Partnership in Practice: Nursing Informatics and Models of

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Partnership in PracticeNursing Informatics and
Models of Nursing Practice

• Ruth Schleyer, MSN, RN BC, CPHIMS
• M. Kathy Johnson, BSN, RN, MBA

Providence Health System, Oregon 22 February 2004
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Providence Health SystemOverview
Prov Anchorage MC
Prov Seward H
Prov Kodiak H

• 18 hospitals
• 5,000 acute and long-term licensed beds
• Served more than 750,000 people through managed
  care plans
• Primary care visits 1,523,286
• Outpatient facility visits 2,873,246
• Inpatient admissions 159,259
• Employees (FTE) 36,000
• Revenue 3.8 billion

Providence Everett MC
Providence Olympia MC
Providence Centralia H
Prov Seaside H
Providence Portland MC
Prov St. Vincent MC
Providence Hood River H
Prov Newberg H
Providence Milwaukie H
Providence Pacific Communities H
Providence Medford MC
Providence Holy Cross MC
Providence St. Joseph MC
Providence Little Company of Mary
Providence South Bay
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Providence Hood River Memorial Hospital
Providence St. VincentMedical Center
Providence Portland Medical Center
Providence Milwaukie Hospital
ProvidenceSeaside Hospital
Providence Newberg Hospital

• Integrated Delivery System
• 7 Hospitals 3 urban, 5 rural
• Home Care/Hospice 1,500 patients
• PPO Health Plan 600,000 people
• Employed Medical Group 210 employed primary care
  MDs
• 2,000 private affiliated physicians
• 4,500 registered nurses

Providence Medford Medical Center
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High Tech for High TouchBuilding a Nursing
Informatics Program

• Director of Nursing Informatics position created,
  reporting to CIO
• Why then and now?
• Maximize opportunities for statewide Nursing and
  IS synergies
• Use IT tools to assist Nursing with top priority
  patient safety and quality initiatives
• Provide practice support tools that automate
  nursing processes for greater efficiency
• Maximize IT investments of finite resources
• Develop Nursing partnership in global PHS Oregon
  clinical systems strategy, collaborating with
  CMIO

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High Tech for High TouchBuilding a Nursing
Informatics Program
2000

• Organizational education
• What is Nursing Informatics?
• Formation of Nursing Informatics Council (NIC)
• Acute care focus
• Vision, goals, ANA Scope and Standards
• Current state assessment
• Nursing information map
• Interviews with Oregon Nurse Executives
• Sharing the findings and ONE priorities
• Start with the basics benefits to nurses and
  nurse execs
• Then, focus on educational resources/referencesan
  d clinical practice strategies

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Current State Assessment 12/00
Summary Findings Nursing Information Map
Currently installed
Installation pending
No funded plans
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High Tech for High TouchBuilding a Nursing
Informatics Program
2003

• Organizational education
• Nursing Informatics role at each facility and
  other program areas
• Evolution of Nursing Informatics Council (NIC)
• Cross continuum representation
• CARE Model (Clinical, Administrative,
  Research/Quality, Education) developed to
  encompass vision, goals, and revised ANA Scope
  and Standards
• Current state assessment
• Nursing systems matrix
• Continuing dialogue with Oregon Nurse Executives
• ONE priorities
• Links with expanded Nursing leadership team -
  Oregon Nursing Center of Excellence
• How can informatics help achieve outcomes?

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High Tech for High TouchBuilding a Nursing
Informatics Program
Herrmann/SchleyerCARE Model of Nursing
InformaticsSupport
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Current State Assessment 12/03
Summary Findings Nursing Systems Matrix
Currently installed
Installation pending
No funded plans
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Current State Assessment 12/00
Summary Findings Nursing Information Map
Currently installed
Installation pending
No funded plans
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Focus on Our Future Creating a Nursing Center
of Excellence

• Oregon Regional Nurse Executive position created,
  reporting to Chief Executive Officer, Oregon
  Region
• Why? Within PHS Oregon . . .
• Facilitate the benchmark integrated experience
  for patients and Nursing staff
• Create a unified Nursing culture and system of
  care
• Advocate for patients and Nursing in strategic
  decision-making
• Achieve efficiencies within Nursing by
  eliminating duplicative efforts

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Focus on Our Future Creating a Nursing Center
of Excellence

• How?
• Develop common vision, philosophy and conceptual
  framework
• Operationalize through key strategies, tactics,
  metrics, and timelines
• Develop a process and structure to organize,
  support, and sustain our work
• Identify key partners and strengthen
  collaborative relationships

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Providence Health System Oregon Nursing Center of
Excellence
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Focus on Our Future Creating a Nursing Center
of Excellence
Vision for Nursing

• Nursing achieves outstanding patient
  experiencesand outcomes guided by excellence in
  practicewithin an environment of supportive
  systems.

Nursing Philosophy Values
We believe the work of the profession of
nursingis centered on the patient/family and is
facilitatedby a supportive environment.
Patient
Nurse
Environment
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Focus on Our Future Actualizing the Nursing
Center of Excellence - Strategies

• The patient/family experience comprehensive and
  personalized nursing care.
• Nurses practice at the expert level.
• Benchmark clinical, service and financial
  outcomes are achieved by implementing consistent
  operational and evidence-based Nursing practice
  standards.
• Physical environment and organizational culture
  enable personalized care and excellence
  innursing practice.

• Information is managed and communicated
  effectively

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Focus on Our Future Actualizing the Nursing
Center of Excellence - Tactics
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Focus on Our Future Actualizing the Nursing
Center of Excellence - Metrics
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Nursing COE-Informatics Links

• C Clinical
• Complete Charting Convergence project Phase 1
• Implement integrated point-of-care computerized
  system which includes an individualized and
  interdisciplinary plan of care
• A Administrative
• Complete implementation of Nurse Executive
  Database
• R Research/Quality
• Without starting over, develop reliable and
  automated measurement system for nursing
  documentation and initiatives such as NICHE
• E Education for Nursing Excellence
• Complete HealthStream current pilots. Determine
  recommendations for use throughout PHS-OR
  Nursing. Add to 2005 budget prn.

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Nursing COE-Informatics Links

• Internet/Intranet initiatives
• Statewide Web page integrating Nursing Center of
  Excellence
• Showcase Nursing and provide a common toolset
• Development of a Nursing plan to inform the
  capital action planning process
• Six Sigma tools to create and apply criteria for
  project planning and funding requests

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Next Steps
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Partnership in Practice
The work of nursing is at the heart of
nursing informatics and informatics tools and
methods only facilitate this work.
Scope and Standards of Nursing Informatics
Practice, ANA 2001
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Thank you!