By Suzi Birz, Principal, HiQ Analytics
The Annual Healthcare Information and Management Systems Society (HIMSS) Conference and Exhibition has grown exponentially over the past few years, not only in number of attendees-some 21,000 attended this year's conference, held Feb. 13-17 in Dallas, Texas-but also in breadth of professions.
Beginning as a conference for management engineers and adding information technology professionals, this year's HIMSS conference drew doctors and nurses in record numbers. The physician symposium preceding the conference doubled its attendance from last year, and the nursing informatics symposium was standing-room only-and not because the nurses were provided a small venue. There were more than 300 nurses in attendance.
Nurses turned out to hear highly respected keynote speakers, including Cisco Systems Chief Executive Officer John Chambers, David Brailer, M.D., Ph.D., national coordinator of healthcare information technology, and former First Lady Barbara Bush, as well as attend presentations on topics ranging from technology and patient safety to the future of technology and nursing education.
The message was clear: Technology is a tool that, when implemented properly and learned thoroughly, can be used to improve all areas of nursing.
"We have the power," said Joyce Sensemeier, RN, MS, CPHIMS, HIMSS director of professional services, when discussing the emerging technological roles for nurses. Sensemeier then encouraged attendees to be "inspired to go out there and do it."
Here are a few areas where nurses can heed Sensemeier's call to action:
When Donna Scott, RN, BSN, was recruited as administrative director of outcomes for University Community Hospital, Inc., in Tampa, Florida, the hospital had just performed a wrong-sided surgery at the same time the Joint Commission for the Accreditation of Healthcare Organizations (JCAHO) was on-site performing an accreditation survey.
Since then, Scott has implemented a Patient Safety Integrated Database, which "brings together the data from various departments-including infection control, risk management and quality improvement-to tell one story," she said.
The integrated database includes voluntary reporting sources, departmental logs and coded information used to measure medical errors, near misses or close calls and adverse or sentinel events, Scott explained. By asking questions about what happens, how often it happens, where and to whom it happens, how severe the problem is and what the outcomes are, the database is able to collect information, examine the cause and work to find solutions. After data is recorded, it is continually assessed and evaluated so that improvement initiatives and education programs can be established.
Scott explained that the take-away for nurses is that to maintain the gain from the database, three things are needed: leadership commitment, scorecards and staff access and feedback. She also explained that before embarking on a database project, it is necessary to examine the culture of the organization.
"If you don't address the systems that are broken, you're going to fire everybody," she said.
For more information, visit the University Community Hospital Web site.
Third party-imposed nurse-to-patient ratios, like those instituted in California, have caused a stir in the health care industry, whether its opposition from hospital administrators or strong support from nursing organizations.
Frank Overfelt, MBA, president of Delta Healthcare Consulting Group, in Greensville, South Carolina, and Patti Rogers, RN, MBA, special projects coordinator at Texas Children's Hospital, in Houston, Texas, brought the business side and the nursing side together to create an alternative to mandatory staffing ratios: dependency-based staffing.
According to Overfelt, the dependency model relies on a "workload measure of how reliant a patient is on nursing caregivers to meet care requirements." The model uses time- and motion-based studies to compute nurse-staffing needs.
Rogers explained that at Texas Children's Hospital, the dependency system is tied to the computer-based staffing system. Perspective staffing is done on each shift. Approximately two hours before the end of the shift, an assessment is done and entered into the staffing system. Then the system reports the target requirement compared to the actual staffing. Changes to staffing on each unit are made based on these reports.
In order for the dependency system to work, Rogers explained that it must be:
- Objective-not subject to individual interpretation.
- Auditable-traceable to a patient's chart or orders.
- Discriminating-differentiating between various patients.
- Statistically valid.
"The system must be owned by nurses for it to succeed," Rogers said.
For more information, visit the Texas Children's Hospital Web site.
Recruitment and Retention
Employees all want access to their own information. That was the message presented by Timothy Stettheimer, Ph.D., vice president and chief information officer of St. Vincent's Hospital, in Birmingham, Alabama, when discussing ways to use technology to solve nurse recruitment and retention issues.
Stettheimer discussed the methods implemented by two hospitals, St. Vincent's Hospital and University Medical Center, in Tucson, Arizona, which have both seen improvement in recruitment and retention of their personnel.
St. Vincent's Hospital incorporated a system that allows employees online access to human resources information, including demographics, benefits and payroll information. Stettheimer explained that this system, which allows employees to feel ownership of their data, has increased nurses' desire to work at St. Vincent's.
For its part, University Medical Center has developed an ActiveStaffer scheduling process, which allows nurses to input requested schedules, vacations and education time, as well as request to work and shift swap.
Both systems, according to Stettheimer, allow staff to have more control, demonstrating to them that "people matter."
For more information, visit the University Medical Center Web sites.
For more information on the 2005 HIMSS Conference, visit the HIMSS Web site.
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