Seven Users, Seven Views: A Data Distribution Plan for Organ and Tissue Donation Referral Data at a Regional Hospital
[Student Name]
University of Phoenix
NSG/542: Information Workflow
Week 6 Assignment
[Instructor Name]
[Date]
The hospital, its departments and the plan are a composite written for a model paper.
Over five weeks, this course has followed the organ and tissue donation referral workflow at our regional hospital from selection, through a current-state map, a data needs analysis, a redesigned workflow and interoperability decisions. This paper completes the work with a plan for distributing the referral data to everyone who needs them.
Principles
Four principles, drawn from the earlier weeks, shape the plan. Distribute by decision: each user receives the data its decisions require, identified in Week 3. Capture once, show many times: data entered in the redesigned structured fields feed every view, so no one reenters them. Limit by role: access follows the minimum necessary principle discussed in Week 5. And measure delivery: the plan is monitored to confirm that data arrive in time. A distribution plan succeeds when each person sees what they need at the moment they need it, and nothing that would distract them or expose a patient without reason.
Distribution by User
User 1, bedside and charge nurses. Data: trigger status, referral task with one-hour clock, referral number and time, organization plan. Form: alert, worklist task and chart banner. Channel: the electronic health record. Timing: in real time when a trigger is met. Access: assigned nurse and unit charge nurse.
User 2, intensivists and attending physicians. Data: referral status, organization plan and planned time of coordinator arrival. Form: chart banner and a line in the rounding summary. Channel: the record. Timing: real time. Access: the treating team.
User 3, the organ procurement organization. Data: the referral message with demographics, trigger, vital signs, ventilator settings, key laboratory values, diagnosis codes and family contact, as specified in Week 5. Form: HL7 message to the organization's case management system, followed by a confirmation call. Timing: at referral. Access: time-limited read-only remote record access for 72 hours for assigned coordinators, logged. Governance: the data sharing agreement.
User 4, chaplains and social workers. Data: referral status and planned family meeting time. Form: a status indicator on their patient list. Channel: the record. Timing: real time. Access: status only, no clinical data beyond what their role already sees.
User 5, decedent affairs. Data: time of death and tissue and eye referral status. Form: electronic release checklist that cannot be completed without referral status. Channel: the record. Timing: at death. Access: status only.
User 6, quality and regulatory department. Data: every trigger event with trigger time, referral time, referral number, minutes to referral, outcome and, for deaths, tissue and eye referral status. Form: an automated monthly report and an immediate notification for any trigger not referred within two hours. Channel: the analytics system, which draws from the structured fields. Timing: monthly and on exception. Access: quality staff. This supports the hospital's reporting of compliance with its notification obligations (Condition of Participation: Organ, Tissue, and Eye Procurement, 2023).
User 7, unit leadership and education. Data: referral timeliness by unit and shift, reasons for any delay recorded in a structured reason field and trends. Form: a unit dashboard. Channel: analytics system. Timing: monthly, with a quarterly review. Access: unit managers and educators, without patient names; drill-down to individual cases available to managers for case review.
What Is Deliberately Not Distributed
The plan also states what users do not receive. Chaplains and decedent affairs do not see clinical values. The organization does not receive data about patients who never meet a trigger, which is why the continuous feed in Week 5 was rejected. Unit dashboards do not show patient names, because improvement work needs patterns, not identities. Uses and disclosures to the organization rely on the permission for disclosures that facilitate donation, which does not remove the obligation to limit what is shared (Uses and Disclosures for Which an Authorization or Opportunity to Agree or Object Is Not Required, 2023).
Governance and Ownership
A data owner is named for each element: nursing informatics for the trigger rule and referral fields, the privacy office for access controls, the quality department for the monthly report and the interface team for the exchange with the organization. Changes to triggers, fields or recipients require review by a small governance group that includes critical care nursing, the organization's liaison, quality and privacy.
Monitoring Delivery
The plan will be monitored with five measures: the percentage of trigger events referred within one hour, with a target of 95%; the percentage of deaths with a documented tissue and eye referral, with a target of 100%; the number of referral messages that fail to transmit, with the confirmation call as a backstop; alert burden, the number of alerts per nurse per month; and the time the quality department spends preparing its report, expected to fall from about eight hours a month to under one. Unertl et al. (2010) include outcomes as part of any workflow description, and these measures are the outcomes of this one.
Education About the Plan
Users need to know what they will see and why. Nurses will learn about the alert, the task and the fields in the education described in Week 4. Chaplains and social workers will learn to read the status indicator. Decedent affairs will be trained on the electronic release checklist. Quality staff will receive a guide to the new report, including how minutes to referral are calculated. Unit managers will be shown how to read the dashboard and how to use the reason field to plan education.
What Could Go Wrong
The plan faces three foreseeable problems. Alerts could be ignored if they fire too often; the monitoring of alert burden addresses this. The interface could fail silently; the confirmation call and the transmission failure measure address this. And access controls could drift as staff change roles; the privacy office's monthly access review addresses this.
Cost
The plan uses existing systems: the record, the analytics platform and the interface engine. Its costs are informatics build time, interface work with the organization and education, estimated at a few weeks of analyst time, against the eight hours a month the quality department now spends assembling reports by hand and the harder-to-count cost of families who never had the chance to decide.
Review Cycle
The plan will be reviewed at 30 days after the pilot, at six months and then annually, or sooner if regulations, the organization's requirements or the record system change.
Conclusion
The distribution plan gives each of seven users the referral data its decisions require, in a form and at a time that fits its work, through channels that capture data once and protect privacy. It rests on the workflow analysis, needs analysis, redesign and interoperability decisions of earlier weeks and ends where the course began: with the goal that every family whose loved one meets a trigger has the chance to make a choice about donation, because the right data reached the right person in time.
References
Condition of Participation: Organ, Tissue, and Eye Procurement, 42 C.F.R. § 482.45 (2023).
Unertl, K. M., Novak, L. L., Johnson, K. B., & Lorenzi, N. M. (2010). Traversing the many paths of workflow research: Developing a conceptual framework of workflow terminology through a systematic literature review. Journal of the American Medical Informatics Association, 17(3), 265-273. https://doi.org/10.1136/jamia.2010.004333
Uses and Disclosures for Which an Authorization or Opportunity to Agree or Object Is Not Required, 45 C.F.R. § 164.512 (2023).
How this NSG 542 Week 6 example is structured
The NSG/542 description ends with demonstrating the ability to develop a plan for data distribution. This paper brings together the workflow map, the data needs analysis, the redesign and the interoperability decisions into one plan organized by user, with a distribution table in prose form, governance and measures that show whether the data reach the people who need them. Students search this week as NSG 542 Week 6, NSG542 Wk 6 or NSG/542 Wk 6; all three are the same assignment.
NSG/542 Week 6 questions, answered
What does NSG/542 Week 6 usually ask for?
The course description ends with developing a plan for data distribution. Many sections close with a plan stating which departments receive which data, in what form, how often and with what protections.
What belongs in a data distribution plan?
For each user: the data elements, format, channel, frequency or trigger, access controls and the person responsible, plus governance, monitoring and review.
How does role-based access support a distribution plan?
It gives each role access only to the data its work requires, which protects privacy and keeps displays focused.
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