With Health Information Technology (Health IT) Assessment Tool for Administrators
The Readiness Assessment Tool is designed to help nursing homes assess whether they are ready to undertake organization-wide practice and culture changes for Quality Improvement (QI). The information obtained through the baseline assessment from use of the tool can form the basis of dialogue and problemsolving across all levels of staff to enhance an organization's readiness for QI activity. It can also be used as an internal QI tool to assess the organization's progress in developing a QI culture. Benchmarking data for organizations interested in assessing their readiness and capacity for QI relative to their peers is not available.
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Readiness Assessment Tool / Health IT Assessment Tool
Readiness Assessment Tool for Nursing Homes
Background
Successful implementation of quality improvement (QI) initiatives begins
with an honest and objective assessment of the current state of an organization's
culture and its attitude and commitment toward improving the quality of care
and services it provides. Without first assessing its readiness—in
attitude, resources and infrastructure—for change, an organization may likely
find itself unprepared and unable to support its QI goals. As a result,
the organization is apt to experience little success in meeting these goals.
This Readiness Assessment Tool is designed to assist nursing homes in assessing
whether they are ready for and have the capacity to undertake organization-wide
practice and culture changes for the purposes of QI. The tool focuses
on assessment of several distinct areas fundamental to successful QI, areas
such as:
- Organizational commitment to QI.
- Leadership.
- Communication.
- Teamwork.
Completion of the tool will help an organization to identify the area(s)
in which it is weak and which may lessen the organization's degree of
readiness and capacity for change. This knowledge will, in turn, help
the organization strengthen particular aspects of its infrastructure to ensure
more successful implementation and sustainability of QI efforts.
This tool is intended to be completed by all levels of organization staff,
from upper and middle management to front-line workers. This comprehensive
process will help to identify areas in which various levels of staff differ
in their perceptions and attitudes of the organization and how it operates. A
lack of agreement among these perceptions and attitudes is one indication
of weakness in an area and a sign that an organization is not yet fully ready
to implement change.
It is assumed that this tool will be completed primarily by various levels
of nursing staff, however, the incorporation of other departments into the
QI process is always beneficial. Thus, the tool may also be administered
to various levels of staff in other departments within the organization.
This Readiness Assessment Tool can serve multiple purposes. The information
obtained through the baseline assessment can form the basis of dialogue and
problem-solving across all levels of staff to enhance an organization's
readiness for QI activity. It can also be used as an internal QI tool
to assess the organization's progress in developing a QI culture. This
tool also can provide benchmarking data for organizations interested in assessing
their readiness and capacity for QI relative to their peers.
In sum, by identifying areas of weakness where organizational readiness and
capacity are limited, this Readiness Assessment Tool can serve as a guide
in the QI process, helping to establish a better understanding of what areas
an organization must address in order to achieve success in its efforts to
improve quality.
Glossary
Please refer to the following definitions when completing the tool.
Quality Improvement (QI): Ongoing revision/improvement of
the processes within an organization.
Management: Those who lead the facility from day to
day. In most cases this will be the Administrator, Executive Director,
and/or Director of Nursing.
Information Technology (IT): Technology that aides
in the storage, retrieval, communication, and management of information. Examples
include computers, palm pilots, and digital pens.
Communication: The exchange of information by various
means, some personal and some technical. Communication suggests routine
mechanisms that are not
necessarily interactive.
Please rate your level of agreement with each of the following statements
by checking one response for each item.
If you have comments about any item(s), please write these comments in the
comment box.
Title |
Strongly Disagree |
Disagree |
Neither Disagree nor Agree |
Agree |
Strongly Agree |
Don't Know |
1. QI plans and decisions for
my facility are made locally and not by a corporate or headquarters office. |
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2. My facility compares the
quality of care and services it provides with the quality of care and
services provided at other facilities. |
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3. My facility effectively handles
the changes necessary to improve quality. |
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4. My facility's leadership
cares about how QI efforts will affect staff at all levels. |
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5. My facility provides enough
resources (for example, money, equipment, people, and time) to help improve
quality. |
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6. My facility has a system
through which all levels of staff can suggest ways to improve quality. |
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7. My facility monitors the outcomes of
its efforts to improve quality. |
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8. My facility continually tries to find
ways to improve the quality of care and services it provides. |
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9. My facility collects information about
how well we are caring for residents. |
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10. My facility uses the information it
collects to help improve the quality of resident care. |
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11. All levels of staff are told about the
things the facility learns from the information it collects. |
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12. Management is very involved in what
my facility does to improve quality. |
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13. Management has enough knowledge and
skills to help my facility provide better quality of care. |
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14. Management makes decisions about quality
improvement efforts without asking staff what they think. |
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15. Staff at all levels understands how
the facility's QI efforts will affect their work. |
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16. Staff knows what the facility's goals
are for improving the care and services it provides. |
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17. All levels of staff are involved in
creating the facility's plans to improve quality. |
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18. All levels of staff are trained in how
to recognize when quality should be better and how they can make it better. |
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19. My facility has general rules for how
information is to be charted. |
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20. Staff understands why they have to chart
the things they are asked to chart. |
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21. Staff helps decide what information
is charted. |
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22. Staff helps decide how things should
be charted. |
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23. Staff has the knowledge and skills they
need to chart things correctly. |
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24. Staff has too much paperwork to do. |
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25. Staff is often charting the same thing
in more than one place. |
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26. Staff is held responsible if they don't
do a good job of charting. |
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27. Staff uses some kind of IT (for example,
computers, palm-pilots, etc.) when they chart. |
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28. There is a computer system where the facility
stores information about residents and the care/services they are receiving. |
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29. Staff knows how to use the IT necessary
to chart or do other job duties. |
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30. In the past, my facility has tried to
make our work more organized and efficient. |
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31. In the past, my facility has succeeded in making our work more organized and efficient. |
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32. Staff has too much work to do in order
to do everything well. |
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33. The amount of work staff is asked to
do is fair. |
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34. Staff does not have enough time to
get everything done. |
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35. Staff has the resources they need to
do their work well and be effective in their job. |
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36. Staff has a good understanding of residents'
care plans. |
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37. The amount of work staff has to do causes
them to miss important changes in residents' conditions. |
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38. Staff knows how to review the
quality of their work to see if improvements are needed. |
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39. Staff at all levels is regularly offered
opportunities to learn and develop new skills. |
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40. Staff members are confident in their
ability to do their job. |
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41. Management responds to staff concerns. |
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42. Staff respects the facility's management. |
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43. Staff receives praise from management
when they do their job well. |
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44. Management is clear about what they
expect from staff. |
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45. Management values the work done by staff
at all levels. |
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46. Management thinks staff should be given
the authority to do more things and make more decisions on their own. |
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47. Managers support staff and work with
them to learn new things. |
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48. Management encourages teamwork among
staff. |
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49. Supervisors usually provide help to
their staff when asked. |
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50. Supervisors consider what their staff
has to say when developing resident care plans. |
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51. Supervisors give staff credit for the
things they do to help care for residents. |
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52. Supervisors act like they are better
than their staff. |
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53. Supervisors deal effectively with staff
who create problems or don't do their share of the work. |
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54. Supervisors allow staff to decide on
their own how to do their work. |
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55. Supervisors allow staff to correct problems
when they see that the quality of care/services is poor. |
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56. Staff feels free to question the decisions
or actions of their supervisors. |
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57. Individual staff member responsibility
is very important at my facility. |
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58. Staff makes decisions as part of a team. |
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59. It is difficult for staff to get others
to help them when needed. |
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60. Staff is encouraged to work with other
departments to solve problems. |
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61. There is good cooperation among departments
that need to work together. |
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62. Communication among staff is very open.
(For example, you can talk easily to your supervisor about your concerns.) |
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63. All levels of staff communicate effectively
about efforts to improve quality. |
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64. The information passed among staff is
generally correct. |
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65. Staff receives the information they
need about a resident's care in a timely manner. |
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66. There is good communication between
staff across shifts. |
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67. Staff is well informed about what is
happening during other shifts. |
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68. It is easy for staff to
get the information they need to solve problems on the job. |
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69. Some staff members have
a hard time doing their jobs (for example, reading charts, and notes)
because they speak a different language or have difficulty reading. |
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70. This facility is a comfortable
place for staff of different races/cultures to work. |
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71. Not enough of the facility's
supervisors are from different races/cultures. |
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72. Staff members of different
races and cultures don't talk together much. |
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73. Some staff have problems
communicating with other staff members who speak a different language. |
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Health IT Assessment Tool for Administrators
Background
Administrators Only: Please respond to the following questions
regarding the implementation of health information technology (IT) at your
facility.
1. Below is a list of various types of technology. Please indicate
whether or not each type of technology is used in your workplace. If
you respond “yes” to a type of technology, please describe how
that type of technology is used in the workplace.
Type of Technology |
Yes |
No |
Don't Know |
If yes, how? |
E-mail |
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Internet connection |
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Locally networked computers |
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Electronic health record (EHR) |
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Hand-held devices (e.g., palm
pilots) |
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Other (please specify) |
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2. If you have not implemented an EHR system, why not? (Please
prioritize in order with “1” being the most important and “9”
being the least important.)
_____ Financial constraints
_____ Unable to secure everyone's commitment to use EHR
_____ Vendor support was inadequate for technological needs
_____ Initial data entry is too labor intensive
_____ Vendor stability and viability
_____ Software requires extensive customization to fit our organization
_____ Difficult to select a system
_____ Do not know where to begin
_____ Other
3. If you have implemented an EHR system, please indicate
to what degree the following areas were or have been obstacles to your organization's
implementation of an EHR.
Obstacle |
Not an obstacle at all |
Minor obstacle |
Major obstacle |
Availability of funds |
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Experience with IT |
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Clinical staff support |
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Administrative staff support |
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Technical proficiency of staff |
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Inability of staff to enter
data and use the EHR system |
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Insufficient time to select
and implement an EHR system |
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Lack of IT infrastructure to
support an EHR system |
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Other (please specify): |
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Current as of June 2007
Internet Citation:
Readiness Assessment Tool for Nursing
Homes. On-Time Quality Improvement for Long-Term Care. June 2007. Rockville,
MD, Agency for Healthcare Research and Quality.
http://www.ahrq.gov/research/ltc/pureadinesstool.htm