High-Tech Nursing

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Informatics Team Leads the Way

by Susan Middaugh

At The Johns Hopkins Hospital, prescriber orders that used to be written on paper are now entered into a comprehensive electronic ordering system. A team of five Nurse Informatics Specialists who report to the Manager of the Clinical Informatics Program, Deborah Sherman BS, RN, and executive leader Stephanie Poe, DNP, MSN ’92, RN ’78, Director of Nursing, Clinical Quality and Chief Nursing Information Officer, ensure that health information technology supports patient care and quality outcomes.

The electronic order-entry system is just one dimension of a continuing and multidisciplinary effort which began several years ago. Consistent with the organization’s mission, the goal is to design and implement systems that enable high-quality, safe, efficient, effective, equitable, timely, patient/family-centered care. Critical sub-elements include creating a comprehensive electronic system that enhances multidisciplinary communication and facilitates evidence-based decision-making, while meeting regulatory, legal, and reimbursement mandates.

To achieve these goals, it is crucial that policies and practice expectations are standardized (where appropriate) and that policies and practice align. “In the beginning, it was a challenge to standardize policies and documentation expectations so that patient information is accessible to the healthcare team when needed,” said Tammy Hodge, BSN, RN. “This work demands close attention to detail and collaboration.”

Another factor contributing to the success of the Informatics team is prior informatics experience and enthusiasm to lead new projects. Team members James Smith, RN, and Hodge bring both qualities to their respective projects. In addition to his clinical nursing experience, Smith worked for 12 years in The Johns Hopkins Medicine Center for Information Services. In her prior role, Hodge was the lead clinical informatics representative for the Neuroscience Department. “Informatics is on the cutting edge, the way of the future,” said Hodge.

Critical-thinking skills and systems-thinking are two important skill sets that are vital to the design and implementation of electronic clinical systems. The informatics team is fortunate to have two critical-care nurse experts, Barbara Bryant, BS ’90, RN, and Elizabeth Taffe, RN. Bryant is the Project Leader for the barcode specimen collection and transfusion verification system that will reduce specimen misidentification errors. Taffe, who worked in the same ICU for 34 years, now leads clinical groups in the design of and enhancements to the electronic clinical documentation system. “This project has expanded my focus to nursing, medical and ancillary providers throughout the hospital,” Taffe said.

In addition to designing and building information systems to improve patient care, Annette Perschke, DNP, RN, has built an internal Informatics Support Program that includes 450 doctors, nurses and other providers with IT skills who shepherd new applications for the clinicians on the unit. She has done so by working with interdisciplinary committees, networking with colleagues, positive feedback/referrals, and electronic communications. Perschke will present on the outcomes associated with this reengineering at the October 2011 ANCC National Magnet Conference in Baltimore.

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