Coordination And Compliance Analysis

Hospitals are complex organizations in which multiple healthcare professionals work interdependently to deliver care (Gatrell, 2005). Unfortunately, such conditions raise the potential for confusion, errors and delays for both the hospital and the patients. It is important that the patient information is accurate and provided on a timely basis. However, better collection and dissemination of information on patients and provider performance appears to be a cornerstone for building improved care coordination (Hofmarcher et al. 2007). For this purpose, Information and Communications Technology (ICT) appears to “hold promise as a vehicle” (Hofmarcher et al. 2007).

Coordination is about “synchronizing and integrating activities, responsibilities

(2008), simple tasks are easily coordinated by mutual adjustment, but when work becomes more complex, direct supervision is needed and becomes the basic means of coordination. When things get even more complicated, standardization of work processes (or outputs) becomes the basic mechanism, in combination with the other two. Finally, when things become really complex, mutual adjustment tends to become the basic mechanism again, but in combination with the others (Figure 2). Different tasks are responsible for the different mechanisms. Mutual adjustment and direct supervision can be “categorized as coordinating by feedback” because coordination is transformed according to how people observe the effects of their own and others’ actions (Smite et al. 2008). It is therefore important to understand the obstacles that may occur in the coordination. One obstacle can be the non application of standardization which can lead to direct supervision becoming the prevailing mechanism. However, this will only result in decreased communication and missing feedback (Smite et al. 2008). Also, trust and a common understanding of the work processes are conditions for succeeding with standardization, direct supervision and mutual adjustment. Finally, frequent communication and feedback through mutual adjustment are important in overcoming the different tasks. Thus, coordinating mechanisms shall be chosen thoroughly and in balance (Smite et al.

In addition to this, the use of electronic medical record in a single facility may increase communication and coordination among clinicians in that facility, as they could all access and add to the record simultaneously (Thompson & Brailer, 2004). The electronic medical records allow physician practices to pursue more powerful quality improvement programs than is possible with paper-based records (Miler & Sim, 2004). Electronic medical records offer benefits to the quality of care over improved documentation and communication. Files are safely kept and recovered whenever needed compared to the paper records that could easily get lost. Furthermore, due to the fact that patients do not have to carry their medical history overview with them when visiting physicians, it is unlikely for errors and misunderstandings to be caused. Another characteristic of paper records is that some were proved to be imprecise, unreadable and incomplete (Shortliffe, 1999). Certain authors have stated that paper records cannot support the entanglement of health care that is provided (Shortliffe, 1999; Varon & Marik, 2002). According to a report from the Institute of Medicine (IOM) each year, between 44,000 and 98,000 deaths occur in hospitals as the result of medical errors (Kohn, Corrigan, & Donaldson, 1999). Hospital EMR use may reduce medical errors by excluding inadequate handwritten patient