Our engineering colleagues want answers about the application of technology to improve bedside care. Unfortunately, I cannot provide answers, because it is just not that straightforward.
Every hospital has a different process, a different set of technology systems, a different physical structure, and different patient populations being served daily by literally hundreds of different providers. Once again, the ambiguity of the human experience is the culprit.
Defining communication needs of healthcare providers is a “moving” target and one reason why a universal EHR and smart device usage is lagging behind other industries. Those industries, such as financial operations, deal with clear boundaries, which are easily translated into consistent code. It is tedious to hear others insist that hospitals are not willing to dedicate the resources or to try hard enough to meet Meaningful Use requirements. I find it appalling that the consequences for noncompliance are financial penalties for these hospitals. Technology is expensive. Taking more money away for failing to meet the implementation deadlines is like punishing truancy by suspending students.
If we consider this “moving” target, actual financial constraints, and federal mandates and monitoring, it is a miracle that healthcare has gotten this far. I was visiting with my new “virtual friend” Murielle Beene and we agree that part of the issue has been the delay to empower bedside caregivers during the development and integration of systems. Over 85% of nursing leaders responding to our recent survey believe that the CNO has influence on technology decisions, but only 20% of staff nurses say they have a chance to evaluate devices. I think that Nursing and IT department leaders are trying to involve nurses more than in the past, but is seems that clinical nurses don’t take action when invited to participate. The goal must be an active, informed nursing voice within technology domain decisions. Nurses must engage around this work and insist on involvement.