Clinical Informatics Agents (CIA s): Engaged bedside clinicians promoting best practices and increased end user communication. 1
Clinical Informatics Agents (CIA s): Engaged bedside clinicians promoting best practices and increased end user communication. Dawn Walters RN, BSN, MBA Director of Clinical Informatics Angella Herrman RN, BSN Nursing Informatics Specialist Elizabeth Weeks RN, BSN, CMSRN Nursing Informatics Specialist 2
Objectives Identify benefits provided by a Nursing Informatics Council and Clinical Informatics Agents for EMR implementations/optimizations. Recognize a Nursing Informatics Council and Clinical Informatics Agents impact on patient outcomes and communication. 3
THE UNIVERSITY OF KANSAS HOSPITAL 4
The University of Kansas Hospital Founded in 1906, became a public authority in 1998 Tertiary and quaternary hospital; the teaching hospital for the State of Kansas Licensed for 727 beds, staffed to support 674 beds and 24 FT nursery beds Over 60 facilities providing inpatient and outpatient care Product lines include cardiology, cancer, neurosciences, trauma, critical care, organ transplantation, and burn. 5
The University of Kansas Hospital FY13 Volume: 30,688 Inpatient Discharges 526,380 Outpatient Encounters 50,620 Emergency Department Visits 21,058 Perioperative Procedures Currently over 6,800 employees with over 40% of those in nursing roles Accreditations include TJC, CAP, Level 1 ACS Trauma, Burn Center, Advanced Comprehensive Stroke Center, NCI, ACS Commission on Cancer, Blood Bank, Radiology, FACT and Chest Pain Center 6
The Level I Trauma Center The official healthcare provider of: Kansas City Royals Kansas City Chiefs Kansas Speedway 7
Awards Nine of our specialty areas are ranked nationally by the U.S. News & World Report Best Hospital Lists." Magnet designation National Cancer Institute 8
NURSING INFORMATICS 9
Nursing Informatics Nursing Informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate: Data Information Knowledge Wisdom in Nursing Practice Nursing Informatics Scope and Standards 10
Nursing Informatics What my friends think I do What nurses & doctors think I do What I feel like I do What society thinks I do 11
Nursing Informatics: What We Really Do Created on www. wordel.net 12
NURSING INFORMATICS COUNCIL 13
MISSION: Nursing Informatics Council The Informatics Council will assist the department of nursing by using value based decision making processes to provide appropriate informatics solutions to positively impact the quality and safety of our patients while lowering costs and supporting the improved delivery of state of the art nursing care. 14
Responsibilities of the Council Providing leadership and support by implementing evidence based nursing practice through the appropriate use of informatics solution systems. Assuring that requirements in nursing practice are upheld, sustained and embedded in our electronic documentation and systems. 15
Nursing Informatics Council Identify membership Representation from all divisions. Determine right size of membership How many representatives from each of the divisions? Recruit! Identify O2 savvy staff who are also leaders in practice. 16
Membership Representatives from all divisions (not every unit. Med Surg Progressive Care Intensive Care Maternal Child Periop Procedural Diagnostic Ambulatory 17
Second Year (FY11) Review all Nursing Requests Support all DON Strategic Goals Develop Super User Program 18
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Developing a Super User Program Goals Improve optimization request process Real time education to end users Go Live support Unit specific O2 education Bring forward design considerations 20
Roles and Responsibilities Represent nursing units Bring forth optimizations, explain unique workflows Partner with Nursing Informatics Distribute communication materials Provide O2 Education to peers 21
Expectations Attend 75% of monthly 2 hour meetings Represent unit needs and workflow by soliciting input from peers Participate in education development opportunities Submit Tips and Tricks to O2 Nursing intranet site Unit Downtime Champion Maintain O2 educational postings/in services on unit 22
Expectations Continued Perform audits related to documentation quality Support all disciplines on the unit as Clinical Informatics go to Participate in Task Forces as needed Assist with Test Script Development End User Trainer Go Live Support 23
Eligibility Positive and supportive with regard to O2 and embraces change Excellent communication Understanding of unit workflows Can see big picture Respected by peers Ability to teach others.50 FTE or greater No corrective action in place Demonstrates competency in O2 24
Application: 25
Commitment Forms: Applicant 26
Commitment Forms: Manager 27
Survey We conducted a SurveyMonkey with our council in an effort to improve the group. Survey was open for 3 weeks 20 responses out of 32 eligible members 28
Survey Results Upon examination, 85% of CIAs agree information obtained through the program is beneficial to their nursing practice & 90% find value with hands on offerings provided by the program. 29
Survey Results Ideas from our CIAs to improve meetings Day in the life Hands on Breakout sessions Tip sheets Welcome packet 30
Accomplishments The CIAs worked with implementing a clinical decision support tool resulting in increased utilization of the fall risk plan of care from 51% to 81%. 31
CIA: What is in it for me? Direct input in the design of the system. Unit leadership opportunity. Be in the know, knowing the changes before they happen. NLAP (Nurse Leader Advancement Program) credit Increased access to Nursing Informatics. Increased hands on time on new and proposed functionality. Access to other super users in similar departments. Global picture of EMR integration. 32
Early Lessons Learned Assure attendance Virtual meetings Communicate agenda in advance Increase meeting frequency to address volume of requests HITS (Health Information Technology Services) attendance critical 33
Next Steps: Resurvey staff to see if we are meeting their needs. Possible council structure redesign to increase efficiency 34
References ANA Scope and Standards of Practice: Nursing Informatics (2008) Informatics Competencies for Every Practicing Nurse: Recommendations from the TIGER Collaborative http://www.thetigerinitiative.org/docs/tigerreport_i nformaticscompetencies.pdf 35
QUESTIONS? 36
Clinical Informatics Agents (CIA s): Engaged bedside clinicians promoting best practices and increased end user communication. Dawn Walters RN, BSN, MBA Director of Nursing Informatics Angella Herrman RN, BSN Nursing Informatics Specialist Elizabeth Weeks RN, BSN, CMSRN Nursing Informatics Specialist 37