Purpose: This poster highlights the creation of a nurses in support roles (NISR) council designed to support non-traditional nursing roles like nursing informatics within a safety-net hospital. The council offers a dedicated platform for nurses in supportive, non-direct care roles, allowing them to collaborate, develop professionally, and advocate within the hospital system. These nurses, who work in areas such as infection prevention, health information management, nursing operations, and nurse navigator, often operate in isolated or remote positions. The council’s purpose is to bridge the gap between bedside practice and operational nursing, promoting collaboration and enhancing the role of support nurses in overall patient care. Through initiatives focused on mentorship, leadership, professional certification, and interdisciplinary collaboration, the council strengthens the hospital’s shared governance model, empowering nurses to contribute their expertise and support healthcare delivery effectively.
Relevance/significance: Nurses in support roles have specialized needs for communication, professional growth, and knowledge sharing. Unlike bedside nurses, they often work in siloed positions, with limited natural opportunities to collaborate across the organization. Many support-role nurses operate remotely, making professional interaction more challenging. Support nurses play a vital role in enhancing patient care, ensuring regulatory compliance, and driving organizational change. Yet, they are often under-recognized due to their indirect patient care functions. The NISR council addresses this by fostering a structured, supportive environment where these nurses can connect, share knowledge, and contribute more visibly to the organization’s mission.
Strategy/implementation: A survey was conducted among nurses in support roles to identify interest and establish goals, with 154 responses indicating a strong desire for mentorship, improved communication, and professional recognition. Based on these findings, the council was created, with a charter and executive sponsorship from the chief nursing executive (CNE), who actively participates in meetings. Co-chairs rotate on a two-year basis to ensure mentorship and sustained leadership within the council. The council meets monthly, with agendas featuring job role-sharing to educate members on each support role, updates from the CNE, and celebrations of accomplishments. The council has also introduced the "bluebonnet award," an internal peer-nominated accolade that recognizes outstanding contributions by nurses in non-direct care roles.
Evaluation/outcomes: The council has successfully met its membership goal, with an average monthly attendance of 32 participants through a hybrid meeting model. Survey data show high levels of engagement, with members reporting increased certification achievements and feeling recognized through awards. Council activities have expanded to community-focused initiatives.
Conclusion: The NISR council has established a vital community for nurses in support roles, fostering professional development, collaboration, and recognition. This council demonstrates the importance of shared governance in engaging and empowering non-traditional nursing roles, ultimately enhancing the healthcare team’s resilience and effectiveness. Through this model, the council supports the organization’s mission of collaborative, compassionate care and sets a precedent for recognizing and leveraging the contributions of support-role nurses.
In today's rapidly evolving health IT landscape, informatics educators must understand the diverse learning styles across generations, particularly when educating new clinicians on the use of electronic health records and other technology support applications for patient care. This presentation explores the learning preferences of baby boomers, generation X, millennials, and generation Z and how technological advances over the years have influenced these learning styles. This discussion underscores the application of theoretical frameworks and their significance in understanding generational learning preferences. These insights will better equip informatics educators to integrate these differences into their teaching practices.
As educational landscapes evolve, the differences in how generations engage with technology can present challenges for informatics educators. A growing technology gap reveals disparities in digital literacy, emphasizing the need for tailored approaches to create inclusive learning environments. Baby boomers often prefer traditional and structured learning environments. Generation X, referred to as digital immigrants, prefers a combination of traditional and technology-based learning methods. Millennials, having grown up during the rise of the internet, favor interactive, collaborative, and technology-driven learning environments. Generation Z prefers multimedia and immersive learning experiences facilitated by modern technologies.
Considering these generational differences with theoretical frameworks on adult learning and technology acceptance, informatics educators can better understand learning needs in group and individual settings and structure educational scenarios based on the clinician being taught. Utilizing the technology acceptance model (TAM), educators can predict user acceptance of a technology by assessing "perceived usefulness" and "perceived ease of use" from the end user's perspective. This can facilitate the ability for informatics educators to better understand opportunities for growth among generations that may be less familiar with technological innovations, fostering an environment that supports digital literacy development. Informatics educators can apply Malcolm Knowles' andragogy, or adult learning theory, by adapting instructional strategies to address varying levels of digital literacy, implementing technology-enhanced learning, and promoting greater inclusion and engagement among diverse age groups.
By synthesizing these generational characteristics, this presentation proposes tailored educational strategies that leverage each generation's preferred learning methods to enhance learner outcomes. It underscores the importance of adaptive teaching methodologies that cater to each generation's unique needs, ensuring clinicians of all ages can effectively master new health technologies. This presentation will provide educators with actionable insights to help bridge the technology gap, making technology-based training more accessible and effective for a diverse workforce.
This poster will discuss the implementation of patient wearable technology to monitor patients ECG rhythm and vital signs in ED waiting areas until they are able to get to a monitored bed. The wearable integrated technology has provided a safer patient environment by allowing continuous monitoring of higher risk patients, thus decreasing negative outcomes for patients with long ED wait times.
The improved outcomes of this implementation include the ability to monitor patient vital signs and ECG rhythm of higher risk patients that are in the ED waiting room, EMS offload areas, and continuous flow areas. This allows clinicians to see if a patient's condition is declining prior to the patient being placed in a monitored ED bed that has central monitoring. The wearable technology has provided a decrease in negative outcomes for patients with a longer wait time for an ED bed.
The problem we are trying to address is negative outcomes in an overcrowded ED waiting room due to the lack of available monitored beds in the ED. With this wearable technology integrated with our EHR, a central monitoring system will be available for patients that are scattered across several waiting areas within the ED as well as hallway beds. This will provide clinicians with real-time viewing of the patient ECG tracing as well as automatic interval vital signs, such as o2 sat and blood pressure reading. If a patient's vital signs start to decline, the clinicians will be able to respond immediately and provide potential life-saving interventions. Research articles report that the sooner life-saving interventions can be implemented, the higher the chance of a positive outcome for the patient.
Purpose: Implementing a third-party inpatient hospice program improves patient outcomes and reduces mortality rates, but the discharge-readmit workflow is complex and error prone. Learn how Stanford enhanced the standard discharge-readmit toolset to address these problems, with notable success at our community hospital.
Description: Integrating a comprehensive inpatient hospice care model within a community hospital involves multidisciplinary collaboration and teamwork among physicians, nursing, case management, social service, and community partners to be successful. It is a transformative approach to end-of-life care for a patients and their family, including bereavement process, that aligns with an academic framework to ensure rigorous, evidence-based standards.
This poster addresses the pressing need for compassionate, effective hospice care within community settings, a need that becomes even more critical as hospitals face increasing demands for quality end-of-life support. In alignment with Stanford Health Care's academic framework, this approach bridges high-quality patient care with a robust technical implementation of discharge-readmit toolset to guide the users in making it both practical and replicable.
In many community hospitals, hospice care services may lack standardization, often resulting in fragmented care, lack of early goals of care conversation with a patient and their family, unmet patient needs, and unnecessary hospitalizations that diminish patient quality of life. The challenge lies in establishing a model that not only provides compassionate end-of-life care but also integrates effectively with the existing medical and academic frameworks. This topic responds to that need, aiming to create a seamless, holistic approach that addresses both the emotional and medical needs of patients while reducing strain on hospital resources.
Implementing a GIP program with a hospice vendor requires two Epic encounters with unique HARs. Discharging patients from the original encounter and readmitting under a new HAR is a complex workflow with many moving pieces, and before implementing our novel solution for GIP, encounters often lacked a unique HAR and required manual chart correction post-discharge.
We partnered with our Epic inpatient and grand central teams to implement a novel order panel that automatically creates a pending preadmission with a unique HAR for the GIP encounter when the discharge-readmit order reconciliation tool is used. This innovative solution streamlines the technical components of this complex workflow and facilitates accurate admissions under the GIP service.
This model is innovative because it emphasizes a seamless integration of palliative practices within a community hospital, bringing interdisciplinary expertise to a traditionally underserved area. It leverages personalized care pathways and early intervention strategies to ensure patients receive timely, appropriate support, which not only enhances patient comfort but also reduces risk of unnecessary hospital admissions.
Outcome: Attendees will gain a detailed framework for implementing inpatient hospice care within a community setting, including strategies for aligning clinical practices with academic standards. By learning about early intervention methods, tailored care plans, and interdisciplinary collaboration, participants will be equipped to improve end-of-life care in their own hospitals. This approach not only enhances patient and family experiences but also optimizes hospital resources, ultimately leading to a more compassionate, effective, and sustainable model of care.
BJC’s clean sweep initiative marks a transformative approach to optimizing electronic medical record (EMR) documentation, particularly within high-traffic flowsheets. The BJC clinical informatics services (CIS) team presents a comprehensive strategy aimed at alleviating the excessive charting burdens faced by nursing staff. Through the utilization of Epic tools like Workflow Analyzer, Slicer Dicer, and NEAT, this initiative identifies non-clinical content and processes inefficiencies, significantly reducing the nursing documentation workload. Attendees will benefit from insights into the project timeline, clinician feedback, and preliminary outcomes that illustrate improvements in nursing efficiency and patient care quality. The presentation will underscore the importance of a “less is more” philosophy, exemplified by the streamlining of care plans to adhere to the “within defined limits” (WDL) concept, minimizing documentation clutter while enhancing compliance with regulatory standards. Participants will learn about the collaborative processes between clinical informaticists and front-line clinicians and how strategic data use drives sustainable changes in EMR practices, ultimately fostering a more inclusive approach to patient management.
As youth with chronic conditions are surviving longer into adulthood, their transition from pediatric to adult healthcare has become a challenge. This transition period is associated with worsening clinical outcomes, including morbidity and mortality, and heightened stress among caregivers and youth. Frameworks for improving the process of transition emphasize the importance of documenting key elements, such as independence goals, transition care plans, care transfer details, and tracking progress. Given the complexity of this transition, detailed documentation is essential to keep track of all this information and enable seamless communication and coordination among health team members. Academic frameworks around transition to adult care provide guidelines around what to track and encourage working within an EHR to develop the best system to achieve these goals.
Through experience in attempting to create a transition documentation tool at Ann & Robert H. Lurie Children’s Hospital of Chicago, it was found that documentation needs to be easy to enter and update through different visits and by various care team members over many years, customizable for each division, easily visible by numerous divisions, allowing for reportable data elements, and live on a patient level. This all needed to be balanced along with ease of build and maintenance. In response, a multidisciplinary team developed a transition to adult care smartform.
The smartform tracks transition preparedness based on the patient’s problem list and age, with questions customized for specific programs like lupus or diabetes. It features discrete data elements that integrate within the EHR, supporting departments tracking population health. For example, data can be queried to determine if a patient has transitioned to an adult provider, aiding the emergency department or transfer center which serve as hospital entry points. Attendees will learn about a potential solution that simplifies documentation of transition to adult care, making it easy to enter, view, and access, while meeting diverse needs across healthcare tams and facilitating reporting and data tracking.
Quality measures included clinician satisfaction, user knowledge of transition documentation, and documentation accessibility. A pre- and post-go-live survey were conducted in the pilot divisions of genetics and rheumatology, with responses from multiple disciplines, including advanced practice providers, genetic counselors, physicians, nurses, registered dieticians, and social workers. Regarding clinician satisfaction, 61% of respondents (n=24) were dissatisfied with their existing workflow. After the smartform’s introduction, 100% expressed satisfaction with the new process, which has currently been used on 33 patients.
User knowledge of transition-related documentation was also surveyed. Before the smartform, 44% of users were unsure where to document transition-related conversations, but after go-live, 100% “strongly agreed” that the smartform met their needs. Regarding accessibility, 43% of users reported difficulty finding their own documentation while 57% could not find other individual’s documentation. Post go-live, 100% of users found both their own and other individual’s documentation easy to locate. As the smartform has become a documentation standard, it will expand to more divisions, and pre- and post- surveys will continue to measure outcomes.
Purpose: This poster presentation examines the unique challenges of overnight remote-working nurse informaticists in maintaining a healthy lifestyle and offers practical tips for mitigating these effects.
Description: In 2020, the World Health Organization classified working night shifts as a probable class 2A carcinogen. Potential health risks associated with night shift work include circadian disruption, cardiovascular diseases, gastrointestinal abnormalities, mental health disruptions, and increased cancer risk. This is in addition to stress caused by technical issues, limited supervisory support, isolation, disconnection, and threats to work-life balance. This poster explores evidence-based strategies to promote physical, mental, and social well-being among these professionals. Learners will be able to identify strategies to promote physical, mental, and social well-being among overnight remote-working nurse informaticists.
Key recommendations include establishing a structured daily routine, regular check-ins with supervisors to maintain a sense of community and support, prioritizing health by incorporating regular exercise and a healthy balanced diet, adopting practices that prevent eye strain from prolonged screen time, and seeking support through networks and professional organizations to increase socialization and combat isolation and stress. By integrating these practices, nurse informaticists can enhance their overall health and productivity, ensuring they remain resilient and effective. The findings highlight the necessity for supportive measures to address the well-being of nurse informaticists, ultimately leading to better healthcare outcomes.
Evaluation/outcome: Implementing these evidence-based practices has enhanced overall health and productivity among nurse informaticists. Studies indicate that remote workers who maintained structured routines and prioritized self-care reported higher job satisfaction, lower stress levels, and enhanced work-life balance. Additionally, in the literature, maintaining social connections has been proven to mitigate feelings of isolation.
Organizations can empower clinical transformation at their sites by promoting a healthy work environment, acknowledging the health challenges faced by overnight remote-working nurse informaticists, and supporting them by encouraging a healthy work-life balance through employer-provided education on stress management, exercise, nutrition, and mental health. Employer-provided support services will help nurse informaticists manage stress and maintain well-being. These resources can be provided as annual mandatory education modules. Nurse leaders should use their position and influence to invest in these supports. By prioritizing these additional supports, employers can prevent burnout and ensure nurse informaticists remain engaged and motivated.
Purpose: The support of continuing education (CE) in nursing informatics professional organizations is vital for several reasons. Nursing informaticists need to be equipped for the ever-changing healthcare landscape. By being exposed to the latest trends, research, and innovative technologies, nursing informaticists can have a wider lens to see different perspectives. By prioritizing CE, professional organizations can cultivate their members to meet the challenges of a continuously shifting healthcare environment.
Description: National professional organizations and their local chapters strive to provide programs that enhance the knowledge of their members by offering education to support a culture of continuous learning. This is done by collaborating with educational institutions, healthcare organizations, and accrediting bodies. The pursuit for continuous learning will support professional development with certification achievement, career advancement, and personal growth.
However, there are also challenges that professional organizations face when developing CE programs, such as financial, operational, and expertise level of the members. Financial constraints can limit resources available for developing and delivering high-quality educational programs. Operational challenges with completing the application process and coordination of CE activities can be daunting. Furthermore, the organization's maturity may have an impact on completing the CE application process, as less experienced members may lack established networks and collaboration skills.
Evaluation: The effectiveness of CE programs in nursing informatics is shown through metrics like member engagement, certification rates, and program feedback. CE participation enhances informatics skills, improves patient care, and increases job performance. An artificial intelligence CE program is an example of a crucial topic, as it transforms nursing practice by improving safety, reducing errors, and increasing efficiency. Feedback indicates that CE engagement leads to higher job satisfaction and a motivated workforce.
Outcome: The findings highlight the importance of CE for nursing informaticists to maintain proficiency and proactively adapt to their roles. Prioritizing CE by professional organizations enhances member skills, raises nursing informatics standards, improves patient care, and strengthens the healthcare system. However, financial and operational challenges need addressing. The research advocates for increased investment in CE to prepare nursing informaticists for future healthcare challenges.
Next steps: To maximize the impact of programs offering CE, professional nursing organizations should assess the learning needs of their members by using surveys. The results can guide the nurse planner to tailor the evidence-based CE programs and leverage technology.
The fall electronic medical record (EMR) tracking workgroup seeks to improve communication about patient falls between clinics and those in patient care roles. The desired outcomes are prevention and reduction in patient falls whether they occur within the Vanderbilt footprint or at a local shopping mall. This information is being utilized as a key driver to better address the safety needs of patients that are ween within our organization.
A historical falls data abstraction was completed in March 2023 to capture all falls from all ambulatory care areas from the previous 2 years. During the review and analysis of the data, it became evident that multiple patients were falling more than once across our vast geographical footprint. Often there was no communication between clinics regarding the fall, and sometimes the fall was not clearly documented in the EMR. Currently, fall risk assessments within the EMR only self-populate for patients 65 years of age and older. This fall risk assessment is encounter-specific and does not populate entries made in prior visits. Adult ambulatory care fall data highlights many patients under 65 years of age that fall within our ambulatory care footprint. In the first quarter of the 2024 calendar year, 21 patients under the age of 60 experienced a fall while visiting an ambulatory care clinical area. Additionally, the Falls Identification and Reporting in the Ambulatory Setting Standard of Practice states “The fall event, the patient assessment, and any interventions are documented in the patient’s medical record.” Currently many team members are not in compliance with this policy and fail to document a patient's fall within the EMR.
Front-line staff participated in a focus group to define the current state and strategize for quality improvement. This focus group identified information that should be collected and documented following a patient's fall and would remain in the chart for one calendar year. The desire was to make this documentation as quick and easy as possible for clinical staff. There are no hard stops within the falls tracking form, and it can be accessed either from within or outside of an encounter.
The following recommendations were made by the focus group: 1) Add the falls tracking documentation form to the intake tab, 2) launch storyboard notification if a patient is positive for a fall, 3) add the falls tracking documentation form to the quick navigator for falls occurring outside of the VUMC facilities, 4) add falls tracking print group to the outpatient whiteboard snapshot report, 5) embed the patient fall icon column on the outpatient whiteboard, 6) construct a smart phrase to help standardize documentation into clinical note, and 7) review historical falls over the last calendar year in the synopsis view.
Purpose: Virtual nursing is a forward-thinking care delivery model that leverages technology to engage patients while simultaneously supporting bedside nurses through administrative workload reduction. Providing more patient interaction time for meaningful connections while optimizing their workload directly contributes to nurse well-being and satisfaction.
Nursing faces challenges, such as administrative burdens, that detract from patient care and lead to burnout and nurse turnover. A virtual nurse program can alleviate workload, improve clinical nurse and patient satisfaction, and expedite discharge processes by early identification of patient needs. The virtual nurse program empowers bedside nurses to function at the top of their license, restoring their satisfaction and bringing joy back to their profession while increasing patient experience and quality of care through innovative nurse connections.
Description: Strategic planning and research began one year prior to the program launch, utilizing research and networking to determine project scope in this pioneering field of practice. Preparation included focused work group design sessions with bedside nurses, patient and family advisors, and ancillary teams to develop value-added and mutually agreed upon workflow and communication strategies. From those findings, the team partnered with information systems and informatics to test and explore opportunities that would maximize the patient interaction through user-friendly technology practices for both staff and patients. The virtual nurse program has grown to three of four system hospitals, in select units, with projection to be in all hospitals by winter of 2024 in acute, PCU, and ICU levels of care. The program is supported by 10 virtual workstations, co-located at system services to provide virtual visits 12 hours a day, five days a week.
Outcomes: Within 6 months, the team has delivered virtual care to over seven thousand inpatients, plus additional administrative support to the bedside team. The team has achieved patient experience scores up to the 99th percentile for communication about medicines, discharge information, and care transitions in patients with a virtual visit. Nursing satisfaction surveys and rounding demonstrate 75% agreeing the program adds to overall sense of accomplishment with their role and 83% experience time savings for other important care tasks. Patients receiving virtual visits have fewer excess days compared to the GMLOS and are experiencing less 7- and 30-day readmissions.