The Nursing Informatics Implementation Guide 1st Edition by Eleanor Callahan Hunt, Sara Breckenridge Sproat, Rebecca Rutherford Kitzmiller 0387408371 9780387408378

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ISBN 10: 0387408371

ISBN 13: 9780387408378

Author: Eleanor Callahan Hunt, Sara Breckenridge Sproat, Rebecca Rutherford Kitzmiller

Health institutions are investing in and fielding information technology solutions at an unprecedented pace. With the recommendations from the Institute of Medicine around information technology solutions for patient safety, mandates from industry groups such as Leapfrog about using infor­ mation systems to improve health care, and the move toward evidence­ based practice, health institutions cannot afford to retain manual practices. The installation of multi-million dollar computerized health systems repre­ sents the very life blood of contemporary clinical operations and a crucial link to the financial viability of institutions. Yet, the implementation of health information systems is exceptionally complex, expensive and often just plain messy. The need for improvement in the art and science of systems implemen­ tation is clear: up to 70-80% of information technology installations fail. The reasons are multi-faceted, ranging from the complexity of the diverse workflows being computerized, the intricate nature of health organizations, the knowledge and skills of users to other reasons such as strategies for obtaining key executive support, weaving through the politics peculiar to the institution, and technical facets including the usability of systems. Thus, the art and science of successfully implementing systems remains deeply layered in elusiveness. Still, given the pervasiveness of system implementa­ tions and the importance of the outcomes, this is a critical topic, especially for nurses and informatics nurse specialists.

The Nursing Informatics Implementation Guide 1st Table of contents:

Chapter 1: Implementation Overview

System lifecycle

Select system

Form project team

Determine project scope, time line, and budget

Determine stakeholders, build support

Assess risk

Customize the system

Train all users of the system

Deploying the system to users

Evaluate implementation, software, and use of system

Maintain, enhance and install upgrades

Start again

The semantics of project and system implementation

Implementation strategies

Big bang implementation

Parallel implementation

Phased implementation

Pilot approach

Organization of this book

References

Chapter 2: Nursing Informatics Overview

Introduction to nursing informatics

What is informatics?

History

Education and certification availability

Informatics nurse competencies per ANA scope and standards of practice

In summary

References

Chapter 3: The role of the informatics nurse in a computer system implementation

The informatics role in implementing systems

Responsibilities

Scope of implementation role

Information needs

Coordinating department-level needs

Coordinating patient care information needs

Coordinating organizational information needs

Data collection

Communication

Technical skills

NI skills development

System selection

Project management

Software customization

Training

Software and hardware deployment

Maintenance, support, evaluation

Responsibilities summary

Relationships

Relationship building

Communications

Departmental involvement

Reporting structure and job title

Relationship summary

Job descriptions

Analyst

Manager

Director

Chief information officer

References

Chapter 4: System Selection

Overview

Selection team

Selection team formation

Selection team tasks

Technology History

Needs assessment

Conducting the needs assessment

Impact of regulations, reports, and watchdog groups

RFI and RFP

RFI format

RFP format

Deadlines

Evaluation process

Vendor information gathering

Vendor visits or vendor fairs

Scripted demonstrations

User interviews (vendor and capability awareness)

Site visits

Making the decision

Choosing the vendor

Formal evaluation systems

Methodology approaches

Deciding what to buy

Contract negotiations

Key points

Transition to project implementation

In summary

References

Chapter 5: Project Scope, Time line, and Budget

Project scope

Understanding & definitions

Symptoms of scope creep

Managing scope

Strategies to avoid scope creep

Managing buy-in and the question “what is in it for me”

Scope changes in different-sized projects

Change management database

Managing attitudes: this is the way we have always done it

Project time line

Planning

Work plan

Planning documentation

Estimating work to be done

Implementing and executing control

Hardware considerations

Date setting

Forward and reverse planning

Timeline set in stone

Common misconceptions of planning

Project budget

Project evaluation and learning

References

Chapter 6: Political Landscape

Political landscape of the organization

Strategic goals

Organizational culture

Organizational culture defined

Politics at its best

Decision-making

Working in a changing organization

Garnering project support

Identifying project stakeholders

Advocates and resisters

In summary

References

Chapter 7: Risk

Identifying risks, barriers, and opportunities

Changing organizations

Change management

Observations of change efforts in health care

Project risk management

Risk identification

Risk analysis

Risk response

Risk monitoring

Creating a change ready organization

Project communication management

Information flow

Communications planning

Information distribution

Performance reporting

In summary

References

Chapter 8: Product Customization

Configuration and customization

Vanilla products

Beyond the vanilla

Requirements gathering

Workflow analysis

Processes and models

Systems perspective

Workflow questions

Using super users

Integrating standardized terminologies

Requirements analysis summary

Making the changes

Testing

Testing categories

How to test

Quality activities

In summary

References

Chapter 9: Training

Planning

Evaluating training needs

Needs assessments

Scheduling

Budgets

Materials

Adult learning theory

Learning styles

Personality styles

Creating a learning environment

Training methods

Teacher-led learning

Self-paced (self-directed or autonomous) learning

Traditional learning method

Computer-based training

Just-in-time training

E-training

Video-based training

Print-based materials

Audio-based learning

In summary

References

Chapter 10: System Deployment

Deployment plan

Go-live date

Implementation strategy

Time-line considerations

Organizational culture

Resource availability

Software

Vision, mission, goals

Training needs

Hardware deployment

Renovations

System hardware requirements

Team effort

Deployment checklist

Software deployment

Software version and upgrade controls

Software freeze

Testing

Deployment testing

Practice system

Preload preparedness

Documentation

Communication with users

Policy and procedure development

Supply ordering

Staffing and support

Vendor support

Fixing problems

Help desk

Backout planning

Celebrations

In summary

References

Chapter 11: System Evaluation

System evaluation

Evaluation of the system implementation process

Postproject team review

Conducting a postproject review

Communicate with the team

Choose a setting

Conduct the review and document lessons learned

Evaluation of system effectiveness

Product performance

System use

Product improvement

Evaluation of return on investment

Identifying quantifiable measures

Evaluation timing

Evaluation publication

References

Chapter 12: System Maintenance

Planning for system maintenance

Ending a project

Completing

Closing

Leaving

Transition the team to maintenance

Complexity theory defined

Team dynamics

During an implementation

After an implementation

Maximizing maintenance team productivity

Risks of equilibrium

Regaining productivity

Simple rule sets

Diversity

Increasing accountability

Self-organization

In summary

References

Chapter 13: Organizational Project Planning

Organizational project planning

Identifying roles

Finalizing project requirements

Breaking down the work into manageable elements

Innovation versus standardization

Assigning work responsibilities

Project staff acquisition

Resource loading and leveling

Enterprise project management

EPM defined

Project summary

Step 1: Strategically thinking about projects

Step 2: Managing the portfolio of projects: requesting resources

Step 3: Building project plans

Step 4: Tracking project progress

Project team dynamics: the art of managing and leading

Skills for the project manager as the leader

Prioritization

Running effective meetings

Improving project communications

Using communication skills to manage conflict

Influence, power, motivation, and effectiveness

Power as a motivator

Team dynamics and team development

Team building

Individual motivation and effectiveness

Reward and recognition systems

Project management tools

Project tracking and presentation

Databases

In summary

References

Chapter 14: Software Development

Software development

Software terminology

Software development process

Languages

Methods

Notations

Other environments

Unified modeling language™ example

In summary

References

Chapter 15: Data Security and Legal Considerations

Medical records

The medical records committee

Legal department

Accreditation and certification

Regulatory bodies and state boards

Regulatory compliance

Pending trends

Data security

Backup and recovery

Downtime scenarios: short and extended

In summary

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