ANIA 2024 Annual Conference

P031 - Defining Ambulatory Care Intake Requirements

Shawn Coomer, MBA, MSN, RN, NI-BC, Manager of Nursing Informatics, Vanderbilt University Medical Center

Tags: staff satisfaction patient satisfaction standardization ambulatory documentation burden reduction

Updated: 05/06/24

In a recent visit from The Joint Commission, it was evident that there was not a clearly defined minimum expectation for documentation of clinic intake in ambulatory care spaces across our institution, which conducts over 3 million outpatient visits yearly (including pediatrics and regional facilities). Before our change, different specialty areas prioritized different clinic intake elements for their patient populations, and there was even variation between staff members in the same department. This resulted in an inconsistent experience for our patients and confusion for our staff and providers. To address this issue, nursing informatics services worked closely with quality and safety, as well as nursing and provider executive leaders to define minimum standards and develop a tool for all ambulatory care spaces to help guide staff through those questions that formed the minimum standards. In doing so, we helped ensure a consistent experience across all ambulatory care areas for our patients, families, staff, and clinicians. Our change also helped ensure regulatory compliance and enhanced the safety and efficacy of clinic intake.

Using a PDSA (plan-do-study-act) cycle, nursing informatics services worked with the eStar ambulatory analyst team to develop a “checklist” that displays in the intake activity within eStar. It displays the organizational minimum requirements, and once a staff member addresses that item at the correct interval, for example, an annual item addressed within the last 365 days, it is checked off the list. This also helped reduce the number of questions asked to patients by crossing encounter departments. For example, if you had been asked in primary care about your advanced directive last month, you would not be asked again in ENT today.
We launched this project in all ambulatory care areas at once! It was such an intuitive design that staff required little at-the-elbow support. The checklist helped guide them through the minimum requirements as designed.

In a second phase of our project, we allowed patients to answer most of the required intake elements via our patient portal system. In doing so, we helped reduce staff documentation burden. This was integrated with our previous checklist work, and many times the patient’s checklist would be completed before they ever sat down in the clinic room for intake.
Overall, we achieved the outcome of defining the core minimum intake requirements and developing a tool to encourage adherence to the new standards. Also, staff reports an increased ability to determine the required documentation for ambulatory care encounters since the change was implemented. Prior to the change, 33% of polled staff reported that it was ”very easy” to determine required documentation for clinic intake. After implementation, that number rose to 51%. Perceived documentation time was also reduced. Before our change, 20% of staff felt that they could complete clinic intake in less than 5 minutes. Afterward, 27% reported being able to complete the process in less than 5 minutes. Through a multi-team approach, we improved nursing workflow and patient satisfaction by helping define minimum documentation standards that meet regulatory requirements and satisfy quality standards.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.

P030 - Improving Patients' Wound Treatments with a Wound Care Nurse-Driven Medication Protocol

Liezel Chmielewski, DNP, BS, RN-BC

Tags: wound care WOCN wound care protocol

Updated: 05/06/24

Purpose: To ensure this organization provides high-quality care for patients who need wound care treatments during their admission, opportunities were noted in the process of ordering these treatments in the electronic health record, as well as reporting. Without a streamlined electronic process or protocol in place, baseline data showed a delay in wound care treatment ordering by 2 days and an increase in HAPIs.

Description/method: A collaborative effort with providers, wound care nursing and nursing, pharmacy, process improvement, and medical informatics was used to explore technological solutions to help wound care nurses follow up on wound care patients, complete their documentation, and order wound care treatments easily and efficiently. Wound care treatment meetings were held biweekly with the team to design a viable solution where evidence-based practice drove the technology to enhance the wound care nurse workflow and care of these patients from hospital admission to discharge.

Evaluation/outcome: Using a collaborative effort has proven to be successful in streamlining the wound care treatment ordering process and has increased quality of care by removing a 2-day delay in treatment and decreased HAPIs by 42% via WOCN-driven medication protocol. Standardizing wound care documentation has also made it easier for reporting. Continuous evaluation of informatics processes is needed to update and support the patient’s quality of care being provided for wound treatment. As technology advances, informatics is able to support documentation, collect data, and use that data effectively for future optimizations.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.

P029 - Implementation of a Toolkit to Improve Documentation Practices and Nurse Satisfaction with Electronic Health Record Usability - A Quality Improvement Project

Arielle St. Romain, DNP, RN, CNEcl

Tags: electronic health record documentation nurse satisfaction copy-paste workarounds

Updated: 05/06/24

Purpose: The purpose of this quality improvement (QI) project was to implement the ECRI safe documentation practices toolkit on an acute-care medical-surgical unit to improve the integrity of nursing documentation while using the copy-paste functionality (CPF) and nurse satisfaction levels with electronic health record (EHR) usability.

Background/significance: In the dynamic realm of health care, where precision and efficiency intersect, the importance of accurate and timely nursing documentation is paramount. EHRs were implemented within healthcare facilities as a method to enhance safety culture and quality of care initiatives. However, despite how they have innovated health care and streamlined data entry, EHRs can contribute to new, unanticipated safety problems for healthcare organizations such as documentation inaccuracy. With increasing documentation requirements supplied by regulatory agencies, nurses often rely on workarounds to improve their efficiency while documenting within the EHR. One such workaround frequently utilized by nurses is CPF, which improves documentation efficiency for nurses during their shift. However, CPF is a double-edged sword when used; it can increase efficiency but may jeopardize the veracity of health records. When workarounds become an inherent part of an EHR, nurses often feel decreased satisfaction with the usability of an EHR and note difficulty in integrating this technology into their own workflow further decreasing their efficiency.

Methods: The ECRI Institute’s toolkit was used to create a new policy on documentation practices and CPF use in the EHR. Asynchronous educational sessions were provided to nursing staff on using CPF safely when documenting. To measure documentation integrity with CPF, audits of a random selection of EHRs were conducted using the ECRI Institute’s copy-paste audit log pre- and post-toolkit implementation. A 23-item Likert scale survey, the electronic health record satisfaction survey (EHRNS), was administered to a convenience sample of 13 nurses pre- and post-toolkit implementation to measure nurse satisfaction levels. Quantitative data was analyzed using a chi-square test of Homogeneity and a Wilcoxon signed rank test.

Evaluation/outcome: The implementation of the ecri safe documentation practices toolkit was shown to have a statistically significant impact (χ2(1) = 17.620, p < .001) on the integrity of nursing documentation within the EHR. However, there was no statistically significant improvement (z = -.548, p = .584) in nurse satisfaction with the usability of the EHR during the same period.

Conclusions: This QI project demonstrates that the use of the ECRI toolkit is a successful method that hospitals can use to improve the safety of documentation practices that utilize CPF.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.

P028 - Nursing Quality and Informatics Framework: A Lean Six Sigma Approach to Achieving Zero Harm Nurse Sensitive Indicators

Mari Akre, PhD, MSN, MS, RN, NEA-BC, CPHIMS, VP-CNIO, Indiana University Health

Tags: clinical informatics nurse-sensitive indicators quality improvement methodology

Updated: 05/06/24

Hospitalized adults often face common events such as falls, pressure injuries, and hospital-acquired infections (HAIs), leading to adverse outcomes for both patients and hospitals. The Center for Medicare and Medicaid (CMS) has designated various nurse sensitive indicators as "never events," pressuring hospital leaders to achieve zero falls, pressure injuries, and HAIs. Direct patient care nurses play a crucial role in contributing to these zero-harm goals. However, intense messaging from hospital administration can lead to nurses developing fears related to patients at risk, resulting in disengagement and unintended consequences on patient care.

To address these challenges, a comprehensive nursing quality improvement and informatics initiative was launched, utilizing lean six sigma methodology, high-reliability and zero-harm principles integrated with core principles and practices of clinical informatics. This initiative aimed to reframe efforts to improve nurse sensitive indicators, fostering deep engagement among multidisciplinary care teams. As a result, zero-harm indicators have shown significant improvement, with operational costs attributed to falls reduced by 35% in the current year compared to the prior year's estimated cost of over 1 million US dollars. Additionally, the system is on track for 20% fewer falls and 20% lower cost per fall compared to the previous year. Falls prevention and mobility enhancement practices will be highlighted.

Moreover, through the application of lean six sigma methodology and clinical informatics workflow analysis, the initiative identified the prevalence and contributing factors of pressure injuries, leading to a positive return on investment. This allowed for the implementation of two full-time equivalent certified wound, ostomy, and continence nurses (CWOCNs) and skin champions unit RN coverage for all acute care medical surgical and critical care units.

The nursing quality and informatics framework also tackled the issue of HAIs through identification and root cause analysis, securing external national grant funding and achieving over 500 days since the last catheter-associated urinary tract infection (CAUTI) or central line-associated bloodstream infection (CLABSI). This framework demonstrated how lean six sigma practices and clearly defined clinical informatics processes enhance nursing care teams' performance with standardized reporting, consistent case reviews, and clinical workflows, ultimately empowering the direct care nursing team.

This presentation will present a nursing quality and informatics framework, supported by lean six sigma methodology, high-reliability principles, and effective clinical informatics for three demonstration cases falls, pressure injury and c-difficile to illustrate the effective pathway to zero-harm nurse-sensitive indicators, reduced operational costs, and increased patient safety. This approach serves as a model for other healthcare systems aiming to achieve excellence in patient care outcomes and nurse engagement through tightly integrated clinical informatics principles with high-reliability methodology.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.

P027 - Leveraging the Metadata of Physiologic Clinical Alarms to Impact Alarm Management, Patient Safety, Utilization, and Staffing

Kyle Karajankovich, MS, RN, NI-BC, CEN, CPHQ | Jennifer Rist, MBA

Tags: informatics metadata safety query alarms

Updated: 05/06/24

Reducing patient harm associated with clinical alarm systems is a national patient safety goal that is a multifaceted problem, requiring systematic and interdisciplinary coordinated solutions. A means to developing a coordinated solution is to leverage physiologic clinical alarm data queries that provide actionable insights. The rich metadata associated with physiologic clinical alarms can be used to develop queries with vast operational use models. These use models should be accessible to a wide range of professionals, including the bedside caregiver.

A foundational alarm query with numerous use models is alarm load. As opposed to aggregated counts of alarms, alarm load rationalizes alarm volume to alarms per monitored bed day. Simply the number of alarms divided by monitored bed days. Filters such as time, unit, bed, and institution can be applied to this query. This query allows an end user to benchmark alarm data, or alarm management methodology, between filter criteria elements. Often unit leadership will benchmark their alarm load queries between like units to gain insights on how unit practices and monitoring utilization may impact clinical alarm management between units.
The high-risk nature of clinical alarm management provides an opportunity for informatics professionals to evaluate alarm queries used in other high-risk fields. Alarm floods defined by the American National Standard Institute (ANSI) as 10 or more annunciated alarms in a 10-minute period per operator is a query that has utility in health care. Alarm floods have the potential to exhaust a caregiver's situational awareness and negatively impact decision-making. The metadata of alarm annunciated time, end time, and caregiver assignment can be used to generate this query. A potential use model for this query is within the care environment level. A charge nurse can utilize this query to adjust staffing levels to better care for high-acuity patients with multiple alarm floods and support staff cognitive demands while caring for these patients.

Caregiver response to physiologic clinical alarms is centric to an institution's alarm management methodology. Measuring the time a caregiver takes to respond to an alarm requires the metadata of alarm type, alarm start time, alarm stop time (from an intentional action), and data points for contextual filtering, such as unit, bed, and alarm severity. The response time can be calculated as an average with a contextual filter applied, such as unit, bed, and severity, to provide additional meaning. Various professionals at an organization can use response times to evaluate if alarms are meaningful, staffing is appropriate, or the policy supports response. Evaluating alarm queries related to nuisance alarms and how alarms terminate or end may complement alarm response queries.

Viewing physiologic clinical alarms as data rich with metadata provides an informatics professional with a sense of creativity in developing alarm data queries. The informatics professional should strive to develop use models for these queries that all levels of an organization can operationalize.

Kyle Karajankovich discloses that he is an employee of Philips Healthcare.

Jennifer Rist discloses that she is an employee of Philips Healthcare.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.

P026 - Nursing Informatics Integrating Science, Technology, Data for Improving Patient Throughput

Deborah Chasco, NEA-BC,CCRN, DNP, CNS, APRN, Director Nursing Informatics, University Medical Center of El Paso

Tags: data technology SDoH throughput TOC

Updated: 05/06/24

Patient throughput benefits can be seen in the literature under peer-reviewed journals. Patient throughput efforts provide for an efficient flow of patients through the hospital or a healthcare organization, ensuring timely and appropriate level of care while improving the quality of patient care and the patient hospital experience and providing positive financial impact. Why do organizations continue to struggle with patient throughput? How can nursing informatics change the course? These are the questions that this poster will attempt to answer based on the data and results from a community academic safety net hospital located in the Southwest.

The challenges faced with throughout in a rapidly growing 355-bed acute care hospital with 11 neighborhood health clinics, a main emergency department seeing over 2000 patients daily with 2 additional freestanding emergency departments that will soon be expanding to a third freestanding emergency department and a free standing children’s hospital will be examined in this poster presentation. In addition to additional space and bed availability, the patient population cared for are 28% over the national average for other like hospitals in the nation. Follow-up and continuous process improvement with real-time data from various service lines and care teams to address decreasing the cost of caring for the most vulnerable and high-risk populations while decreasing adverse health outcomes that can be impacted by social determinants of health (SDOH) and expediting care effectively, efficiently, and timely to meet patient and family healthcare needs while addressing CMS and other regulatory agency requirements.

This poster will investigate change theory, PDSA, and agile methodology in process improvement to address throughput challenges at this Southwestern healthcare safety net organization and examine the data toward meeting throughput strategic goals with nursing informatics integrating science through telehealth in both ambulatory and acute care settings to include the emergency departments, integration of electronic systems and processes, research and science application, and data analysis and validation for real-time bedside decision making to expedite care effectively while providing safe and quality care in working with several healthcare teams. This poster will focus on the four values of agile methodology to include individual and team member leads over processes and tools, work on software and comprehensive documentation via the electronic healthcare record and interfaces, clinical team input from all clinical settings and care providers (physicians, nurse practitioners, residents, nurses, administration, essential health care teams from environmental services, radiology, pathology, lab, health information management, vendors, quality management, patient experience teams, contract services, fiscal, community outreach, information technology, strategists, engineers) to assess and work with the tools being implemented to improve processes, and rapid response to change process to shift strategies on a continuous basis. This poster will compare what this healthcare system has implemented and succeeded with throughput while addressing continued challenges experienced and compare findings to other national healthcare organizations and their success with throughput based on literature review and current research on throughput.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.

P025 - Improving Outpatient Medication Administration Safety

Binni Hagstrom, DNP, RN-BC | Diane Salbego, MSN, RN, CGRN

Tags: barcode safety Quality ambulatory medication

Updated: 05/06/24

Background: As with most ambulatory care settings, this academic institution lacked safe patient medication administration technologies available to the inpatient areas that reinforced best practices of scanning medications or vaccinations upon administration at the bedside. Errors of wrong medication and vaccination being administered to patients in the outpatient setting were identified through reporting from the medication safety committee when orders did not match medication administration documentation. A new EHR implementation prompted ambulatory care services to request barcode medication scanning technology for all ambulatory care clinics to facilitate safe patient medication administration.

Methods: Barcode medication administration was implemented in all 26 outpatient clinics in an academic institution to facilitate medication safety practices and reach 95% compliance congruent with LeapFrog standards of success. Monitoring and tracking the utilization of barcode medication scanning upon implementation identified that there were systemic issues with nursing knowledge in utilization of the technology, the importance for safe patient medication administration practices, and importance of adherence to identified workflows. Pre-data showed that medications were only being scanned approximately 35% of the time and immunizations 65% of the time. This led to a project manager being assigned to improve nursing practice in medication administration which adheres to prevention of errors and safe administration of medications to patients through utilization of barcode scanning.

Analysis: Post-evaluation of baseline metrics, a re-competency program for all existing nursing staff was developed to include skills return demonstration, problem solving strategies on equipment, processes for reporting equipment, medications that do not scan, or workflow impediments. This education was integrated into new hire orientation for all oncoming staff. Identification of barriers and gaps led to process improvement changes and communication to nursing staff that did not adhere to workflows. Monthly metrics were presented to ensure constant feedback. Ongoing issues were discussed in a governance structure with pharmacy and nursing operations to create sustainability in the project.

Outcomes: Ambulatory care nurses have achieved and maintained compliance >95% for medication and vaccination administration from August 2021 to March 2023. Medication administration safety practices are adhered in the outpatient setting and continue to improve the patient experience and safety in a fast-paced environment.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.

P024 - Analysis and Optimization of Titratable Insulin Infusions to Improve Nurse Workflow and Patient Outcomes

Kristen Calaug, MSN, RN-BC, CNE

Tags: project management analytics interdisciplinary best practice diabetes

Updated: 05/06/24

EHR instance consolidation provided a unique post-merger opportunity to align titratable insulin infusion practice across over 50 hospitals and freestanding emergency departments. While significant literature has been published comparing paper-protocol and homegrown external calculator transitions to an EHR-imbedded titratable insulin infusion calculator within a single department or hospital, literature comparing an EHR-imbedded algorithm against proprietary FDA-approved software and across a sizable health system with varied pre-intervention states is lacking. Bon Secours Mercy Health’s (BSMH) varied “prior state” (multiple paper protocols and two different vendor programs) provided a unique opportunity to aggregate pre-/post-intervention data comparing a standardized imbedded algorithm against a wide variety of evidence-based tools (as opposed to a single pre-intervention workflow).

Across this endeavour, nursing informatics worked to design and optimize analytic tools to evaluate effectiveness of the aligned approach during a controlled pilot, then ensure safe expansion across the remainder of the health system. Clinician feedback via weekly touchbases and associate survey allowed for consideration of qualitative findings. Both sets of data proved useful in calculator optimization. Examples of optimization from quantitative data analysis include elimination of an ISC (insulin sensitivity coefficient)/multiplier reset as well as elimination of infusion pause for blood glucose values below target range, but not hypoglycemic. These features were standard in the original algorithm BSMH selected for use; however, they did not align with prior paper protocol or proprietary system behavior – and appeared to decrease time in target range while also increasing anion gap in diabetic ketoacidosis (DKA). Examples of optimization from clinician feedback include development of condition-specific, evidence-based target ranges (to enable use of the calculator across departments for all titratable insulin infusions) and development of blood glucose alerts for ED and IP nurses, with the potential to build out as push notifications. Reminders to switch to dextrose-containing IVF when blood glucose has reached 250mg/dL or below for DKA and hyperosmolar hyperglycemic syndrome (HHS) is another example. This quantitative/qualitative interdisciplinary approach has allowed BSMH to transition to the imbedded calculator with confidence, maximize clinician buy-in, improve patient outcomes, and reduce vendor cost/reliance.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.

P023 - Right Alerts to the Right People at the Right Time: Redesigning Alarm Notifications

Christopher Magdelinskas, MSN, MA, RN-BC, CNL, CEN | Lauren Piech, DNP, MPH, RN-BC, HN-BC, NEA-BC, Director of Cardiac Services, Valley Health System

Tags: alarm fatigue alarm management alerts physiologic alarms

Updated: 05/06/24

Purpose: To reduce alarm fatigue in hospital staff by identifying system-wide processes for managing all alarm alerts in the technology design of a new hospital to support an interconnected “smart” healthcare facility. Research supports the prevalence of alarm fatigue and its impact on patient safety; however, managing alarm alert systems in the clinical area remains a challenge. The existing hospital technology network notification system lacks a paradigm in place to quantify the total volume of alarms in all patient care areas creating a challenge in reducing alarm fatigue.

Description: Using a plan-do-check-act (PDCA) model as a framework, a quality improvement project was conducted to reduce alarm fatigue for hospital staff by quantifying the number of alarm alerts delivered to all staff members to evaluate if the appropriate alarm alert was delivered to the right person at the right time. Analysis of the current state identified opportunities for improvement in the multidisciplinary membership of the alarm management committee (AMC) and expansion of existing organizational policies which focused exclusively on cardiac monitoring alarms, lacking a formal awareness of all the alarms throughout the nursing units. To initiate the project, nurse informaticists were invited to join the AMC, which previously only included members from bio-engineering, information systems, risk management, and clinical registered nurses. Next, an audit of current alarms and workflows, performed by the AMC, revealed a 20-fold increase in documented alerts and alarms when evaluating all sources (paging, medical alerts, engineering, security, patient signs, etc). A matrix was established to identify all clinical alarms and prioritize alarm alerts by leveraging the functionality of new hospital technology (mobile devices, companion applications, centralized staff assignments, real-time location systems), to remain in compliance with organizational policies and The Joint Commission patient safety goals. Through a broader analysis of new vendors and potential alerts/alarms, creative solutions were required when reviewing requirements and designing new workflows to reduce alarm fatigue for all alarms.

Through integrated technologies, alarms are now funneled into a system that can identify the right staff member, target the device, deliver alarms, and provide positive confirmation of receipt and escalate to other clinical staff as needed. Employing logic in escalations reduces the redundancy of alerting the entire unit, providing a significant reduction in alarm notifications to all personnel involved.

Evaluation: This project will afford the AMC and clinical managers the infrastructure to continuously quantify and analyze all existing alarms for the continued sustained efforts in alarm fatigue reduction in the new hospital.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.

P022 - Meeting Informatics Needs for TogetherCare (MINT): A Collaborative Approach to Refresher Training

Rachel Grady, MSN, RN-BC, OCN

Tags: electronic health record implementation refresher training

Updated: 05/06/24

In January 2020, Trinity Health Michigan took a “big bang” approach, and transitioned 9 hospitals, 13 outpatient medical centers, and 11 emergency departments to a single, shared electronic health record (EHR). In March 2020, the COVID-19 pandemic set hospitals into disaster mode charting and deployed many users to areas they did not normally work, as office visits and procedures were canceled. During a time that users should have been cementing in new learning, they were, instead, learning how to provide care in a pandemic setting. Our EHR vendor recommended refresher training within 3 months of go-live; however, given pandemic restrictions this was not achievable.

With the post-pandemic transition back to our new normal, we quickly learned that the pathway to grant access to the electronic health record (EHR) system is relatively straightforward: complete online learning modules, then attend a live class or satisfy a test-out method. This training focused on educating end users on the basic functionality of the system: chart review, admission, discharge, blood administration, and so on. Then, the user received some personalization assistance and/or coaching by a preceptor. Time spent in personalization or with a preceptor is critical, because classroom training fails to speak to the workflows utilized by the end users within their unique departments. Generic training generates workaround and negative feelings towards the HER. Carson et al. (2021) identified this training gap when onboarding nurse leaders and charge registered nurses (RN) and designed training focused on their roles in the department. This intervention generated improved knowledge for those nurse leaders; however, Trinity Health Grand Rapids lacked a specific plan on looping back with end users regarding: quality/regulatory measures, efficiency training, upgrade information, and more, after the initial personalization and preceptor time was completed. Finding the time to pull a user back into a classroom setting proved difficult, too, in lieu of the pandemic, and staffing shortages.

We identified the need to provide ongoing training, and staff provided the feedback that they wanted to experience this training at-the-elbow, so we developed a refresher training program focused on embedding knowledge experts into the units themselves. While nursing informatics (NI) provided the structure and content, bedside staff involvement was the key to success. Department leads meet directly with NI to receive information monthly and then disseminate it to their units. Since team members actively provide bedside care, they sometimes contribute ideas on efficiency, and often, identify which topics need to be reviewed. Freeman and Wilson (2023) identify that we should work to incorporate our bedside staff as “the subject matters experts” (p. 6). With nurse leader and clinical ladder support, it was relatively easily to embed our program into the department, and garner participation. Since April 2021, program successes include covering over 30 topics between inpatient, emergency, and surgical areas; pathway for updating and educating end users; blueprint for additional ministries going live to follow, for their own refresher programs; and increased staff awareness of informatics resources.

Learning Objective:

After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.