NURS FPX 6218 Assessment 1 Proposing Evidence Based Change

NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change

Proposing Evidence-Based Change


Capella University


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December 2023

Proposing Evidence-Based Change

This report delves into the proposal of a significant change within the local health care system—the adoption of an electronic health record (EHR) system.

Acknowledging the distinct impacts of health care finance models and policy agendas on resources and patient outcomes, this report explores the multifaceted aspects of integrating EHR as a transformative measure.

By leveraging insights from international healthcare systems, analyzing financial and health implications, and drawing lessons from successful implementations abroad, the report aims to provide a comprehensive understanding of the proposed change’s potential benefits and challenges, laying the groundwork for informed decision-making and positive reform in the local healthcare setting.

Executive Summary

In response to the imperative need for improved patient outcomes and operational efficiency, this report draws on international healthcare insights, notably from the National Health Service (NHS) in the United Kingdom and the German healthcare system.

The proposed EHR implementation is rooted in evidence-based practices, aligning with proven strategies for centralized coordination, preventive care emphasis, and balanced public-private participation. Financially, the change entails upfront investments with anticipated long-term savings, while the decision not to adopt the EHR system may perpetuate inefficiencies and compromise patient safety.

This executive summary underscores the transformative potential of technological innovation, advocating for an informed and forward-looking approach to enhance the resilience and patient-centricity of the local health care system.

Local or Regional Health Care System for the Proposed Change

In the local health care system, an aspect that warrants focused attention is the integration of electronic health records (EHR) to enhance efficiency, accessibility, and overall patient care.

Currently, the system relies on disparate paper-based records, leading to delays in information retrieval, potential errors, and suboptimal coordination among healthcare providers. Transitioning to a comprehensive EHR system promises significant improvements (Cline, 2020).

EHR implementation is associated with increased patient safety, streamlined communication among healthcare professionals, and improved overall health outcomes. By adopting a user-friendly, interoperable EHR system, the local health care system can anticipate reductions in medication errors, improved care coordination, and enhanced patient satisfaction, aligning with the broader national trend toward digital healthcare transformation (Cline, 2020).

Moreover, the implementation of EHR aligns with the broader healthcare policy agenda, such as the meaningful use criteria outlined by the Centers for Medicare & Medicaid Services (CMS). Fulfilling these criteria not only ensures eligibility for financial incentives but also demonstrates a commitment to providing high-quality, patient-centered care. The integration of EHR positively impacts patient outcomes by facilitating timely access to medical information and improving diagnostic accuracy (Malhan et al., 2022).

Therefore, advocating for the incorporation of EHR in the local health care system is not only a pragmatic response to contemporary healthcare challenges but also aligns with evidence-based practices that have demonstrated positive outcomes in similar contexts.

Desirable Outcomes

Desirable outcomes of implementing an electronic health record (EHR) system in the local health care system encompass several key facets, each contributing to overall improvements in patient care, operational efficiency, and financial sustainability. Firstly, improved patient safety is a paramount objective.

By minimizing medication errors, facilitating accurate and timely access to patient records, and supporting seamless communication among healthcare providers, the EHR system aims to enhance the quality of care delivered to patients (Tubaishat, 2019).

This aligns with the broader goal of achieving positive health outcomes and reducing the likelihood of adverse events, contributing to an overall safer healthcare environment.

Secondly, the desirable outcome includes increased care coordination and continuity. An EHR system enables healthcare professionals to access comprehensive patient histories, diagnostic reports, and treatment plans, fostering collaboration and ensuring that patients receive holistic and well-coordinated care.

This outcome not only improves the patient experience but also contributes to better health outcomes, particularly for those with chronic conditions who require ongoing management and follow-up (Tubaishat, 2019).

The financial aspect of desirable outcomes involves the optimization of healthcare resource utilization. While the initial investment in EHR implementation may be substantial, long-term cost savings through reduced paperwork, enhanced operational efficiency, and improved resource allocation (Lewkowicz et al., 2020).

The justification for this definition is rooted in the evidence-based understanding that EHR adoption is associated with positive financial outcomes over time, making it a strategic and sustainable investment.

However, factors limiting the achievement of these outcomes include potential resistance to change among healthcare professionals, the need for comprehensive training programs, and initial financial constraints (Lewkowicz et al., 2020).

Addressing these challenges requires proactive strategies, such as robust change management initiatives, ongoing training, and exploring avenues for financial support or incentives to mitigate the initial implementation costs. By acknowledging and addressing these limiting factors, the health care system can better position itself to achieve the desired outcomes effectively and sustainably.

The Rationale for the Proposed Change

The specific changes involving the integration of an electronic health record (EHR) system are anticipated to lead to improved outcomes due to several interconnected factors. Firstly, the EHR system streamlines data access and sharing, mitigating delays and reducing the likelihood of medical errors. Swift access to comprehensive patient information enables healthcare providers to make informed decisions promptly, leading to more accurate diagnoses and timely interventions (Noaeen et al., 2023).

Secondly, the enhanced coordination and continuity of care facilitated by the EHR system contribute to a more holistic and patient-centered approach. Improved communication among healthcare professionals ensures that patients receive seamless and well-coordinated care, particularly crucial for individuals with chronic conditions or complex medical histories. Additionally, the EHR system supports preventive care measures, allowing healthcare providers to proactively address potential health issues before they escalate (Noaeen et al., 2023).

Comparative Analysis of the Healthcare System

In analyzing two non-U.S. health care systems, namely the National Health Service (NHS) in the United Kingdom and the healthcare system in Germany, valuable insights emerge that have clear implications for a proposed change in the U.S. health care system. Both systems exhibit noteworthy characteristics that can inform positive transformation in the U.S. healthcare landscape.

The NHS in the United Kingdom exemplifies a publicly funded, universal healthcare system. A key lesson learned is the potential benefit of a more centralized and integrated approach to healthcare delivery.

The NHS’s emphasis on preventive care, primary care accessibility, and a unified electronic health record system contributes to improved patient outcomes and satisfaction (Anderson et al., 2022). This suggests that in the U.S., integrating health records, enhancing primary care accessibility, and promoting preventive measures could lead to more efficient and patient-centric care.

Similarly, the German healthcare system, characterized by a multipayer model with mandatory health insurance, offers insights into achieving a balance between public and private participation.

The coexistence of statutory and private health insurance provides citizens with options while maintaining a high standard of care (Blümel et al., 2020). This model suggests that incorporating elements of choice and competition within a regulated framework could be explored in the U.S. to foster innovation, control costs, and improve service quality.

Financial and Health Implications

The proposed changes to implement an electronic health record (EHR) system in the healthcare system carry both financial and health implications.

Making the change involves initial financial investments in EHR infrastructure, staff training, and system integration. However, the long-term financial implications include potential cost savings through reduced paperwork, enhanced operational efficiency, and improved resource allocation.

Health implications are positive, with anticipated improvements in patient safety, care coordination, and overall health outcomes due to streamlined communication and access to comprehensive patient information (Aguirre et al., 2019). Not making the proposed changes, on the other hand, implies maintaining the status quo of paper-based records, which may result in continued inefficiencies, delayed access to critical patient information, and increased potential for errors.

The financial implications of not making the changes may include perpetuating resource-intensive manual processes, hindering the potential for long-term cost savings (Aguirre et al., 2019). Furthermore, the health implications of not implementing EHR may involve a missed opportunity to enhance patient safety, jeopardizing the quality and coordination of care.


The proposal to integrate an electronic health record (EHR) system within the local healthcare framework emerges as a strategically sound initiative with the potential to revolutionize patient care, operational efficiency, and long-term financial sustainability.

Drawing on insights from international healthcare models, notably the National Health Service (NHS) in the United Kingdom and the German healthcare system, this report highlights valuable lessons that underscore the benefits of centralized coordination, preventive care emphasis, and balanced public-private participation.

The financial implications of making the proposed change suggest upfront investments with promising returns in the form of reduced paperwork, enhanced resource allocation, and improved cost-effectiveness


Aguirre, R. R., Suarez, O., Fuentes, M., & Sanchez-Gonzalez, M. A. (2019). Electronic health record implementation: A review of resources and tools. Cureus, 11(9). https://doi.org/10.7759/cureus.5649

Anderson, M., Pitchforth, E., Edwards, N., Alderwick, H., McGuire, A., & Mossialos, E. (2022). United Kingdom: Health system review. Health Systems in Transition, 24(1), 1–194. https://pubmed.ncbi.nlm.nih.gov/35579557/

Blümel, M., Spranger, A., Achstetter, K., Maresso, A., & Busse, R. (2020). Germany: Health system review. Health Systems in Transition, 22(6), 1–272. https://pubmed.ncbi.nlm.nih.gov/34232120/

Cline, L. (2020). The electronic health record and patient-centered care. Nursing Management (Springhouse), 51(3), 6–8. https://doi.org/10.1097/01.numa.0000654880.27546.6a

Lewkowicz, D., Wohlbrandt, A., & Boettinger, E. (2020). Economic impact of clinical decision support interventions based on electronic health records. BMC Health Services Research, 20(1). https://doi.org/10.1186/s12913-020-05688-3

Malhan, A., Pavur, R., Pelton, L., & Manuj, I. (2022). Role of electronic healthcare record adoption in enhancing the relationship between quality measures and hospital financial performance. American Business Review, 25(2), 515–532. https://doi.org/10.37625/abr.25.2.515-532

Noaeen, M., Amini, S., Shveta B., Zohreh G., Ahmed, A., Omid J., & Zahra, A. (2023). Unlocking the power of EHRs: Harnessing unstructured data for machine learning-based outcome predictions. PubMed. https://doi.org/10.1109/embc40787.2023.10340232

Tubaishat, A. (2019). The effect of electronic health records on patient safety: A qualitative exploratory study. Informatics for Health and Social Care, 44(1), 79–91. https://doi.org/10.1080/17538157.2017.1398753

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