Real-time data displayed on touch screens accessible anytime, anywhere.
Clinical decisions founded on evidence-based practice recommendations to improve patient outcomes.
Realized efficiencies in nursing that help the financial bottom line.
Nurses who feel energized and empowered in their ability to provide the best care possible.
These are some of the promises of data-driven care and management.
Hospitals have access to an incredible amount of data and tools that could, and should, be leveraged to improve care and efficiencies. These have the potential to result in significant savings, and provide the ability to do more for their patients and the communities they serve.
But the promises of data-driven care are far too often empty ones, and the reality is that nurses are struggling and spending less time at the bedside.
Nurses are spending more time trying to understand the onslaught of data and metrics that, at times, tell conflicting messages.
If the data and metrics are understood, nurses often struggle with knowing definitively and confidently what actions to take.
There is the added struggle of working with various technology, tools and workflows that are not intuitively designed to enhance patient care and result in less time with patients. There are a number of reasons for this:
Disparate information systems that don’t communicate with each other the way they should.
End-users without the training or empowerment to understand and act on the data.
Workflow engineering that works in theory, but not in practice.
Organizational culture that has not embraced or embedded formal quality improvement programs or concepts.
Lack of collaboration between different groups within the organization.
Attention paid to the last issue should help alleviate the others.
Understanding, Collaboration & Compromise
An all-star nursing informatics team requires cooperation between three groups: Nursing, Finance, and IT. These groups, at most organizations, are generally islands unto themselves.
To egregiously oversimplify it: Nursing cares for patients, Finance focuses on costs and expenses to keep the doors open, and IT makes sure that everything hums along like it should.
Looking at each group separately, it’s easy to identify gaps in the relationships.
Nurses are surrounded by technology. They use it constantly. They often don’t give themselves enough credit for their ability to leverage it – and they have to use it in so many ways. They need to leverage technology to care for patients and to run their departments efficiently. Nurses and Nurse Managers are continually learning new equipment and software to better care for patients, but when it comes to analyzing metrics, including productivity data, they often are not provided with the training they need. Nurse Managers typically get where they are because of their excellence as clinicians and their innate leadership qualities, but they generally lack business and financial training. As a result, they typically don’t demand, and are not offered, access to the data and tools they need to efficiently run their units like a business – something that is required in the current state of healthcare.
If healthcare Finance teams are guilty of one thing it is their tendency to be insular. Not a knock on them by any means, they have a huge job to do, but by sharing what they know and the tools they have with Nursing, the entire organization would benefit. Providing the basic business and productivity training to Nursing will close a major knowledge gap that many Nurse Managers have when they initially begin their management career. By sharing their internal tools and having training or collaboration sessions with Nursing Managers relative to setting their productive targets or Labor Hour Standards, Finance can help their organization achieve greater success. Nurse Managers will be able to improve their performance with this additional insight and training, giving them the more control in meeting their financial and productivity targets.
Like Finance, IT can be insular as well, but in a different way. IT is constantly working with other groups, but far too frequently not in a strategic way. Often, IT is an order taker. They respond to trouble tickets, install new software, and keep the servers working. IT can come to the rescue and fix something that isn’t working, but in general they are not sought to help steer initiatives – to use their technical and strategic wherewithal to help guide the organization. They are brought in at the end and asked to “make it work.” The lack of high-level communication with other groups keeps IT from knowing the business needs and challenges these groups face. Not having an understanding of the vision and business needs often result in IT pushing for a solution (or a vendor) they feel comfortable with, rather than a solution that will propel the organization forward.
Bridging the Gap
How then do these groups get on the same page?
Like anything, each group needs to be willing to gain an understanding of what the other groups need. Each one must step outside of their expertise and put themselves into the shoes of their counterparts.
Finance and IT need to visit a nursing unit and see the nurses in action. Nursing likewise needs to appreciate that in order to care for patients, the revenues received must cover the expenses of the organization, and that they can play an active role in meeting budgets.
Nursing and Finance also need to appreciate the incredible task that IT has in keeping the various systems and tools running, and their additional privacy and data protection responsibilities.
The last thing anyone in healthcare needs is more meetings. But, by committing to cross-functional steering committees, health systems can be sure that the lines of communication stay open.
Having the commitment to involve key stakeholders from Finance, Nursing and IT at the beginning of any initiative will ensure that the vision, mission and goals are understood with shared vision and a commitment by all involved to collaborate to work together and develop the processes and tools that best meet the business needs of all.
There is extremely little in today’s healthcare environment that doesn’t have a connection to all three groups. Each has insight into challenges that are unique, and all groups have knowledge that the others do not.
By tapping into that insight the right answers can be uncovered.
Jenny Korth is a Senior Consultant at Avantas.