Nursing Informatic Strategic Planning and Implementation Lessons Learned Nursing Informatics Symposium 2009 A View fr

1. Nursing Informatic Strategic Planning and Implementation � Lessons LearnedNursing Informatics Symposium 2009A View from Northern CaliforniaMarch 6, 2009 Dennis Kneeppel, BA, MPA, RN Vice President Patient Care Services Chief Nursing Officer

2. Slide 1 DISCLAIMER The opinions expressed in this presentation do not necessarily represent those of my current or former employers, colleagues past or present, nor current direct reports. :-/ Dennis Kneeppel

3. Slide 2 Clinical Informatics Goals support the mission and vision of the organization be aligned with the available financial resources support evidenced based practice improve patient outcomes enhance communication, documentation and efficiency improve patient safety

4. Slide 3 Clinical Informatics Applications Business (ADT, billing, inventory tracking, HR, payroll Operations support (decision support, scheduling and staffing, time and attendance, communications (email)) Clinical (EMR, specialty (critical care, peri-op), results reporting ancillary )lab, pharmacy, rad, cardio), CPOE, MD documentation, barcoding

5. Slide 4 Clinical Informatics Nursing leadership has a role in all and needs to be at the table as options are debated, priorities are set and decisions are made Why? each system either directly impacts the frontline staff � or impacts how resources are allocated

6. Slide 5 Nursing Informatics Clinical application adoption will most likely involve clinical transformation � or � the adoption of new processes to improve clinical workflow and patient outcomes if nursing leadership isn�t involved in every phase of the clinical transformation process, there is a significant risk of organizational disruption or even failure

7. Slide 6 Clinical Transformation Phases of clinical transformation Strategic planning (what are we going to do and why and over what timeframe) System selection (which vendor(s) will we use � what can it really do?) Contract negotiations (how much and who�s accountable for what and when) System deployment (rolling it out) System support (on-going training, technical support, end user support)

8. Slide 7 Lessons Learned Be mindful of the goal Watch scope creep � and the impact Understand the true costs current infrastructure is NEVER adequate training costs are often underestimated listen to the vendor - carefully Support your nursing leaders too they may not know what to expect either be clear with what �owing� means

9. Slide 8 Lessons Learned Involve your quality and regulatory experts � very early they should be present during the strategic planning discussions and goal setting they should be present during the build process they should be present during testing they should provide system report requirements

10. Slide 9 Lessons Learned Involve all levels of the clinical organization � especially the staff RNs build process testing training tool development deployment strategy discussions hardware strategy provide clear framework tell the truth

11. Slide 10 Lessons Learned Keep an open mind and be willing to learn assume that some decisions may have to change know that you don�t know it all you don�t always know what you don�t know listen to your experts listen to your staff

12. Slide 11 Lessons Learned Be an advocate for your nurses just because it can be done, doesn�t mean it should be done put yourself in their place most will never be technical experts � they just want to take care of their patients the value the nurse leader adds at the table is clinical knowledge and perspective � don�t forget that

13. Slide 12 Lessons Learned Don�t forget labor (union) this is a change in working conditions and skill expectations � be prepared to negotiate � and do it early If a new workflow is too complicated � don�t do it error on the side of patient safety and common sense � always Communicate, communicate communicate

14. Slide 13 Lessons Learned Celebrate and recognize � often Engage and partner with your MDs Make sure that your training and support plan includes the physicians they need real-time almost immediate support in order to be sold � they do not want to waste time

15. Slide 14 Lessons Learned Questions?