Nurses occupy a unique place in the delivery of care. They often have the most direct patient contact and they are involved in several different stages of treatment. For these reasons,
Speakers at the HIMSS Nursing Informatics Institute said nurses deal with patients from the time they are admitted all the way through discharge. This means nurses have a unique understanding of their organization's workflow.
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"Nurses touch every aspect of care," said Dana Alexander, RN, vice president of integrated care delivery and chief nursing officer at Andover, Mass.-based Caradigm. "This means they need to manage change and lead, particularly when it comes to IT."
Nurses aren't always involved in the decision-making process when it comes to technology implementation, but Alexander said organizations should always bring their focus back to the question of, "What is best for the patient?" When this factor is considered, it becomes clear that nurses have to play an active role in determining IT systems.
Getting nurses more involved in technology implementation could also help hospitals embrace new models of care. Speakers at the HIMSS nursing event said the role of nurses is a perfect fit for accountable care organizations (ACOs) and patient-centered medical homes. But in order to function successfully in these models, nurses must be capable users of electronic health records and other technologies.
"The new models of care coming really get at the core of what nurses do, and that's coordinate care," said Joyce Sensmeier, RN, vice president of informatics at HIMSS.
But nurses can't just be along for the ride. Sensmeier said that in order for nurses to figure prominently in the transition to pay-for-performance care models, they will need to lead and manage change at their organizations. She recommended nurses take advantage of opportunities to sit on boards and committees directing the implementation of electronic health records (EHRs) and other technologies.
Nurses touch every aspect of care. This means they need to manage change and lead, particularly when it comes to IT.
chief nursing officer, Caradigm
Mark Sugrue, RN, director of PricewaterhouseCoopers, said documentation collected by nurses will be central to the ability of ACOs to manage patients' diseases and deliver lower costs. This further underscores the point that nurses will need to be proficient users of EHRs.
He said big data is set to change the way care is delivered, but for analytics to improve quality, organizations need to be sure the data they have available is accurate and relevant. This is where nurses come in. Because nurses are responsible for a large amount of record taking, they must be sure to use IT tools to collect the most accurate data possible.
"Imagine the richness of the data," Sugrue said. "That's where I see the power, but without the documentation; we can't get there."
Sarah Collins, RN, nurse informatician at Partners Healthcare, said the time immediately following an EHR implementation is an important stage, when workflows become established. She recommended hospital CIOs work with nurse leaders, like chief nursing officers, to ensure the transition is going smoothly.
Nurse leaders are one of the greatest resources for IT executives to make sure the transition to EHRs is going smoothly, Collins said. This is because nurses interact with physicians from many different departments and have an understanding of how staff is using systems.
Nurses may be resistant to assimilating new technology into their workflows, just as some physicians have been, said Cindy Spurr, RN, clinical implementation director for Partners Healthcare. But health care organizations have a lot to gain from having nurses who are comfortable putting data into EHRs and interacting with decision support systems. When nurses are supported by these technologies, they can help coordinate care among different departments and with outside organizations.
"It is the thing that we know best," Spurr said." We understand how all the care flows in almost every setting."