The Future of Nursingand the

Role of InformaticsWilla Fields, RN, DNSc, FHIMSS

Professor, San Diego State UniversityProgram Manager, Sharp Grossmont Hospital

Outline

• Future of Nursing Report

• Health IT and Patient Safety Report

• National Quality Strategy

• HIMSS Nursing Informatics Committee Position Statement

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The Future of Nursing

“The United States has the opportunity to transform its healthcare system, and nurses can and should play a fundamental role in this transformation.”

-IOM (Institute of Medicine). 2010. The Future of Nursing: Leading Change, Advancing

Health. Washington, DC: The National Academies Press.

Download

Report

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Four Key Messages

1. Nurses should practice to the full extent of their education and training.

2. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.

3. Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States

4. Effective workforce planning and policy making require better data collection and information infrastructure.

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Health IT and Patient Safety

• IOM Mission

– Advise the nation to improve health

• Committee charge

– Summarize existing knowledge of the effects of health IT on patient safety

– Make recommendations to maximize and promote safety of health IT assisted care

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Key Findings

• Health IT can improve patient safety, although gaps in literature

• Health IT needs to be viewed as part of the larger sociotechnical system

• All stakeholders need to work together

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Summary of Recommendations• Potential risks of health IT not adequately

addressed

• Need coordinated effort to identify and understand patient safety risks associated with health IT by– Facilitating free flow of information

– Creating reporting and investigating system for health IT related deaths, serious injuries, and unsafe conditions

– Researching and developing standards and criteria for safe design, implementation, and use of Health IT 7

Aims of the National Quality Strategy

• Better Care

• Affordable Care

• Healthier Communities

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Nursing Informatics defined

• Nursing Informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge and wisdom in nursing practice.

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Informatics Nurses

• Effect change in the development and adoption of interoperable systems across the nation, showing quantifiable impact on national health

• Responsible for driving implementations for interoperable systems within healthcare delivery organizations

• Combined collaboration among stakeholders is needed to develop, adopt, and accelerate healthcare transformation

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Impact of Having Informatics Nurses Involved with Clinical Systems

5.61

5.81

5.89

5.94

5.95

6.03

6.15

6.17

6.21

Reduction of Never Events

Alerts / Reminders

Design / Configuration

Accuracy of Documentation

Quality Outcomes

Screen Flow

User Acceptance

Workflow

Patient Safety

Scale of 1-7

Connecting the Consumer

• Patients are no longer bound by physical space

• 2011 is a tipping point year for patient engagement

• 59% of adults, including older adults, use technology to access healthcare information

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Implications for Time & Place

• Technology is revolutionizing the way that healthcare is delivered

• Clinicians & consumers are incorporating new technological solutions into their daily lives

• Healthcare environments are incorporating wireless solutions, mobile computers, and automated exchanges

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New Ingredients in Transforming Nursing

Informatics

Technology

Engaged Consumers

Expanded Access

Data

Exchange

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HIMSS Position

Together, nurses and nursing informatics must lead, and be visible, vocal and present at the table to achieve healthcare delivery transformation.

Leadership

Education

Practice

Policy

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Steps for Transformation

Leadership

• Partner with nurse executives to lead technology changes that advance health and the delivery of healthcare.

• Support the development of informatics departments and nurse informaticists in analyst, leadership and officer roles.

• Foster the evolution of nurse informaticists in leadership roles such as a Nursing Informatics Executive or Chief Nursing Informatics Officer (CNIO).

Education

• Transform nursing education to include informatics competencies and demonstrable behaviors at all levels of academic preparation.

• Promote the continuing education of all levels of nursing, particularly in the areas of EHRs and health IT.

Practice

• Ensure that data, information, knowledge and wisdom form the basis of 21st century nursing practice by incorporating informatics competencies into practice standards in all healthcare settings.

• Facilitate the collection and analysis of interprofessional healthcare workforce data by ensuring data can be collected from existing heath IT systems.

Policy

• Enable nursing informatics leaders to be knowledgeable and engaged in current public policy initiatives.

• Government agencies must recognize that regulations and reimbursement policies that remain exclusively physician-focused will not achieve the goals of healthcare transformation in the U.S.

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Opportunity of Our Lifetime

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Position StatementResources

Download the Position Statement: http://www.himss.org/handouts/HIMSSNIPositi

onStatementMonographReport.pdf

Download the Talking Points: http://www.himss.org/handouts/HIMSSNIPositi

onStatementTalkingPoints.pdf

Request hard copies/more information: informatics@himss.org

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Willa Fields, RN, DNSc, FHIMSSProfessor, San Diego State University

Program Manager, Sharp Grossmont Hospital

Willa.fields@sbcglobal.net