By Sarah Collins, RN, PhD, Nurse Informatician, Clinical Informatics R&D, Partners Healthcare Systems, and Instructor in Medicine, Harvard Medical School & Brigham and Women’s Hospital
I am a nurse informatician and former critical care nurse. I was selected as an Alliance for Nursing Informatics Emerging Leader in 2012. This incredible opportunity is expanding my vision of the role and responsibilities of nursing informatics to partner with patients and stakeholders to advance and re-define healthcare.
As part of this program, I am interviewing nursing informatics leaders at hospitals throughout the country to understand existing models of nursing informatics governance. Based on this work, I’ve drafted a list of:
Top ten 10 focus areas for nursing informatics governance at hospital organizations
10. Challenging our assumptions. Should nursing informatics governance be part of, or separate from, a clinical informatics governance model, a nursing shared governance model, or a mixed-model? There is great variation in approaches used at hospitals throughout the country. What is best? How do these models align with Nursing Informatics Scope and Standards of practice and HIMSS Nursing Informatics Position Statement? http://www.himss.org/asp/topics_FocusDynamic.asp?faid=578
9. Defining role functions and role-based competencies. Many job titles exist, along with much confusion, on the expectations of educational and training requirements for entry and advancement. How can we standardize these expectations? What are the challenges?
8. Understanding and evaluating various reporting structures for nursing informatics. How does reporting within nursing versus IT impact communication paths and decision-making and an understanding of constituents, stakeholders, and users?
7. Understanding evolving governance models. An organization’s needs during EHR implementation are different than the needs of an organization with a mature clinical information system. How does nursing informatics adapt to this?
6. Promoting inter-professional collaboration at all levels of an organization. Collaboration is critical to develop systems that promote patient-centered care, and to optimize knowledge management, hospital analytics, and knowledge discovery for patient-centered care. Are interdisciplinary committees the solution? What else?
5. Influencing and directing accountable care organization strategies. Nursing informatics will be critical for successful care redesign. Have you been involved in ACOs?
4. Promoting innovation. Any nursing informatics governance model should consider how roles, effort and time are reserved to focus on innovation and system optimization to benefit patient care. This can be a real resource challenge. Has your organization successfully overcome these challenges? How?
3. Ensuring that expeditious decision-making is aligned with a set of guiding principles. Many informatics issues impact nursing practice. Nursing informatics governance can establish formal structures, processes, and guiding principles to ensure that the best decisions are made for patient care and knowledge management. How does your organization do this?
2. Increasing and maintaining patient safety. Nursing informatics governance can promote patient safety through formal education, competency training, transparent communication, and promotion of best practice at all levels of a hospital organization. How does your organization use competencies?
1. Promoting participatory healthcare and adoption of social media. Governance is needed to figure out how to partner with patients and do it right. Nursing informatics can lead, and contribute to, thoughtful policies and innovations that promote patient participation in all levels of care by embracing the use of social media, rather than limiting it. Where do we start?
What would you add, modify, or edit? I’d love your thoughts and opinions!
Sarah Collins, RN, PhD, Nurse Informatician, Clinical Informatics R&D, Partners Healthcare Systems and Instructor in Medicine, Harvard Medical School & Brigham and Women’s Hospital
Dr. Collins is an ANI Emerging Leader and is investigating models of nursing informatics governance