“Better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try.” ― Atul Gawande

Analysis completed by:Kathryn Fleming PhD, RN, CPHQ, NEA-BCTimothy Sperling MSN, RN, CENDorothy Vanderwiele DNP, RN, MPA, NEA-BCJanice Wojcik MS, RN, CCRN, ACNP-BC, ACNPC, CPHQ

ONL Informatics Survey Assessment

Purpose• Nursing informatics committee identified a need to complete

an environmental scan as it related to technology• Phase 1: A survey was created to accomplish the following:

• Identify current landscape• Identify needs of constituents• Identify opportunities for further research

• Phase 2: Assess quality of Phase 1 responses • Reword questions for clarity• Encourage informatics assistance to nurse executive survey completion

Phase 2: Improve value of resultsTeam added clarification of questions and

requested nurse executive to complete survey with assistance from Informatics department/contact.

Survey Revision

Phase 1:Data to be collected was defined and questions crafted. Domains focused on:

→ Respondent demographics→ Structure and role of Nursing Informatics within

the organization→ IT systems and software used→ Utilization in nursing practice→ Device use and integration

Role of Responder

Phase 2 Responses

Phase 1 Responses

Responders primary role is Informatics

Hospital Demographics

Part of a healthcare

system?

Which region is hospital located?

In addition to nurses, who else documents in the EHR/EMR?

(n=17)

16 17 17 17 17

5

0

5

10

15

20

Physicians/Providers

RehabTherapists

RespiratoryTherapists

Dieticians Pharmacists Other

In addition to nurses, who else documents in the EHR/EMR?

“Other” (n=5)

4

5

1 1 10

1

2

3

4

5

6

CaseManagers

SocialWorkers

PastoralCare

PalliativeCare

Counselors

What is the reporting structure for the clinical informatics department?

1

8

6

1

0123456789

No Response InformationTechnology (IT)

Nursing Other

If not a direct report to nursing, is there any reporting structure to nursing leadership

1

6

2

01234567

No Response Dotted line relationship tonursing

No relationship to nursing

Key Findings: IT Systems and Software Used• 100% of respondents are using a Clinical Information System

– Soarian, as in the previous survey, ranked the most used system at 35%– Cerner Millennium (PowerChart, FirstNet, etc.) was second at 23.5%– Allscripts and Meditech were third in ranking at 12% each

• The remainder of the respondents (18%) used other clinical systems:– McKesson– Cerner Invision– NTT Data

Key Findings: IT Systems and Software Used• Of the 17 respondents, 13 (76%) indicated use of a “Best of Breed” system

outside of their main clinical information system• The majority of those that indicated having a best of breed system have

systems that focus on capturing documentation in the following top three specialty areas:– Perioperative– Emergency Department– Obstetrics (Labor and Delivery, Post Partum, etc.)

Key Findings: IT Systems and Software Used• The following were reported as being used as providing medication and

patient education– Micromedex: 65%– Lexicomp: 41%– Elsevier’s ExitCare: 41%– Mosby: 18%– Multum: 18%

• The other selections included 24% of unlisted software including the following:– Krames– UpToDate– Medline– Truven Care Notes

Do you have any niche or “best of breed” systems in place?

(n=17)

Yes, 13

No, 4

Do you have any niche or “best of breed” systems in place?

(n=17)

Centricity, 9

PICIS, 3EDIMS, 2

OBIX, 2

EDIS, 2

Intellispace OB, 1

Accudose, 1

Nextgen, 1

Crib Notes, 1

MedHost, 1Avatar, 1

Provation, 1 Sensis, 1

Clinicians using the clinical system rate it as"user-friendly."

(n=17)

1

4

8

4

00

2

4

6

8

10

Strongly Agree Agree Neutral Disagree Strongly Disagree

74%

53%

42%

16%

5%

Point of Care Testing

Cardiac Monitoring

Vital Signs

Smart Pumps

Ventilators

Devices Integrated to Send Clinical Data Directly to EMR

100%

95%58%

53%

32%16%

WOW DesktopWallmount PC in common area Bedside (other than WOW)Tablets Smart phone

Key Findings: Devices Used to Document in EMR

• Best Practices (such as care planning)• Alerts• Protocols that would standardize care• Contact list to include EMR system expertise (vendor, application[s])• Meaningful Use information• Resources for professional development• Legal implications in electronic documentation, design and usage• Project management tracking tools• Informatics-driven competencies• Tools for tracking ROI from systems• Other toolkits exist – do not need to reinvent one (possibly link to other

helpful sites)

Needs Assessment: Future Toolkit Areas

Environmental ScanPhase 1 Suggestions:• Enhance survey questions to

improve depth of information gathered

• Provide more detailed questions with examples to assist the respondents

• Provide additional assessment of device utilization and integration

Phase 2:Questions were added with specific responses to retrieve more details related to:• Medical device system integration• Health information sharing (HIE

participation)• Meaningful Use participation• Barriers to utilization