In: Nursing
Read the following case study:
A small community hospital in the Midwest has used a homegrown
information system for years. The system began in the early 1970s
with a financial module. Over time, additional modules were added.
A limited number of departments selected a commercial system and
interfaces were used to integrate these into the overall
functionality of the hospital information system. Except for
physicians, most in-house clinical or care-related documentation is
online. However, about 15% to 20% of this documentation is done by
free text and is not effectively searchable. In addition, the
screens, including the drop-down and default values, were built
using terms selected by the in-house development team in
consultation with clinical staff; thus there is no data dictionary
or specific standard language. In the last few years, the hospital
has purchased two outpatient clinics (obstetrics and mental health)
and a number of local doctor practices. The clinics and doctors’
offices are now being converted to the hospital administrative
systems. A few of the clinical applications that are tied directly
to the administrative systems such as order entry and results
reporting are also being installed.
A major change is being planned. A new chief information officer
(CIO) was hired last year and she has appointed a chief medical
information officer (CMIO) and a chief nursing information officer
(CNIO). No other significant staff changes were made. With her team
in place, one of the CIO’s first activities was to complete an
inventory of all applications. Rather than continue to build, a
decision was made to switch to a commercial vendor and the hospital
selected a commercial system.
As a member of the clinical staff with informatics education, the
CIO has requested that you develop a training and information
presentation for the clinical staff that will:
• Identify two or more issues with the existing
system
• Provide staff with appropriate “work-around” for
using the existing system
• Provide an overview of two of the standard languages
used within the new system including discipline or specialty,
updating frequency, and available cross-maps
o One standard language should pertain only to
nursing
o One standard language should be
multidisciplinary.
• Obtain clinical staff input, using a five-question
survey, of specific methods to support transition to the new
system; questions should be open-ended.