The unofficial SINI2005 blog

The hosting provider for this blog has changed - so some of the ‘bells and whistles’ may be missing until we can find time to recreate or re-upload them. However, the basic text has been maintained as a historical record.

See more recent SINI blogs  - SINI2006 at http://differance-engine.net/SINI2006blog/

- and watch out for the forthcoming SINi2007 blog.

We have devised a short evaluation questionnaire to get some views on the value and use of the health/nursing informatics blogs we developed during 2005. We provided blogs for the following conferences: HC2005, SINI2005, MIE2005. Before taking the work further in 2006, we want to get some views from the health/nursing informatics community.

You are invited to visit the following webpage, which provides a little information about the online questionnaire, and a link to it:
http://www.differance-engine.net/blogseval/blogsevaluation2005.htm

If you have any questions - eg if anything is not clear - please email Peter Murray (peter@open-nurse.info). We also welcome any additional feedback on the blogs or the questionnaire. The questionnaire is not ideal, but a compromise between not being too long, and getting a good range of information.

The data gathered will be used for several purposes: to feed back to the conference organisers, to help us in making decisions on how best to develop blogs in the future; to develop papers and conference presentations about the issues. No respondent-indetificable data will be released.

Thank you for your time and input.

Peter Murray; also on behalf of Karl Oyri and Rod Ward

What a joy to hear the comments of Maggie McClure and Linda Fischetti. It was inspiring to listen to a encouragement from people in their positions. Getting nurses involved at the grassroots level of the EMR movement is crucial for success. Often Information Systems Departments are moving forward whether there are clinical resources involved or not. Once the technology procurement contract has been signed the clinical staff must be able to devote time to the development and implementation of the system.
Two factors stand out as inhibitors for clinical nursing involvement. Linda told us we could not be timid at this important time. Unfortunately, unless the national education cirriculum for nurses includes informatics nurses will be ill equiped to help in the development of sophisticated systems. Secondly, enabling nurses at the bedside to advise the IS departments is an organizational concept that many understaffed community based hospitals are missing. Facilities that use increasing numbers of agency and have the philosophy that staffing is being sure there is a ‘warm body’ for the shift are suffering in the implementation of systems.
Suzan

The following are a few miscellaneous photos taken at and around SINI2005 and Baltimore .

Baltimore is festooned with crab sculptures at present: one with the Maryland arms found near the School of Nursing.

Another pair of crabs near Inner Harbor.

And a third, just for fun.

The School of Nursing building:

A view of the poster area:

If anyone else has photos they would like to upload, send them to me.

Peter Murray

Links to sites and entities mentioned but not necessarily included in presentation are listed below.
Scott

UNYPHIED (http://www.unyphied.org)
WNY Healthenet (http://www.wnyhealthenet.org/)
WNY AHEC (www.r-ahec.org)
WNY Healthcare Association (www.wnyha.com/)
Pursuing Perfection (P2) Collaborative of Western New York, Inc. (http://fammed.buffalo.edu/unynet/projects.html)
The Personal Touch (biometrics) (http://www.chsbuffalo.org/body.cfm?id=1037)
HealthTransaction Network (http://www.healthtransactionnet.com/)
Uniform Data System for Medical Rehabilitation (http://www.udsmr.org)

Although SINI2005 is now over - and everyone agrees it was a huge success - your opportunity to contribute to the blog is still open. If you were at SINI2005 and did not get the chance to input your thoughts, you cans till do so, as main posts or as comments to existing posts.

I have some more bits and pieces to add in (mainly photos - unless paid not to ;-)) ) and will be organising an evaluation of the SINI2005 blog experience around mid August.

Peter Murray

I found a large proportion of the presentations and topics presented at this years SINI event higly relevant and interesting. However, what I missed was a session dedicated to the future use of IT in Nursing. A panel focused on NI in 2020-focusing on the future “Ideal” stuation defining where we want to go/be in 2020, involving a panel of todays expert would be very interesting. Most presentations wer on the macro-level, and what I find particularly interesting is what will come up on the micro level with the development of MEMS/NANO technology and Genomics. These new pardigms represents new paradigms that really are going to change healthcare dramatically from symptom treatment to prevention of disease before it occurs based on cellular interventions and Genomic profiles.

SINI2005 is now drawing to a close. Dr Mary Etta Mills thanked the Planning Committee and the (purple-shirted) student volunteers. The webcast has had over 110 participants.

SINI2006 will be July 19-22, 2006, with the theme ‘Advancing clinical practice through nursing informatics’.

The final part of the closing was the traditional raffle, which included CARING memberships, 1-year CIN subscriptions, UMB t-shirts and books donated by Springer, iPod shuffles, Tungsten PDA and SINI scholarships for 2006.

The final content session of this year’s SINI is a panel titled ‘Innovations impacting nursing informatics’. Lead by Judy Murphy, the panel is going to look at innovations that can help to provide care more effectively and efficiently.

Diane Carr lead off the panel by talking about smart cards for health and turning data into useful information. Diane described in detail the EHR developed at Queens Health Network in New York, and fheir success in implementing CPOE and its level of use across the network. She ended by saying a little about their 10,000 patient pilot using smartcards (’Health Connection Card’) that function as patient ID and that have a chip which contains a summary of health information.

Patsy Sublett was the second speaker, addressing the Danville Regional Health System’s use of point-of-care barcode medication administration systems and their use in preventing medication errors.

Christine Gamlen rounded up the panel by talking about Vocera Communications’ devices that provide wearable instant voice communications over wirless networks within the health environment.
http://www.vocera.com/

The second plenary of the morning comes from Charlotte Weaver, Chief Nurse Officer and Vice President, Cerner Corporation, with a talk titled ‘Lessons from the field: 10 top reasons why clinical implementations derail’. The starting point of Charlotte’s talk is the assumptions that the strategic and business plans are aligned, system selection has been done, the project implementation plan is completed and agreed, etc., and the project governance structure is appropriately set - so, if this has all been done correctly, and the project management areas have all been completed, what happens next? Charlotte sees the cultural issues as being central to successful implementation from this stage on.

Working up from number 10:

no. 10 - ‘why and what are we doing?’ - fuzzy on targeted value when implementing clinical documentation, lack of guiding pronciple to direct re-design, clear message on the ‘what and why’ is missing. CNO not sure when asked by nurses as to what will be the benefits etc.

no. 9 - ‘it’s hard work, don’t stay the course’ - discipline and political will falters, executive team has to stay the course and not get tired (or fired - can be rapid turnover of executive teams), 5-year implementations can be deadly. Can be fatigue factor and time needed for recovery.

no 8 - ‘re-aligning 3 basics of project management’- time, money, resources and clinical leadership. ‘Successful project’ = on time and on budget - but politics enter into setting ‘go live’ date = organisational readiness for cultural change still poorly understood. Clinical systems give new meanings to ’success’; need to deliver value to clinicians, make patient care better and safer, win adoption by clinicians.
Is there enough stakeholder engagement?

no. 7 - ‘insufficient resources, skills or finance’

no. 6 - ‘nursing in CPOE is missed’ - transformation in acute care is about nursing; cultural adoption driven and supported by nursing; safety depends on nurses monitoring and surveillance

no. 5 - ‘organisation hires third party consultants’ - clinet has set set and enforce rules of collaboration

no. 4 - ‘team members in fox holes’ - team members in adversarial relationships; do not work well together; reflects leadership’s (in)ability top make teams accountable; ofen occurs within sacred turfs (eg radiology, IS)

no. 3 - ‘culture of mistrust’ - no-one in organisation is really happy; poor partnering; tend nto be IS-lead sites

no. 2 - ‘clinical executives not in lead role’ - clinical systems are about transformation of clinical processes; IS cannot lead these projects; CNO and CMO need to be joint team to manage decisions, strategy, etc/

Number 1 issue - ‘executive team does not play well together’ - lack of trust across executive team; just don’t like each other; (such situations are ‘not an anomaly’ in healthcare settings). Nurse executives may be marginalised by alliance of other executives.