HIMSS Tennessee chapter meeting

CARING Newsletter, Winter, 2007 by Stefanie Kingsley

The first collaborative venture of TN HIMSS and CARING was a huge success. The event, Nursing's Vital Role in Technology Implementation, was held Thursday, October 25, 2007 at the Vanderbilt Center for Better Health. The Center for Better Health is a state of the art facility located near the Vanderbilt University Campus with the mission of "accelerating change in health care". The Center accomplishes this mission in part by supporting events such as this that bring providers from different settings together to meet and swap innovations to support best practices. Intel Corporation sponsored the event in conjunction with TN HIMSS and CARING and a representative was on hand to demonstrate new software applications.

The event began at 3:30pm with a reception including lovely and delicious hors d'oeuvres. As is usual in any event involving food, people congregated around the food tables while enjoying the company of their colleagues. There was ample time to meet and greet for the approximately 50 attendees prior to the start of the panel discussion. Many of the key participants had not met "in person" prior to this event. It was joyous to watch people who had only ever communicated via email to meet face to face; truly an example of a picture is worth a thousand words.

A representative from the Center for Better Health opened with a few words about the methods used to accelerate change. The Center is a beautiful, modern facility with a large, open floor plan--I could live there. The shelves are stocked with books and playthings--including an Etch a Sketch and wooden pose able human figures. Comfortable chairs and good lighting rounded out an atmosphere conducive to discussion and exploration of issues facing nurses in informatics.

Next, our panel moderator, Susan K. Newbold, PhD, RN-BC, FAAN, FHIMSS from Vanderbilt University introduced the speakers for the event: Fern FitzHenry, PhD, RN, Vanderbilt University Medical Center; Jill Hartman, RN, Hospital Corporation of America; Sandy Savage, RN, Mountain States Health Alliance; and Susan Buckles, MSN, RN, CNO, Aionex, Inc. Dr. FitzHenry was the first to present.

Dr. FitzHenry is an instructor at Vanderbilt's Department of Biomedical Health. She has been instrumental in building the business case for technology in the health care setting. She presented on "Evaluating Implementation: Preventing Medication Administration Errors with Bar Code Medication Administration". She is currently working to determine the hard return on investment (ROI) gained by implementing a Bar Code Medication Administration system in a major healthcare facility. Dr. FitzHenry presented us with several estimates of the "hard dollar" cost of an adverse drug event (ADE) stating the findings from a study by Bates et al in 1997--$4685 per event--best reflects the true cost. She also discussed that "error fatigue" may be an issue with nurses using a bar coding medication administration system; this has major implications for informatics professionals. Dr. FitzHenry will be conducting research to investigate the cost of adverse drug events with a concentration on anticoagulants. These medications have historically been implicated in adverse drug events that cause patient harm severe enough to adversely impact the institutions financial risk - either because of increased length of stay or from resulting legal action.

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Jill Hartman, then presented "New Challenges when Implementing Clinical Systems and Devices". She began with a slide showing the cover of the first American Journal of Nursing from 1900, and then proceeded to remind us that our current processes and paper routines have evolved over the last 100 years. In contrast, electronic records have only been of use in health care for the last 10-15 years. Her bottom line message- have patience, we will get there. Mrs. Hartman also gave us a good mantra to use in explaining Nursing Informatics to our colleagues, "Nursing Informatics=Fancy Paper, Fancy Pen".

Our next presenter, Sandy Savage, brought her expertise as Project Manager of Project SAFETYfirst to the discussion. She provided us with an overview of how clinical systems implementation should be done. Her organization, Mountain States Health Alliance, identified the importance of involving staff in the process from the start. Ms. Savage outlined strategies used to keep the process moving forward and identified critical success factors. A crowd favorite in her presentation involved showing a Bassett Hound with a rocket strapped to his back with the caption "Strapping new technology on old systems doesn't work". She also reminded us that cultural transformation takes 5-15 years and "Don't let perfect get in the way of better". All good advice for those of us working in health care informatics.

The final presenter, Susan Buckles, provided us with an excellent basis for the need for nurses to be involved in the implementation of any information technology in health care: "No one knows more about the clinical processes in the hospital than the nurses who are present 24/7. No one. If it doesn't make sense to nurses, it doesn't make sense for the organization." She then presented us with an example of an implementation in which mistakes were made and lessons learned.