By Christopher M. Walden, RN, BSN, MHAI, Director Application Services at Flagler Hospital
If you want to spark an instant debate, ask a group of nursing informaticists what reporting structure makes the most sense to them. Just to add flavor to the debate, ask the same question to nursing leadership, education leadership, and information services leadership.
I challenge you to find a unanimous answer. I have surveyed hundreds of people and organizations across the U.S., and if they have a dedicated informatics department, the reporting structure in each institution is different. Some informatics professionals report to the Chief Nursing Officer (CNO), others the Chief Information Officer (CIO), some to the Chief Medical Information Officer (CMIO), the Chief Nursing Officer (CNO), the Chief Nursing Information Officer (CNIO) and some to the education department. While I cannot tell you which reporting structure is right, what I can provide are the challenges associated with each of these real-life reporting scenarios.
The CNO reporting structure:
- When informatics is aligned with nursing, the informaticists tend to be involved in the day-to-day clinical operations and can get easily out of touch with the technology side of his or her role.
- This risk is increased in the decentralized model, which calls for having informaticists assigned to a unit or multiple units as opposed to a centralized model of having an informatics department, where the team sits in one location.
- Nevertheless, aligning Informatics with the CNO can also leave non-nursing roles, such as pharmacy and lab, without informatics representation, since the obvious association with the responsibility of the informaticist under the CNO is to nursing.
The CIO reporting structure:
- Has more of a technical focus; informaticists under the IT/IS umbrella often face challenges with their clinical counterparts when it comes to who they represent.
- Exposed to more of the technical side of the equation and quickly picks up the lingo of IT counterparts.
- Can be extremely beneficial in bridging the gap between clinical and IT.
- Can challenge the relationships the informaticist has with their clinical peers who may feel the informaticist has lost touch with what really goes on in the clinical setting.
Next week, in Part 2 of this blog series, we will look at the challenge Informatics teams face when reporting to the CMIO or the education department, and how the role of a CNIO can benefit your organization