Integrated health information technology and the quality of patient care: A natural experiment. Journal of (2017). Integrated health information technology and the quality of patient care: A natural experiment. Journal of Management Information Systems, 34(2), 457-486.

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