“Chicago has two seasons–winter and construction.” It’s an old joke, but it holds a grain of truth. Here in the Chicago-area we’re subject to frigid temperatures made worse by the “wind chill” and perpetual traffic snarls made worse by orange cones and backhoes. When you’re creeping along at 20 MPH on an expressway where the speed limit is 65, you can’t help but wonder if Henry Ford had this in mind when he introduced the Model T.
Technology can do amazing things like allowing us to get from one point to another in minutes rather than days. But it can also produce new problems no one ever dreamed of. Ask a group of nurses what they think about Health IT and you’ll see what I mean. For example, when I worked at the bedside we switched from standard medication carts to a Pyxis. We were pretty enthusiastic about it since we wouldn’t have to wait for medications to be delivered by pharmacy. Instead the Pyxis would be stocked with medications common to our patient population. Our pharmacy wait time decreased but medication administration times didn’t. Why? Because the nurses had to stand in line to access the machine.
Identifying potential issues in using HIT is essential to success. If technology is cumbersome or slows clinicians down, they’ll find ways to work around it, giving rise to patient safety concerns. So how can these problems be headed off at the pass? Chief Nursing Informatics Officers may be the solution.
Cheryl D. Parker, PhD, RN, FHIMSS, is part of this emerging nursing informatics role. As CNIO at Rubbermaid Medical Solutions, she works with research and development colleagues and engineers to provide insight into healthcare workflow patterns. Her role at a vendor may differ slightly than a CNIO at a healthcare organization, but Parker said no matter where they are employed, these high-level nurses have common roles:
- Speak for bedside clinicians since CNIOs understand their needs
- Implement and optimize use of HIT
- Coordinate strategic and organizational HIT use
- Understand technology’s effect on patients
“We bring clinical experience and informatics knowledge,” said Parker.
The CNIO position logically rose out of the Chief Medical Information Officer role about five years ago, said Parker.
“CMIOs are well versed in their community and understand workflow from outpatient to inpatient,” she said. “CNIOs focus on inpatient workflow and understand the 24/7 needs of an organization. CNIOs understand [technology needs] from a different angle. When you put them together with a CMIO, it’s powerful.”
CNIOs also support the roles of Chief Nursing Officers. Case in point, while Parker was at a recent American Organization of Nurse Executives conference, some CNOs said they didn’t always get the technology their nurses need. A CNIO could work with a CNO to address this problem.
“We serve as advisers and help them understand when they need to get a broader picture and bring recommendations,” said Parker.
Parker recommends the following traits for aspiring CNIOs:
- Be experienced clinicians with a broad range of specialty experience
- Have previous informatics experience
- Have a master’s degree in nursing
- Be certified in nursing informatics
Though there will never be hundreds of thousands of CNIOs, said Parker, the field is definitely growing with the push for EMR implementation and the Institute of Medicine’s recommendation that there be expanded “opportunities for nurses to lead and diffuse collaborative improvement efforts.”
As technology grows, expect to see more CNIOs driving health IT use and showing nurses’ ability to lead in the “C suite.”
Jennifer Thew, RN, MSJ
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