Saturday, October 12, 2013

How I fell into Informatics Nursing


After working in nursing administrative roles for 25 years, jobs such as charge nurse, nursing supervisor, nurse manager, and director, I was captivated by the idea that the care process could always be re-evaluated and improved upon and that better care delivery and outcomes could be achieved.  I was never satisfied with the status quo and continuously looked for ways to improve clinical outcomes, improve staff efficiency and satisfaction, and engage patients and caregivers as self-care agents. The challenge to me was how to make systems easier to learn so as to increase the probability of adoption.  I was in search of techniques there were evidence based – techniques that yielded lower complication rates, raised patient satisfaction, improved staff attrition rates, and increased staff satisfaction. To me, the opportunities to improve were endless; yet, there were so many stakeholders to engage and so many issues to address.

At the same time I was watching my nonprofessional life improve, with access to mobile devices, smart TVs, on line banking, and best of all on line shopping.  So why was the healthcare delivery system so slow to embrace technology?  I wondered how technology could enhance care delivery processes, the same way it had my everyday life.  I was struck by this question and, although I did not know the answer, I did know there were IT professionals telling me that EHRs would improve healthcare delivery.  EHR software sales staff touted that the EHR would improve health care record keeping and support provider decision-making.   So, at first, I welcomed the computers being placed on the nursing units. As the computers were deployed by our technology staff, I came to view the computers as large heat generating devices that consumed space, which was once available for multiple charting functions and now supported only one.  I watched in horror as lines to access the computer formed. I observed and concluded that simply adding computers to the unit was not going to improve things.  In fact this approach actually created workflow problems and, in some cases, exacerbated workflow issues that had already existed in our paper-based record system.

Lesson Learned:  There are number of factors to be considered when deploying EHRs and some are not as obvious as others.

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