Management

Why Nurses Are Key to a Strong Health IT Strategy

By opening the door to share experiences, expectations and needs, the caretakers can be a benefit to tech teams.

Linda Harrington is a health informatics and digital strategy consultant. She also edits a technology column for AACN Advanced Critical Care, a journal published by the American Association of Critical-Care Nurses.

Editor’s note: This content series, featured in your Insider dashboard, will be rolled out over the coming weeks to offer advice on driving collaboration between IT teams and clinical staff. (If you’re not already an Insider, sign up for free here.) The associated articles explore why nurses should be included in the decision-making process for purchasing new equipment and how to develop this relationship as part of your IT strategy.

It’s one of the first things I routinely ask any group of health IT professionals: “Raise your hand if you’ve ever been asked by a nurse to change a technology, such as an electronic health record, only to be told after you completed your hard work that the solution doesn’t work as expected.”

Invariably, everyone’s hand will go up. Sadly, that scenario plays out far too often — and it’s a lose-lose situation for all parties.

A fuzzy start is often the culprit. Without a clear and accurate identification of needs, definitions and expectations agreed upon by both parties, no one is satisfied. The disconnect can also waste time and money and delay effective care.

How does this happen? It starts with the fact that health IT teams and nurses speak different languages, and both are complex.

For example, one group may refer to a cell as a battery that creates electrical energy; the other is likely to view it as the basic structural unit of a living organism. Similarly, each party may have its own views of a medical device’s capacities or shortcomings during various stages of the patient journey.

Nursing is the nation’s largest healthcare profession, so continued efforts to break down silos with IT support is essential. Here’s how to get started.

1. Understand Your Differences and Pivot Accordingly

Many health IT professionals come from the business world, where they’re probably used to working on financial, human resources, supply chain and other business-related applications — not clinical ones.

As such, they may bring tools and solutions that don’t work well with healthcare delivery.

More than 50 percent of a nurse’s workflow is cognitive in nature. They’re continually collecting and analyzing data, making individualized patient decisions and pivoting as new data is generated. Nurses also identify and evaluate patient goals, often for multiple cases at once, in concert with other healthcare professionals.

Tools such as business process mapping or swim lane diagrams, then, may not be appropriate. To understand how nurses interact with technology, cognitive task analyses can provide more insightful results.

2. Get to Know Nurses’ Work — Up Close and In Person

One technique to better understand nursing practice is to experience it firsthand. Try having your IT professionals shadow nurses for a full shift — keeping in mind that nurses practice differently depending on the specialty, patient acuity and other factors.

Still, it is important to appreciate nurses’ heavy cognitive workflow in all settings. IT staff must ask questions to uncover what nurses are thinking about: What data do they collect and analyze in their minds? What decisions are they making?

Similarly, nurses should be invited to participate in health IT meetings to listen, learn and share insights. Ideally, these should be expert informatics nurses who are educated and experienced in bridging the gap between nursing practice and technology teams to achieve desired outcomes.

Such experience is invaluable. A recent survey by the Healthcare Information and Management Systems Society found that the top barrier to success in technology used by nurses is the disharmony between IT and nursing technology priorities.

3. Work Collectively to Identify Key Challenges and Opportunities

Purchasing new technologies for nurses should be part of an overall strategy led by nurse leaders with input from clinicians and health IT leaders.

This strategy must include clear identification of needs as well as knowledge of nursing practice and preferences, any constraints related to the physical environment, and available options. Otherwise, even a well-intentioned effort could fail.

I’m familiar with a health system that purchased ceiling-mounted lifts — an excellent solution to weigh and reposition patients while preventing back injuries to nurses. However, the equipment was placed in an inconvenient location for the bedside care team due to space limitations, so the staff would instead quickly pull together a few nurses and use sheets to turn patients.

Another example underscoring the value of logistics is the electronic health record. Although the platform is a central part of care, EHR complexities require a vast training ecosystem: instructional designers, people who train the trainers, end-user trainers, classroom training, weekly updates, pocket guides, clinical help desks and more.

A better front end would be upfront EHR improvements driven by nurses and guided by usability experts. This reduces efforts and costs involved in training while enhancing learning — indicators of a better back-end technology.

4. Support Representation and Open Dialogue Between Departments

Any organization needs to be structured and operate for success, and healthcare is no different. But it is unique in that patient care operates within a narrow margin for errors, which can impact human life and are often irreversible.

This is why open and ongoing communication, guided by representatives to collect and deliver feedback, can be most impactful to creating change.

Which change would have the biggest impact in reducing burnout among #nurses? #healthcare

— HealthTech Magazine (@HealthTechMag) July 6, 2020

Nurses, while users of technology, aren’t typically knowledgeable about how to assess needs and evaluate options related to it. They may be simply asking for a solution they have seen or used in another context. Health IT professionals, on the other hand, may assume the nurses know everything about the solutions they are requesting.

The best strategy is to hire the right expert — ideally, an informatics nurse specialist — to serve as a liaison between nurses and IT teams and plant the seeds that lead to better back-end outcomes. The results benefit everyone.

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