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NURS FPX 8012 Assessment 5 Quality Improvement Project Plan

Student Name Capella University NURS-FPX 8012 Nursing Technology and Health Care Information Systems Prof. Name Date Introduction Problem Allen Medical Clinic is committed to delivering high-quality patient care, but its inefficient and outdated infrastructure poses challenges to the effectiveness of the Electronic Health Record (EHR) system in the clinic. This inefficiency disrupts clinical workflows due to inadequate staff training, compromising patient data security and neglecting confidentiality and privacy regulations. Stakeholders play a crucial role in improving the organization’s performance. The inefficient EHR system affects IT, executive leaders, clinical staff, and finance departments. Data breaches compromise patient satisfaction, leading to a decrease in patient volume and impacting the organization’s financial status. It also contributes to burnout among clinical and administrative staff, further affecting the organization’s performance. Stakeholders collaborate to address the identified risks (Kaihlanen et al., 2020). The EHR system can result in clinical errors such as medication mistakes, incorrect diagnoses, and treatment plans, as evidenced by the Jump data assigning Allen Clinic a Grade “C” in this regard (Jump Clinic Security Grade, 2019). Furthermore, breaches of patient health information due to poorly designed EHR systems lead to severe consequences for the healthcare organization. Poorly maintained EHR systems may also frequently experience downtime, causing setbacks for patient care that result in negative patient outcomes, as indicated by Federal healthcare comparison. Compared to other hospitals in the same area, such as Sartori Dedication Hospital (SDH) and Mercyone Waterloo Medical Center (MWMC), Allen Clinic showed a 3-star patient review rating, reflecting increased accountability for healthcare professionals and healthcare costs due to the lower standard of care provided to patients (Federal healthcare., 2023). Proposed Solution The vision is to enhance patient health outcomes for financial success at Allen Hospital. The proposed solution is to implement the latest technology, such as an advanced EHR system, to improve healthcare setting interoperability. Educational training will be provided to personnel on EHR usage to implement the solution. Additionally, financial resources will be required to integrate the latest software, such as Computerized Physician Order Entry (CPOE) and Patient ID system (Beauvais et al., 2020). Planning material and financial resources are necessary to implement the proposed solution in the healthcare setting. An Electronic Health Record (EHR) system is used in healthcare settings to collect, store, retrieve, and analyze patient data. Healthcare professionals should use EHRs properly to enhance the standard and safety of patient care (Gariépy-Saper et al., 2021). To develop and integrate electronic health records, EHRs function as an informatics solution and rely on a combination of networking, software, and hardware technologies. EHRs aim to increase the quality and safety of patient care by providing authorized healthcare providers with comprehensive patient health information. Additionally, they enable data analysis to enhance population health and support care coordination among various providers and patients (Vos et al., 2020). EHR adoption and effective use improve interoperability, data security, and privacy in healthcare settings. Measuring and Monitoring Three Data Points of Interest Patient satisfaction: A crucial indicator of how well healthcare organizations provide healthcare services to patients is patient satisfaction. Healthcare staff uses a patient satisfaction survey tool like the Consumer Assessment of Healthcare Providers and Systems (CAHPS) to track patient satisfaction (Xenakis et al., 2020). The organization collects healthcare patient feedback regarding healthcare provider behavior, provision of timely care, and a clean environment. Hospital readmission rates: The hospital readmission rate is a significant metric for assessing patient care in healthcare organizations. The Readmission Reduction Dashboard created by the Agency for Healthcare Research and Quality monitors readmissions (Wong et al., 2020). Healthcare professionals identify high-risk patients and provide the best care to prevent the readmission rate with the help of this tool. Death rates: The death rate is a data point that measures an organization’s performance in healthcare services. The death rate due to specific diseases like pneumonia, heart, and kidney diseases informs hospital care services. Using a mortality dashboard enables the detection of risk factors and opportunities for coordinated care improvement. The dashboard depicts mortality data in categories such as by unit, healthcare provider, or patient population (Greco et al., 2021). EHR Implementation Issues and Challenges The potential of various software programs to exchange data and enhance interoperability is challenging as different departments use different standards in the healthcare organization. Data security and confidentiality are crucial, so improving interoperability through upgraded EHR requires collaboration between stakeholders to ensure patient data remains secure during transition (Li et al., 2021). This can be achieved through proper communication channels between departments. The use of telehealth will also be beneficial in the secure dissemination of information between healthcare providers. Financial resources will be needed to implement the new informatics in the healthcare organization (Shaw et al., 2020). Implementing informatics technology may raise ethical issues if data privacy is breached due to cyberattacks. The breach of patient privacy gives the patient the right to file a lawsuit against the physician and organization (Seh et al., 2020). To overcome this issue, the healthcare setting can use two-factor authentication to safeguard patient health information. Only authorized users access patient data by using a specific PIN or password (Xiang et al., 2021). Similarly, the nurse’s code of ethics will be imparted to the staff, enabling them to safeguard patient information by adhering to the HIPAA rules in the organization. A skilled workforce is needed to operate the EHR system to achieve better patient outcomes. Accurate and up-to-date patient information is needed to make clinical decisions. Integrating Clinical Decision Support Systems (CDSS) into the organization will be beneficial for positive outcomes. It improves the real-time workflows of the organization and helps healthcare professionals protect patient data under HIPAA rules (Muhiyaddin et al., 2020). Thus, CDSS and EHR integration require human resources, which will be challenging in implementing informatics. Staff educational training and practical sessions will enhance their effectiveness in using the EHR system and the clinical problem-solving skills of healthcare professionals, thereby increasing patient health outcomes. Role of the Leaders in Change Strategy Leaders guide the team to implement change strategies

NURS FPX 8012 Assessment 4 Risk Mitigation

Student Name Capella University NURS-FPX 8012 Nursing Technology and Health Care Information Systems Prof. Name Date Risk Management Plan: Identifying and Addressing Risks Using SAFER Guides Risk Identification: Risk Possibility of Occurrence Potential for Harm Mitigation Strategy Data loss due to low resilience of software Sometimes Mild Implement a robust contingency plan Poor IT infrastructure Frequent Severe Invest in upgrading technology infrastructure (Rhoades et al., 2022) Low clinical workflow Frequent Mild Enhance staff productivity through training (DiAngi et al., 2019) Misrepresentation of patient data Sometimes Severe Integrate a reliable patient identification system (Riplinger et al., 2020) Poor communication among staff Frequent Severe Utilize novel communication channels to reduce barriers Electronic Health Data Leakage Sometimes Severe Implement multifactor authentication for accessing patient data (Bahache et al., 2022) Ethical or Legal Issues Related to Identified Risks: Distorted patient information poses serious ethical and legal risks, potentially violating privacy rights and leading to legal consequences. Patients have the right to expect confidentiality, and any misrepresentation of their information could breach this trust (Balynska et al., 2021). Such breaches may result in legal actions, and healthcare professionals must uphold ethical standards to avoid legal repercussions (Choi et al., 2019). Adverse Consequences of Unaddressed Risks: Failure to address these risks within a healthcare organization can lead to poor-quality patient care, financial instability, and low staff morale. Patient safety may be compromised, resulting in medical errors and potential legal actions. Non-compliance with regulations, such as HIPAA, can lead to penalties and reputational damage. Operational risks, like ineffective staffing, may impact financial performance. Proactive risk identification and mitigation are crucial for ensuring patient and staff safety, regulatory compliance, and financial stability. Justification of Actions: Upgrading Electronic Health Record (EHR) systems, improving IT infrastructure, and enhancing staff training can streamline healthcare processes, reduce errors, and provide real-time insights for better decision-making (Rhoades et al., 2022; DiAngi et al., 2019). Implementing a patient identification system ensures accuracy in clinical records (Riplinger et al., 2020). Multifactor authentication safeguards patient data and complies with HIPAA regulations (Bahache et al., 2022). Change Management Strategies: Effective change management is vital for successful implementation. The Lewin model and ADKAR model offer structured approaches. The Lewin model’s three stages—thawing, changing, and refreezing—can facilitate the transition to upgraded EHR systems and improved software consistency (Harrison et al., 2021). The ADKAR model emphasizes Awareness, Desire, Knowledge, Ability, and Reinforcement, providing a framework for staff training and ensuring successful change implementation (Balluck et al., 2020). Application of Change Management Strategies: For the Allen Medical Clinic, addressing EHR management flaws requires a focus on staff training and IT infrastructure improvement. By employing the Lewin model and ADKAR model, the clinic can enhance patient outcomes, staff satisfaction, and overall organizational performance. Change management strategies also contribute to improved collaboration and shared vision among stakeholders. References: Bahache, A. N., Chikouche, N., & Mezrag, F. (2022). Authentication schemes for healthcare applications using wireless medical sensor networks: A survey. SN Computer Science, 3(5), Article 300. https://doi.org/10.1007/s42979-022-01300-z Balluck, J., Asturi, E., & Brockman, V. (2020). Use of the ADKAR and CLARC change models to navigate staffing model changes during the COVID-19 pandemic. Nurse Leader, 18(6). https://doi.org/10.1016/j.mnl.2020.08.006 Balynska, O., Teremetskyi, V., Zharovska, I., Shchyrba, M., & Novytska, N. (2021). Patient’s right to privacy in the health care sector. Georgian Medical News, 321, 147–153. https://pubmed.ncbi.nlm.nih.gov/35000925/ NURS FPX 8012 Assessment 4 Risk Mitigation Choi, S. J., Johnson, M. E., & Lehmann, C. U. (2019). Data breach remediation efforts and their implications for hospital quality. Health Services Research, 54(5), 971–980. https://doi.org/10.1111/1475-6773.13203 DiAngi, Y. T., Stevens, L. A., Halpern–Felsher, B., Pageler, N. M., & Lee, T. C. (2019). Electronic health record (EHR) training program identifies a new tool to quantify the EHR time burden and improves providers’ perceived control over their workload in the EHR. JAMIA Open, 2(2), 222–230. https://doi.org/10.1093/jamiaopen/ooz003 Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where do models for change management, improvement and implementation meet? A systematic review of the applications of change management models in healthcare. Journal of Healthcare Leadership, 13(13), 85–108. https://doi.org/10.2147/jhl.s289176

NURS FPX 8012 Assessment 3 SAFER Guides and Evaluating Technology Usage

Student Name Capella University NURS-FPX 8012 Nursing Technology and Health Care Information Systems Prof. Name Date SAFER Guides and Evaluating Technology Usage Select Specialty Hospital San Diego relies on Epic as its Electronic Health Record (EHR) system, a crucial component of its critical illness recovery and long-term care services. Located in downtown San Diego with a capacity of 110 beds, this facility specializes in providing acute healthcare settings for patients to recover in various aspects such as speech, eating, walking, breathing, and thinking independently. Epic has been successfully implemented at this hospital for the past five years, significantly contributing to patient care. Despite the effectiveness of Epic as an Electronic Medical Record (EMR) system, it is imperative for nursing staff to enhance their knowledge regarding Health Insurance Portability and Accountability Act (HIPAA) regulations, privacy concerns, security rules, and best practice guidelines to ensure the integrity and security of patients’ data. The HealthIT SAFER Guides play a pivotal role in identifying not only data security and integrity risks but also other risks associated with technology implementation. Comprising nine guides organized into foundational, infrastructural, and clinical process categories, SAFER Guides assist healthcare professionals in optimizing technology to meet organizational needs. The selection of Epic as an integrated EHR system aligns with the preferences of large hospitals and healthcare systems across the United States due to its ability to store, assess, organize, and share electronic medical records effectively (Day, 2016). The utilization of Epic has proven to enhance patient security and profitability. NURS FPX 8012 Assessment 3 SAFER Guides and Evaluating Technology Usage Epic simplifies charting processes and enables a single chart for different specialties in patient care, such as emergency departments, inpatient care, and clinics. Additionally, the system features MyChart, a patient portal tool, empowering patients to access their medical records, communicate with clinicians, schedule appointments, and even participate in online visits (Day, 2016). Involving patients in their care contributes significantly to improving the overall quality of healthcare. The evaluation of technology and its impact within the healthcare organization involves utilizing SAFER Guides to assess various areas, including patient identification, test results reporting and follow-up, and clinician communication (HealthIT.gov, 2018). Notably, the Epic system aids in patient identification by integrating duplicate records into a comprehensive file, employing a matching algorithm for key demographics to prevent duplication. NURS FPX 8012 Assessment 3 SAFER Guides and Evaluating Technology Usage However, challenges exist in the area of test results reporting and follow-up, particularly with send-out tests not being electronically traced. Timely reporting is crucial for patient care, and improvements should be considered to prevent delays or information gaps. Similarly, urgent clinical information, such as critical lab results, is currently communicated to physicians via phone calls instead of through the Epic system, indicating an area for enhancement to ensure timely and accurate information delivery. In addressing ethical and legal concerns related to health care technology, the use of electronic health records, including Epic, brings innovation but also increases clinicians’ legal responsibilities. It is essential for providers to chart in a timely manner, recognizing the potential legal implications of their actions. In conclusion, mastering the use of SAFER Guides is crucial for healthcare workers to identify and mitigate risks in healthcare settings. Collaboration between clinicians and IT teams, along with a commitment to creating a safer and more efficient healthcare delivery system, is essential for improving patient outcomes. References Day, J. A. (2016, September 23). Why Epic. Johns Hopkins Medicine. Retrieved September 6, 2022, from https://www.hopkinsmedicine.org/epic/why_epic/ Safer guides. HealthIT.gov. (2018, November 28). Retrieved September 6, 2022, from https://www.healthit.gov/topic/safety/safer-guides

NURS FPX 8012 Assessment 2 Proposal for a Change

Student Name Capella University NURS-FPX 8012 Nursing Technology and Health Care Information Systems Prof. Name Date Abstract This paper addresses the challenges confronted by nurses at Villa Health in providing efficient and high-quality health services, attributing these challenges to understaffing and limited support from the Information Technology and Data Services (ITDS) division. The proposed resolution involves the implementation of a Clinical Decision Support (CDS) system to enhance response times and overall service delivery. The paper delves into topics such as technology change, standards and specifications criteria, comparison of technologies, legal and ethical considerations, technology impact, future relevance, and stakeholder influence. Introduction Villa Health seeks to rectify inefficiencies in patient services by introducing a CDS system, aligning with the standards set by the Agency for Healthcare Research and Quality (AHRQ) through the National Quality Strategy (NQS). This paper explores the criteria outlined by the AHRQ, including the three aims and six priority areas, and the four levels of CDS system implementation. Standards and Specifications Criteria The AHRQ’s NQS framework provides a comprehensive set of criteria for evaluating CDS systems. This encompasses initiation of problem identification, development of guidelines, creation of a legally valid implementation plan, utilization of HL7 Arden Syntax or equivalent systems for formal schema preparation, and establishment of an IT health architecture. Examples of architectures include the Shareable Active Guideline Environment (SAGE) and the System for Evidence-Based Advice through Simultaneous Transaction with an Intelligent Agent across a Network (SEBASTIAN). Comparison of Technologies Health IT systems, including CDS systems, are frequently compared based on features, support capabilities, real-time data analysis, scalability, and utility to different stakeholders. This paper examines factors influencing the choice of a CDS system, considering the needs of nurses, physicians, and staff in decision support. Legal and Ethical Issues The implementation of a CDS system must comply with government regulations and mandates related to patient data confidentiality. Access control policies, storage, and transmission policies should align with the Affordable Care Act (ACA) and other relevant laws. Ethical considerations, such as recognizing patient vulnerabilities and facilitating access and service delivery, must be prioritized in the system’s design. Technology Impact The positive impact of the proposed CDS system includes an improved workflow centered around patient welfare. Real-time access to diagnostic data empowers healthcare professionals to make quicker and more effective decisions. However, the potential risk of over-reliance on the system and reduced communication efficiency needs to be addressed through proper design and implementation. Future Relevance The proposed CDS system is expected to remain relevant for five to ten years with regular maintenance and upgrades. As healthcare continues to digitize for efficiency and productivity, decision support systems play a crucial role in assisting healthcare professionals and enhancing the quality of care. Stakeholder Influence Engagement of both internal and external stakeholders is crucial for the successful implementation of the CDS system. Regular meetings with internal stakeholders, including patients, nurses, physicians, and hospital staff, will provide insights and feedback. External stakeholders, such as government regulators, ethics boards, and investors, should be engaged through written communication and meetings to analyze the system’s need, explain costs, and discuss returns on investment. Conclusion This paper discusses the proposed technology change at Villa Health, focusing on the implementation of a CDS system to address inefficiencies in patient services. By adhering to established standards, considering legal and ethical aspects, and involving stakeholders, Villa Health aims to enhance healthcare delivery, improve patient outcomes, and contribute to elevated community health standards. References Berner, E. S. (2016). Clinical Decision Support Systems: Theory and Practice. Springer. Butts, J. B., & Rich, K. L. (2019). Nursing Ethics Across the Curriculum and into Practice. Jones & Bartlett Learning. Cerrato, P., & Halamka, J. (2020). Reinventing Clinical Decision Support-Data Analytics, Artificial Intelligence, and Diagnostic Reasoning. Taylor & Francis. Harman, F., & Cornelius, L. B. (2017). Ethical Health Informatics Challenges and Opportunities. Jones & Bartlett Learning. Muhiyaddin, R., Abd-Alrazaq, A. A., Househ, M., Alam, T., & Shah, Z. (2020). The Impact of Clinical Decision Support Systems (CDSS) on Physicians: A Scoping Review. Studies in Health Technology and Informatics, 272, 470-473. NURS FPX 8012 Assessment 2 Proposal for a Change

NURS FPX 8012 Assessment 1 Technology-Informatics Use in Your Practice Setting

Student Name Capella University NURS-FPX 8012 Nursing Technology and Health Care Information Systems Prof. Name Date Technology-Informatics Usage in the Clinical Setting Electronic Health Records (EHRs) serve as advanced repositories containing comprehensive patient information, encompassing socio-demographic data, clinical history, diagnoses, prescriptions, treatment plans, vaccination records, allergies, radiology images, and laboratory findings. These records can be either cloud-based or locally hosted, facilitating healthcare providers in making well-informed decisions and enhancing coordination across diverse healthcare settings (Atasoy et al., 2019). This evaluation examines the advantages and challenges of implementing EHRs at Allen Medical Clinic, focusing on best practices to ensure their effective use in supporting high-quality patient care. Analysis of EHR Benefits at Allen Clinic Specializing in emergency medicine, Allen Clinic provides critical care to patients in need of immediate medical attention (Tingle, 2019). As a former emergency nurse at the clinic, I was responsible for documenting patient care and ensuring seamless communication among healthcare professionals. Allen Clinic encountered challenges with its EHR system, including the need for proper training and addressing cybersecurity issues in the datasets. Implementation without prior assessments and training led to difficulties for nurses in adapting to the EHR system, resulting in medication errors and adverse effects. Patients also expressed concerns about the vulnerability of their electronic health records to breaches and fraud (Al-Muhtadi et al., 2019). Advantages of EHR Implementation Effective EHR implementation can enhance healthcare practices in various ways. For instance, Allen Clinic experienced improvements in patient care coordination by swiftly accessing electronic health records when a patient is admitted. This enables the clinic to retrieve crucial clinical data, minimizing errors, and ensuring appropriate treatment. EHRs also streamline processes, such as prescription refills, by allowing nurses to access patient records and send electronic prescriptions to pharmacies, reducing inconvenience for both healthcare providers and patients (Moore et al., 2020). Additionally, integrated EHRs decrease the likelihood of errors by flagging specific dosages and medications in case of patient allergies. This proactive approach prevents adverse drug reactions, contributing to improved patient outcomes at Allen Clinic (Moore et al., 2020). Moreover, EHRs facilitate efficient access to patient data for healthcare providers working in different locations, fostering interdisciplinary collaboration and enhancing the quality of care. The systematic analysis of population health trends through EHRs allows for early detection of potential pandemics or disease outbreaks, contributing to public health surveillance (Willis et al., 2019). Challenges in EHR Implementation Despite the advantages, implementing EHRs presents challenges. Allen Clinic faced issues related to staff training, as the system was introduced without prior education for nurses. Inadequate training can lead to fatigue and frustration among healthcare providers, resulting in errors and decreased patient satisfaction. Furthermore, security concerns emerged, with instances of phishing and cyber threats jeopardizing patient data. Stakeholders, including nurses and patients, perceived additional responsibilities and time commitments, affecting workflow and potentially leading to burnout (Ogbeide et al., 2022). Workflow Redesign and Recommendations Effective implementation of EHRs requires a comprehensive workflow plan. Allen Clinic’s revised workflow includes patient check-in at the front desk, with the system verifying information to reduce errors. After registration, the updated system detects duplicate patient records, ensuring data accuracy. The workflow also incorporates regular educational sessions and staff training on EHR usage, mitigating challenges related to unfamiliarity (Murugadoss et al., 2021). Conclusion In conclusion, the integration of EHRs in healthcare facilities offers numerous benefits, including improved patient care coordination and quick access to information. However, addressing challenges such as implementation costs, staff training, and privacy concerns is crucial. Collaboration among stakeholders is essential for successful EHR implementation. Allen Clinic’s redesigned workflow aims to enhance patient care, minimize challenges, and effectively utilize EHRs to support high-quality healthcare outcomes. References Al-Muhtadi, J., Shahzad, B., Saleem, K., Jameel, W., & Orgun, M. A. (2019). Cybersecurity and privacy issues in socially integrated mobile healthcare applications operating in a multi-cloud environment. Health Informatics Journal, 25(2), 315–329. https://doi.org/10.1177/1460458217706184 Al-Zubaidie, M., Zhang, Z., & Zhang, J. (2019). PAX: Utilizing pseudonymization and anonymization to safeguard patients’ identities and data in the healthcare system. International Journal of Environmental Research and Public Health, 16(9), 1490. https://doi.org/10.3390/ijerph16091490 Atasoy, H., Greenwood, B. N., & McCullough, J. S. (2019). The digitization of patient care: A review of the effects of electronic health records on healthcare quality and utilization. Annual Review of Public Health, 40(1), 487–500. https://doi.org/10.1146/annurev-publhealth-040218-044206 HealthIT. (2019). What is workflow redesign? Why is it important? | HealthIT.gov. https://www.healthit.gov/faq/what-workflow-redesign-why-it-important Khubone, T., Tlou, B., & Mashamba-Thompson, T. P. (2020). Electronic health information systems to enhance disease diagnosis and management at the point of care in low and middle-income countries: A Narrative Review. Diagnostics, 10(5), 327. https://doi.org/10.3390/diagnostics10050327 Lyles, C. R., Nelson, E. C., Frampton, S., Dykes, P. C., Cemballi, A. G., & Sarkar, U. (2020). Leveraging electronic health record portals to enhance patient engagement: Research priorities and best practices. Annals of Internal Medicine, 172(11), S123–S129. https://doi.org/10.7326/m19-0876 NURS FPX 8012 Assessment 1 Technology-Informatics Use in Your Practice Setting Moore, E. C., Tolley, C. L., Bates, D. W., & Slight, S. P. (2020). A systematic review of the impact of health information technology on nurses’ time. Journal of the American Medical Informatics Association, 27(5). https://doi.org/10.1093/jamia/ocz231 Murugadoss, K., Rajasekharan, A., Malin, B., Agarwal, V., Bade, S., Anderson, J. R., Ross, J. L., Faubion, W. A., Halamka, J. D., Soundararajan, V., & Ardhanari, S. (2021). Constructing a best-in-class automated de-identification tool for electronic health records through ensemble learning. Patterns, 2(6), https://doi.org/10.1016/j.patter.2021.100255 Ogbeide, O. T., Nwaomah, E. E., Nwabudike, E., & Akingbade, O. (2022). Challenges with Electronic Documentation among nurses in public hospitals in Lagos Island. International Journal of Nursing, Midwife and Health Related Cases, 8(3), 45–57. https://doi.org/10.37745/ijnmh.15/vol8n34557 Qiu, H., Qiu, M., Liu, M., & Memmi, G. (2020). Secure health data sharing for medical cyber-physical systems in healthcare 4.0. IEEE Journal of Biomedical and Health Informatics, 24(9), 2499–2505. https://doi.org/10.1109/jbhi.2020.2973467 Tabatabaee, S. S., Mousavi, S., Gholami, S., Rafiei, S., Molapour, A., & Kalhor, R. (2020). Identification of specimen labeling errors in pathology specimens received from different wards of the hospital: A patient safety approach. Scientific Journal of Kurdistan University of Medical Sciences, 25(4), 70–78. https://doi.org/10.52547/sjku.25.4.70 NURS FPX 8012 Assessment 1 Technology-Informatics Use in Your Practice Setting Tingle, J. (2019). Urgent and