Nursing Informatics is not new, but it certainly is NOW! Technology is dramatically altering the ways in which we diagnose, treat, care for and manage patients. It is our past and it is our present.
Our Mission is to support evidence-based nursing practice and improved patient outcomes with technology solutions that enhance nursing communication, documentation and efficiency. We pursue our mission endlessly and passionately!
Nursing leadership at Cleveland Clinic has long recognized that superior quality of care depends on the alignment of people, processes and technology. The Department of Nursing Informatics -within the Nursing Institute- plays an essential role in defining and implementing the strategy for innovative technological systems and processes to support the delivery of quality patient care and to enhance nursing practice.
Nursing Informatics participates in multidisciplinary strategic planning to determine system solutions that support patient care, set standards for clinical applications, conform to accreditation standards and regulatory requirements and transform clinical practice. The department also facilitates the development of automation policies, procedures and guidelines for nursing and is the primary liaison between the Cleveland Clinic Information Technology Division and the Nursing Institute.
At the onset of the department, information technology needs within the Nursing Institute were focused on supporting mainframe applications, developing databases, maintaining desktop applications and deploying office computers. It was during this time when various clinical systems were beginning to evolve, and a clinical nurse manager - interested in how technology could affect nursing practice and patient care - became the first manager of the department. With the advent of an automated order entry/results reporting system, the role of the department quickly expanded along with the staff.
Initially referred to as Nursing Information Systems at its inception in 1988, the area was officially established as a department in 1993 – one year before the American Nurses Association recognized Nursing Informatics as a specialty with ANCC Certification. The name change to Nursing Informatics was implemented in 2006 to coincide with then-current standards of practice and scope.
The Nursing Informatics department is now comprised of registered nurses, educators, systems analysts, a web analyst, a security coordinator and system administrators whose focus is to enhance nursing practice through the creative use of technology, maximizing nursing productivity, improving the work environment infrastructure and further supporting the Clinic’s world class excellence in patient care.
Nurses First
We bring our passion for nursing and our passion for innovation together to improve the way nurses communicate with one another, with other caregivers and with patients.
Informatics nurses see technology as a tool to support, rather than hinder, their love of nursing as well as impact future nursing practices. For this team, technology is leveraged for the benefit of nursing practice and improved excellence in patient care systems and processes. Informatics nurses routinely support staff in using automated applications in their daily assignments on the units and play an important interdisciplinary role that combines their passion for nursing with their love of technology, bringing a nursing perspective into the evaluation of innovative systems so that positive patient outcomes are achieved on all levels.
Champions for Change
Not just change for the sake of change. How can we ensure patient satisfaction, safety and outcomes? How can nursing staff leverage technology to improve the environment for providing exceptional nursing care? That’s our passion!
Clinical Analysts in the Department of Nursing Informatics are Registered Nurses who assess opportunities for innovative technology to improve clinical practices – by first analyzing clinical workflow to determine current practices. Based upon these observations, they facilitate the design and development, testing, implementation, training and evaluation of automated clinical systems. Informatics Clinical Analysts facilitate work groups from the nursing staff to validate the application design and to study and quantify technology impact on improvement of specific nursing practices and processes.
Collaborative Approach to Nursing Education, Quality and Research
Clinical Instructors in the Department of Nursing Informatics are also nurses - providing centralized application training to nursing staff in support of new or revised clinical applications implemented on the nursing units. Working collaboratively with the nurse managers, nursing staff, and the Department of Nursing Education & Professional Development - NI Clinical Instructors provide instruction and user support to ease the introduction of new technology into nursing care workflows. Classes favor independent learning with directed computer lab environments as well as self-directed exercises, but also incorporate computer-based training—a component still evolving from yearly competencies and training in federal regulations to clinical applications training with competency assessment. Unit nursing staff responds positively to the computer-based training, which can be taken at times most convenient to them – even from home.
The progressive evolution to electronic documentation of the medical record not only improves access to patient information at the point of care, it also greatly enhances nursing abilities to benchmark, monitor, audit and report quality measures in support of CMS, The Joint Commission and MAGNET initiatives. Additionally, collaborative nursing-led research is enhanced by the ability to support these projects with patient data that is more easily extracted electronically.
Supporting these efforts and initiatives is a dedicated team of clinical and system analysts who provide support for the development and management of information databases, systems and processes to bring efficiency to nursing-driven quality and research endeavors through informatics. Maintenance and support of all databases and desktops is provided with a team of system administrators within the department of Nursing Informatics whose efforts are driven by a strong sense of ensuring employee satisfaction through greater efficiency.
Innovative Use of Technology Improves Employee and Patient Satisfaction
The Department of Nursing Informatics encourages nursing staff, patients and their families to suggest ideas for greater patient satisfaction. The department supports the resulting suggestions as much as is feasible and to that end, has made computers available for patients who have extended hospital stays. Dedicated solely to patients and their families, the computers provide access to the Internet for e-mailing friends and loved ones, interaction with support groups, researching information or playing computer games.
All Cleveland Clinic nursing staff have an email account in addition to access to the Nursing Institute Intranet site complete with Cleveland Clinic policies and procedures, clinical references, announcements of educational classes and opportunities for professional growth, hospital and nursing award opportunities—everything the nursing staff needs to know in a comprehensive, easy-to-access site.
In 2006, wireless Voice-over-IP (voice carried over internet protocol networks) phones were implemented in all nursing units to facilitate ease of communication and coordination of patient care between staff, physicians, ancillary departments and patients. Voice-over-IP technology is the most state of the art telecommunications methodology available commercially today and is fast becoming the standard for voice communications globally. The results – improved communication and enhanced efficiency to improve patient care and satisfaction.
Taking Patient Care to New Levels
The implementation of the electronic medical record, as with other Cleveland Clinic approaches to clinical medical practice, sets a high standard for innovation, collaboration and interoperability.
Nursing Informatics, in collaboration with the Information Technology Division, is implementing an electronic medical records system from Epic Systems of Madison, WI. Electronic documentation of the patient’s medical record is transforming clinical practice for nursing, allied health and medical practitioners at the Cleveland Clinic. After using EpicCare successfully in ambulatory outpatient services for two years, the Clinic is currently undergoing a phased implementation of the Epic system in the inpatient setting– enabling health care providers to examine any patient record across the entire continuum of care in all Cleveland Clinic facilities. The current implementation includes Provider order entry (CPOE), nursing care documentation, medication dispensing and administration, and results reporting. Cleveland Clinic patients may even access their own records and request prescription renewals via the internet with MyChart.
Nursing of the Future
Technology and the effective use of it – is our future. The future of nursing and Nursing Informatics is in alignment with the future of healthcare – growth in the use of technology to ensure safety, positive outcomes and satisfaction of patients. Nursing is at the forefrontof this wave of technology innovation.
A visionary nursing project currently in place at the Cleveland Clinic is the Nursing Institute’s Nursing Unit of the Future - a collaborative project between the Nursing Institute and Information Technology Division. Established on a foundation of defining the ways in which people, processes and technology can improve patient outcomes and nursing practice, the Nursing Unit of the Future staff evaluates the feasibility of innovative mobile devices, applications and other communication technologies that have the potential to support enhanced workflow, documentation of patient care and the satisfaction of patients and staff.
The Nursing Unit of the Future provides nurses with an opportunity to experience, assess benefits and provide feedback regarding new information technologies prior to implementation house-wide. As the nurses evaluate the clinical efficacy of devices and applications, the Nursing Informatics team also evaluates technical and clinical outcomes criteria including:
- How devices withstand normal wear and tear
- How easily information is gathered and recorded
- User friendliness
- Clinician satisfaction
- Time efficiency versus existing methods
- Impact on patient safety
- Impact on patient satisfaction
- Impact on caregiver satisfaction
Flexibility for the Present
The Nursing Informatics specialty at the Cleveland Clinic offers a wealth of benefits for experienced nurses who like
- Challenge
- Professional and Personal Growth
- Flexibility and Creativity
- A Supportive Team Environment
- Reward and Recognition
- Educational Support.
- A Professional Informatics Career Ladder
- An Informatics Development Program
More Promise for the Future
The future holds rapid and ongoing paradigm shifts for clinical caregivers, especially in the areas of electronic documentation, physician order entry and the collaborative transformation of clinical practice.
Technology holds the promise to eliminate redundancy, aggregate relevant information in easy to access and read formats and improve caregiver efficiency, as it enhances nursing practice and drives improvements in patient quality outcomes.
For Cleveland Clinic nurses, the future promises an explosion of new information technology that includes, among others- implementation of RFID technology and personalized electronic scheduling and automated patient acuity classification. These technology advances and others yet to be defined are focused toward keeping Cleveland Clinic nurses at the forefront of quality care delivery and the Destination for Nursing Practice.
More Information about the Nursing Informatics Specialty:
What is Nursing Informatics?
“Nursing Informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice. Nursing informatics facilitates the integration of data, information and knowledge to support patients, nurses and other providers in their decision-making in all roles and settings. This support is accomplished through the use of information structures, information processes, and information technology.”
(ANA Scope and Standards of Nursing Informatics Practice, 2001, pg vii)
(ANA Scope and Standards of Nursing Informatics Practice, 2001, pg vii)
The ANCC Nurse Informatics Certification was established in 1994. There are currently more than 680 (ANCC, 2007) certified nurse informaticists in the United States.
How and where do I start to become an Informatics Nurse Specialist?
- American Nursing Informatics Association (ANIA)
- Capital Area Roundtable on Informatics in Nursing (CARING)
- Healthcare Information Management Systems Society (HIMSS) - Nursing Informatics Community
- Talk to Nursing Informatics specialists in your own hospital/health system
- Speak with nursing informatics faculty at your school of nursing
- Explore nursing informatics organization sites for additional educational resources and opportunities.
