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Clinical Information TechnologySupports Nursing Excellence By Billie Whitehurst, MS, RN Chief Nursing Officer McKesson Provider Technologies The Catalyst to a Successful Magnet Journey Hospitals that have achieved ANCC Magnet Recognition® have reason to celebrate on two counts: 1) Public acknowledgment that they have met the nursing profession's highest standards and 2) Sheer relief that all the process re-engineering, documentation and reporting required along their "Journey to Nursing Excellence" has paid off. Clearly there is a role for clinical information technology (IT) not only to help achieve the program's high standards but also to report on them. Let's look at how IT supports two of the five new Magnet Model components in particular. Transformational Leadership Like any nurse just out of nursing school, when I began my career I wanted to practice in an environment that delivered high-quality care. I also wanted to be in a place where I could grow and be seen as a valuable part of the organization — and frankly, where I wanted to come to work every day. A participatory management style, such as the widely adopted shared governance model, gives frontline nurses a voice in decisions that affect their practice. But to have an informed voice, shared governance committees need accurate reports that help them monitor and manage nursing performance, and that incorporate clinical, financial and operational information so they understand the bigger picture. To support their analysis and recommendations, shared governance committees need access to information about:  Staffing shortages and costs. Compliance with regulatory requirements and internal policies. Performance against patient satisfaction, complication ratesand other key metrics. Such data is best delivered in the form of Web-based scorecards so users can drill down to investigate variances and determine root causes. Equitable and appropriate staffing practices are also central to Magnet certification, to ensure both staff satisfaction and patient outcomes. Workforce management solutions can collect acuity and care plan data and incorporate it into dynamic staffing recommendations. Web-based, open-shift management gives nurses more autonomy over their time and income while reducing agency costs and scheduling headaches for managers. Exemplary Professional Practice IT plays a strong role within the Exemplary Professional Practice Model Component in three main ways: Providing information when it's needed. Enabling continuous quality improvement (CQI). Making interdisciplinary care planning a reality.These functions also apply to two other Magnet components: .New Knowledge, Innovations and Improvements; and Empirical Quality Outcomes. Information Availability: To be effective, information must be patient specific and incorporate evidence-based content in accordance with national and health system guidelines and quality indicators. Information can be provided in the form of: Alerts, like a reminder that a restraint check wasn't completed. A dashboard showing how outcomes are being affected bya global standard of care. A documentation template that ensures a complete record. A test result presented exactly when needed.Continuous Quality Improvement: Data is also essential to CQI. An organization focused on quality is able to quickly access and work with the data it needs. It has clearly defined metrics, which it monitors closely and broadcasts so all employees know how the organization is doing. As a result, the organization knows how various initiatives are affecting outcomes and can respond nimbly when efforts falter. Interdisciplinary Care: Lastly, interdisciplinary care teams may be the norm today, but if we are to deliver true interdisciplinary care, everyone on the team must be working from the same record — which is far from the norm. To drive interdisciplinary care delivery toward optimal patient outcomes, the care plan must have five key components: 1. An interdisciplinary approach that eliminates duplicate orders and documentation to provide a single view of the patient's progress across all disciplines. 2. Evidence-based content in accordance with national and health system guidelines and quality indicators. 3. Integration with orders, documentation and other systems to generate clinician-specific worklists that automatically update the plan as activities are completed. 4. A focus on outcomes that reduces variability by helping caregivers complete all prescribed care, monitor their patients' progress and anticipate discharge status. 5. Analytics to help the organization measure its performance and drive practice change accordingly. In other words, a true interdisciplinary care plan can drive the kind of professional practice ANCC seeks to propagate via its Magnet program. Start Your Magnet Journey This Year McKesson salutes all hospitals that have achieved Magnet Recognition, especially the select few that have been able to sustain it. Thirty-seven Horizon Clinicals® customers are current Magnet sites, and more than 130 facilities have relied on McKesson's nurse/staff scheduling and enterprise productivity system to meet many of ANCC's robust reporting requirements. The new, simpler model and application requirements may entice more hospitals to go for the gold. The many publicized benefits of Magnet Recognition – higher recruitment and retention of qualified nurses, lower burnout and injury rates, superior clinical outcomes, and higher patient satisfaction – far outweigh the effort. Billie Whitehurst, MS, RN, is Vice President and Chief Nursing Officer for McKesson. Prior to that she was the General Manager for McKesson's medication safety solutions and coordinated and developed McKesson's unified strategy for safe medication administration and patient safety. She has also served as Vice President and Solution Line Manager for the company's physician and nursing solutions.
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