Module Components

• Overview
• Assignments

Topics

• Administrative Systems
• Reporting Requirements
• Managing Organizational Information Presentation

Nurs 736 - Technology Solutions for Knowledge Generation in Healthcare

Module 4: Managing Organizational Information

Administrative Systems

Administrative information systems support the business aspects of patient care by managing financial and demographic information along with providing individual, departmental, institutional, and regulatory reports. According to McGonigle & Mastrian (2011) these systems “provide a framework for reimbursement, support for best practice, quality control and resource allocation” (p. 218)... There are numerous business systems that are essential for performing administrative tasks within a healthcare organization. Below are definitions of different types of administrative systems you might see in a healthcare organization.

1. Admission, Discharge and Transfer (ADT) or Client Registration System – This system is a patient management application that is used to manage the entire patient care workflow within a healthcare system. With this system, the end user registers patients into the system, and collects and stores demographic, payer, and identification information about the client/patient for each visit. The ADT system is also responsible for automating the formation of the medical record number or the Master Patient Index. Admitting, billing, and bed management systems integrate with the ADT systems. Clinical Information systems integrate with the ADT system as a way to manage patient information to include unit and bed location. Key information such as patient name, medical record number, visit or account number and other demographic information are used to interface with other systems.

2. Acuity System – These systems are used as an attempt to identify and classify the level of care needed by individual patients and groups of patents. This is done by monitoring specific diagnostic and clinical indicators of the current patient population within an organization and, in some system, the frequency with which nurses complete a core set of activities. The purpose is to provide management with a tool to determine the intensity of care needed for a group of patients so staff and resources are planned accordingly. Acuity systems are also used to predict the organizations ability to care for certain types of patients and forecast future market trends.

3. Client Scheduling System – This system allows an organization to schedule client/patient appointments more efficiently. These systems are used in ambulatory care, procedural areas (examples: CVDL, Endoscopy), and the operating rooms.  These systems may also contain information regarding resources needed such as equipment, instruments, supplies, room type and department availability, insurance referral and authorization, permits, preparations, charging, billing and staff information. Predetermined rules can be programmed into the scheduling system related to different appointment types or procedure types to streamline the scheduling process. It has been reported that using a scheduling system can increase patient satisfaction, safety, efficiency, staff production and cost savings.

4. Contract Management System – This system is used to mange contracts with third party vendors or payers utilized by the organization. These systems will usually assist the end user to create collaborative contracts, negotiate with vendors and monitor performance and compliance, and manage risk. 

5. Financial System – This is the accounting system in an organization. It is used to manage expenses and revenue associated with billing and reimbursement for health care services. Reports from these systems are used to track fiscal outcomes against organization goals and provide information for making budget decisions.

6. Materials Management System – This system is used to control the enterprise’s materials inventory through maintenance of product and pricing lists, inventory levels, shipment data, information on movement of materials across the enterprise, and counts of materials available. The materials management systems are often the source of bar code configurations used in radio frequency identification tagging.  .

7. Nurse Staffing and Scheduling System – This system coordinates patient care staffing and feeds data and information into other systems managing services, equipment and allocation of patient beds.  Most of these systems permit nurses to self schedule while allowing management to create staffing rules based on census, acuity, time off, direct and indirect activities, and other related care activities. 

8. Payroll and Human Resource Systems – This system is specifically used to track employee time, attendance, credentials, performance evaluations, and payroll information.  The time and attendance aspect of these systems may be manually maintained or may work in conjunction with a badge swipe device that registers the employee start and stop of the work day.  This system is often tightly coupled with the scheduling system.

9. Quality Assurance System – This system is used to monitor outcomes and produce reports that are used to guide quality improvement initiatives.

10. Risk Management System – This system tracks unusual occurrences, incidents, adverse events, or sentinel events that can occur.  Data from these systems are used to alert key personnel to an incident, to assist in the planning for prevention of future like events, and to facilitate root cause analysis of the problem to create systems that minimize the chance of a second or subsequent occurrence.