Web Application Refactoring

Written by Linda Fisher

October 03, 2019

A quick  Google Scholar search did not reveal many new revelations related to “Nursing Workload Management”. The subsequent subjects of “Nurse Turnover”, “Nurse Burnout”, and “Nursing Quality Improvement” should be welcomed into the conversation.  In spite of the fluidity of incorporation to this discussion, for this article, we will be exploring updates to a single unnamed Workload Management System for Nursing Internet-based software package. 

In 2015, the Patient Classification System (PCS) of which had been inpatient focused, was updated to add the ability to capture workloads of inpatient nursing personnel for outpatients. These were patients on the inpatient units that were not admitted as an inpatient. These patients are referred to as “Outpatients in the Inpatient Environment”. These patients were listed as outpatients and consequently, any work the inpatient nursing staff completed was not calculated into the inpatient unit’s workload.  Although this lessened the workload for the outpatient areas being supported, it did not transfer resources to accomplish the work to the inpatient areas. With this update that work is quantifiable, and the transfer of resources can be supported for the areas where work is accomplished. Another large undertaking was the development of a set of extensive training manuals. This addition of over 500 pages of material and 24 video tutorials provided standardized training tools and references for the user community.

Although the community has access to the manuals, a lack of an agreed-upon host site for the videos has kept the community from receiving any video training.  The lesson to be learned in this situation is not to be presumptuous. Although an industry-standard is applied, one must not assume that if a customer has already used a hosting site previously, that they will choose it again. 

The last major update was reporting and the implementation of dashboards. The system reports were largely based on single queries, some of which involved hundreds of lines of code. Although I am not a computer programming expert, I was able to see its faults being a sequential system.  This created more opportunities for issues with individual reports, thus resulting in a slower process when determining where a problem existed in the report’s code. As an expert user for this system, waiting long periods for the discovery and correction of the complicated code is not the key to customer satisfaction. This endeavor is currently being worked on and will take some time to complete. The result will include a simplified, easily updated, and more quickly deployable report changes. 

Additional improvements based on new Cybersecurity requirements have been added to the documentation, testing requirements, and the gates an update must pass through before it is available for customer use. 

It is our intention as the development team to deliver the highest quality, most user-friendly, and data-rich, up to date informative product possible to our customers. 

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