Case Study:

Western Heights Hospital (WHH) is an 1125-bed, 5-hospital academic healthcare system servicing central and western Massachusetts. WHH is the only designated Level I Trauma Center for adults and children in the area and is home to New England's first hospital-based air ambulance and the region's only Level III Neonatal Intensive Care Center.

WHH launched a 5-year strategic plan with a fundamental goal of a system-wide move from a predominately paper environment to an electronic one. Phase I included implementation of an EHR system consisting of order entry for all laboratory, radiology, and patient care orders. Additionally, clinical documentation was implemented, including admission assessments and all nursing flow sheets. The nursing informatics counsel, a 25-member group of nurses representing all disciplines, developed the clinical content. The clinical content was custom built using both free text and structured data entry fields within the application.

Three months after go-live, hospital leadership is reporting that it is unable to report on various state and federally mandated quality measures. These measures track healthcare quality based on national standards, are compared to nationally accepted benchmarks, and are used to plan ways to improve quality. Leadership has communicated that the reports generated by the system are incomplete and are putting the hospital at financial risk due to lower reimbursement rates.

Clinicians are eager and excited to continue to develop content in the application. However, the project's program manager is proposing a stabilization and optimization approach and does not want to go forward with content development until the issue of reporting has been assessed and addressed.

Assuming that you are the clinical content manager and lead all reporting efforts, what approach would you take to address the reporting problem? Create a flowchart outlining the process you would take from determining the problem to finding a solution. Then, detail these steps in a 2-3 page paper, citing references as appropriate in APA format.