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Jim D’Alfonso, RN, MSN, RN, NEA-BC, DFNAP, Executive Director — Professional Practice, Leadership Development and Research, NCAL PCS • Maria V. Chaves, RN, MBA, MPH, Business Technology Partner, Northern California Business Information Office (BIO), IT
Developing a Nursing Technology StrategyKaiser Permanente Northern California (NCAL) Region: Patient Care Services (PCS)
Why Develop a Nursing Technology Strategy?
Developing the Nursing TechnologyUnderstand the Environment
• Site visits and Nurse Manager interviews
• KP environmental scan via intranet and interdisciplinary interviews
• Industry scan: nursing technology literature over last five years
Engage Nursing Leadership
Interview PCS Nursing Leaders to Identify Nursing Priorities and Needs
• Optimize nursing care delivery across patient care settings
• Ensure/maintain regulatory and contractual compliance
• Tools, technology, training and support for Nurse Managers and Assistant Nurse Managers
• Nursing HR recruitment, hiring and onboarding
• Clinical and leadership nursing education programs
Prioritize Needs: Two step approach
1 Organic: Spend $10 on any ideas you like. Spend your extra $1 to indicate your highest priority.
2 Structured and Quantitative Approach:
Financial Simplicity Quality CarePatient and Family Satisfaction Nurse Satisfaction
Regulatory/Compliance
Weighting Weight each criteria against the others: Score 1–10
Definition Potential 5 yr. ROI
What is the relative difficulty to implement?
Will this improve patient quality of care?
Will this improve patient and family satisfaction?
Will this improve nurse satisfaction?
Is this impacted by regulations, contracts, etc. and requires compliance?
Rating Scale 1 < $500K 0 = high 0 = none 0 = none 0 = none 0 = no
3 = $500–$1M 1 = moderate 1 = low 1 = low 1 = low
9 > $1M 3 = low 3 = moderate 3 = moderate 3 = moderate
9 = simple 9 = strong 9 = strong 9 = strong 9 = yes
Outcome: Six out of 28 ideas surfaced as the highest needs (not in ranked order)
1. Engage in continuous capacity management improvement 2. QI HR processes for nurse recruitment and hiring 3. Optimize systems to expedite onboarding, streamline competency validation
and meet compliance requirements 4. Develop/monitor service agreements with non-nursing departments 5. Develop/optimize KPHC tools and workflows to support nursing quality initiatives
(Delirium, Falls, HAPUs, ERAS, etc.) 6. Biomedical device integration that improves nurses’ work, clinical decisions,
and outcomes and recommended by PCS
Strategic Themes and Needs Alignment within context of Professional Nursing Practice at KP NCAL PCS
Benefits• Nursing Vision and Strategic Themes serve as a framework to:
• Communicate nursing discipline, needs and priorities• Evaluate technology impacts• Guide investment decisions
• Improved resource planning for nursing and IT
• Nursing engagement and Labor partnerships recognized and have been built into project roadmaps
• Project team and stakeholders became part of the linkage process across the organization
Lessons Learned• Build your Nursing Business Strategy FIRST!
• The Nursing Technology Strategy and roadmap should articulate how they support the Nursing Business Strategy
• This is only phase 1 — a technology strategy is a living document and an ongoing effort
• Discover your organization’s project funding cycle — PLAN FOR IT in your roadmap
• Become familiar with inflight technology projects that impact nursing
• Discover the good work already done within your organization … there’s lots of gold to be found
“Nothing About Nursing Without Nursing”Nursing Technology VisionProfessional Nursing Practice and the Voice of Nursing will drive the development and implementation of technology innovations and solutions that support the delivery of sustainable, efficient, seamless, high quality nursing care and excellent patient and family experience
Professional Nursing Practice Development
• Ongoing development and implementation of evidence-based practice, innovations, and standards of care
• Quality improvement to optimize patient care and outcomes
• Nursing academic and practice advancement support of future nurses and nurse leaders
Examples• Evidence Based Practice and Nursing Research in hospitals
through nursing research councils• Nurse Scholars Academy• Staff training and competency• Integrated performance data of direct reports
Kaiser Permanente Facts
Santa Rosa
Vacaville
San Rafael
Vallejo
Richmond
San FranciscoSouth San Francisco
Redwood City
San Jose
Fremont
Walnut Creek Antioch
Sacramento
South Sacramento
Roseville
Stockton
Manteca
Modesto
Pacific Ocean
San Leandro
Oakland
Santa Clara
National NCAL Region
7REGIONS
21MEDICAL CENTERS
>50,000NURSES
12,000+INPATIENT NURSES
10+ millionMEMBERS
3.8 millionMEMBERS
Fresno
Fresno County
Nursing Strategic Themes and Needs Alignment
Clinical Intelligence and Optimization
• Simplification and usability of tools and data used for clinical decision making, delivery and documentation of nursing care
Examples• EMR documentation simplification current and future builds• EMR tools and workflows support nursing quality initiatives• Biomedical device data integration• Optimized EMR with patient-facing applications
Efficient Care Delivery and Workflows
• Efficient and effective nursing operational support
• Increased mobility with tools that untether the nurse from the desktop
Examples• Administrative nurse mobility via iPhones; access to EMR
unit dashboards and census• Service agreements with non-nursing departments to help
RNs meet inpatient care needs and impact service scores• One-stop triage for inpatient needs
Operational and Fiscal Management
• Easy to access analytical tools with integrated/prepopulated data to support and align nursing operations, fiscal decisions, and executive review/decisions
• Quality improvement process for HR workflows
Examples• RN recruitment and onboarding to speed RN hire, start
date and nursing unit functioning• Continuous capacity management• Reporting capabilities of clinical systems• Electronic documentation of staff deployment and
equitable assignments
Extraordinary Nursing Care.✓ Every Patient. ✓ Every Time. ✓ Everywhere.
Sustainable, Safe, Efficient, Seamless High Quality CareExcellent Patient and Family Care Experience
Professional Nursing Practice
Nursing and Patient Care Strategic Themes and Needs Alignment
Nursing Infrastructure and Informatics
Voice of Nursing
Acr
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on
tin
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rsing
Techn
olo
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Professional Nursing Practice Development
Clinical Intelligence and Optimization
Efficient Care Deliveryand Workflows
Operational and Fiscal Management
Current State
• Proliferation of technologies across Northern California medical centers and other KP regions
• Nursing priorities, concept development, pilot testing and outcomes in the NCAL Region can vary across medical facilities and across KP Regions
• Vendors contacting KP leaders through many channels of entry leading to siloed development and implementation
Goal
NCAL Patient Care Services framework that guides technology investments that optimize nursing care delivery effectiveness and efficiency
NCAL Patient Care ServicesAnita ZunigaPhilomena WhelanLisa MassarwehCatherine PorterMarilyn MaHughPriscilla JavedDorcas WaltonGretchen Summer
Enterprise ArchitectureBenjamin DaiJohn Michael McKimmieJoji Asirvatham
NCAL BIODonna ScannellWendy Shapiro
CONTRIBUTORS