By Marianne McConnell, MN, RN-BC, NEA-BC, FACHE, CPHQ, CNIO, University of Pittsburgh Medical Center
I have the good fortune to be a chief nursing informatics officer (CNIO) of a large healthcare system at the same time that healthcare pursues the ‘Triple Aim’ (simultaneously improving the individual experience of care, improving the health of populations, and reducing the per capita cost). In my view, this is a golden moment in history and I am right in the middle of it all.
Working as a staff nurse, clinical director, chief nursing officer, chief operating officer and vice president of quality during my career, I have had a many moments when I recognized the need for change in healthcare delivery, needed process improvement, or needed improvement in the patient experience. But never before has there been such a convergence of forces focused on improving quality, reducing cost and improving the patient experience. This creates enormous opportunities to operate more safely, efficiently and competitively. This convergence of forces has created a momentum which is my inspiration to go to work each day. The implementation of electronic records has enabled us to begin this journey.
As a CNIO, I bring into focus the connection between IT and clinical operations at each opportunity. As liaison between IT and nursing, it is the essence of my role to ensure that a clinically driven IT strategy is always at the forefront. Bedside medical device integration and voice communication strategy development may be the top priorities for the nursing organization. My role is to help communicate those priorities, hone in on the most value-added of the array of options, and provide leadership to the planning and implementation process. There is an obvious, direct connection between the nurse being able to work more efficiently and safely with reduced cost and improved quality. It inspires me!
As CNIO, I am actively and directly involved in catalyzing change and clinical transformation activities. This might take the form of a long term co-leadership commitment to the team that is building and re-building the electronic process for medication reconciliation. Providing informatics nursing leadership to system-wide initiatives around sepsis, delirium, and suicide risk assessment, to name a few, provide more opportunities to lead and participate in clinical transformation activities. Current workflow assessments and aligning electronic health record functionality are key contributions to transformative efforts by nursing informatics. At the same time, the work requires collaboration across professions to catalyze change. The work is important and inspiring!
Each and every day there is a pressing need to continually reduce waste and all non-value-added activities for patients as well as clinicians. As CNIO, for example, I am challenged to find every opportunity to reduce redundant or duplicative documentation as well as additive documentation. We have set a goal of 30 percent reduction in overall charting requirements. Using principles of ‘documentation optimization,’ Informatics Nurses and Staff Nurses work together to prioritize documentation projects and to systematically reduce the documentation burden. The principles are that the documentation must be simple, direct, one way, design driven by staff, written to the rule and not the exception, with a reduction in the number of screens, fields, and mouse clicks to reach the charting fields. It has become our ‘mantra’ to optimize documentation. It is difficult work but when we accomplish the goal, it is inspiring.
Thus, I am honored to work as a CNIO as it is an incredible opportunity to achieve unprecedented innovation and improvement in healthcare.
We hope you join us in celebrating National Nurses Week and honor your fellow nurses during this week.