I think other things emerging leaders can focus on within nursing informatics are scope and standards of practice through the American Nurses Credentialing Center. You should really look at having your team certified. The goal is for nurses to work at the top of their license, whether they’re at the bedside or doing informatics. At HCA, we focus on nurse-centered IT initiatives; we have nurses that come forward with ideas. I’m excited to be involved in the nursing-specific hackathon this year. There very much is that push to listen to bedside nurses and hear what they’re saying, what ideas they have to improve efficiency.
Also, even having a CNIO role at HCA — you don’t always see that, even in some large organizations. There may be a chief medical information officer role, but it’s so important to have the largest workforce backed with that CNIO role that really understands the technology and how it can improve efficiency. One thing that HCA has been great at doing is ensuring the CNIO role is a vice president-level role, and that I’m at the table with all executive leaders when decisions are being made.
HEALTHTECH: How have conversations about clinician burnout changed? Where are you seeing successes in tackling burnout, and where are you seeing areas that still need improvement?
HESS: When I was at the bedside, no one ever said the word burnout. There were times I didn’t stop for 12 hours. But times have changed. I think the big thing is we’re talking about it. It’s out there, and it’s acknowledged, and so putting that at the forefront shows there’s a need to address it.
From a national perspective, nurses are spending 30 percent of their day in the EHR or interacting with technology, and only 17 percent of their time in direct patient care. I’ve talked to other CNIOs across the U.S., and the data shows that we’re all spending about that same amount of time. We went into healthcare to help patients, so it’s key that we acknowledge that there’s burnout.
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I think we have a long way to go as an industry on how to best support clinicians. Here at HCA, we provide financial and emotional support for the nurse and their family in many ways; one of them is through counseling, available 24/7. I think one thing we could look at as an industry is, what do you do in a single moment? Maybe I’m having a bad day — is that being recognized? I’ve heard of recharge rooms before, so is there a chance to take five to 10 minutes away and actually go in and recharge? Many of us, we feel what our patients feel. We hurt when they hurt. I think acknowledging that and having leaders really look into that is key.
HEALTHTECH: Can you share some successful approaches to nurse-centered IT initiatives?
HESS: HCA leaders have made nursing care a top priority. We have more than 93,000 nurses, and we’ve deployed almost 100,000 smartphones. We want to give them that mobility. We know that in healthcare, we’re behind in technology at least by 10 years, maybe more, compared with other industries. The nurses love the phones, and they’re not just using voice and text; they’re getting important notifications, and they can easily take photos for documentation.
As I talk to our vendors, I’m asking that they offer more innovation to help nurses focus more on patients. Let’s do something that maybe Amazon or Google is trying.
HEALTHTECH: What are the top three trends you’re following right now in healthcare IT?
HESS: The virtual RN — for more seasoned nurses, they don’t need to be in the same room as a patient to do an admission profile. Or they could mentor new grads. You want this program to help keep that seasoned nurse at your organization longer, so they don’t have to be on their feet for 12 hours and can work virtually. People have been dabbling in it but not for more than a few years. And don’t to nurses’ workload at the bedside — if I do virtual nursing, don’t give me an extra patient. That’s not going to improve nurses’ satisfaction.
I’m also looking at ambient technology. As a nurse, I shouldn’t have to touch a computer. I’d like to come into a patient’s room and have it known that I’m the RN tending to Mrs. Smith, see the chart electronically and start an assessment activated through voice. That could really get the patient involved, and think of the patient satisfaction for that? How do we have that voice recognition for nurses?
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The third is artificial intelligence and machine learning. We’ve talked about it for so long, and we’re not there in many spaces still. But what about for something as basic as fall scales? As nurses, we answer three or four questions in a scale that tells us whether a patient is at high, medium or low risk for a fall. But how about instead of doing that, there’s AI in the background that knows a patient’s medication, the last time she’s walked, those high-risk things that could make her a fall risk? That’s a very simplistic example, but we’ve continued to add to nurses’ burdens, so what more can we do to lessen that?
HEALTHTECH: Anything else to add?
HESS: I just wanted to help people. I didn’t say, “Hey, I’m going to be CNIO one day” — 22 years ago, that wasn’t my goal. I knew I wanted to work on strategy. I knew I wanted to help our nurses in a way to give them more time back at the bedside. I am very proud to be a nurse and proud of all the nurses — the most trusted field for over 20 years.
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