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Vol 20, No. 11, November 2016   |   Issue PDF view/purchase
Data Helps in Improving Nursing Practice, Making Better Decisions

We can’t imagine a world without nurses – it will be chaos everywhere in hospitals and other medical workplaces. They work together with clinicians, facilitating treatment and delivery of patient care. They are the ones on the frontline of healthcare services, saving countless lives and helping people as much as doctors do.

Nowadays, there is a lot more intention around leveraging big data to support clinical decisions in nursing. Most of the time, nurses require real-time information to make timely, critical decisions at point-of-care to patients. The use of big data technologies can help nurses improve care quality, reduce unnecessary procedures and human errors, therefore optimizing patient outcomes.

APBN interviewed Ms Michelle Troseth, who is a registered nurse, and is a prominent and influential leader in the nursing industry, and has been at the forefront of nursing informatics innovation. She brings with her 25 years of experience co-designing and implementing evidence-based practice and technology infrastructures to support patient-centered care.

Interview with Michelle Troseth

1. As the Chief Professional Practice Officer of Elsevier Clinical Solutions, what is your role or job responsibilities?

My role and responsibility is to be a visionary leader; bringing what happens in clinical practice to Elsevier, and thinking of how our solutions can be designed and integrated to meet the needs of clinicians who care for patients every day, and ultimately improve patient outcomes.

I spend time with clinical leaders to help them understand technology and the role that it plays. I also co-design systems with clients, and work with business owners and clinicians to build Elsevier’s portfolio of solutions into their healthcare systems.

I am also engaged in many professional organizations that benefit different professional practices. From these engagements, I am able to bring back to Elsevier different trends in the industry, which help us to make decisions, improve our solutions, and plan our strategy going forward. There is also a hands-on part of my role that comes in facilitating workshops for clinical executives. My role has provided me an exciting career that touches many people locally and globally.

2. What did you share at the HIMSS Asia Pacific 2016 held in Thailand?

Elsevier partnered Joint Commission International (JCI) to write a white paper on Clinical Practice Guidelines: Closing the Gap between Theory and Practice, so I had the opportunity to speak about it with a JCI principle consultant at HIMSS. We discussed the challenges of integrating evidence-based practices into the clinical workflow, and how to take published clinical practice guidelines and make them applicable in electronic health records. We also addressed common technology tools used in healthcare organizations such as clinical pathways.

During the session, I provided case study examples of how tools such as the Care Plan Guide, which contains a synthesis of clinical practice guidelines, systematic views and expert opinions, when integrated into the electronic health record, provides the evidence within the workflow and allows patients to have a voice in the way they are cared for.

Overall, it was a great experience sharing at HIMSS that evidence-based tools and evidence-based clinical decision support can work with electronic health records and we don’t have to recreate the wheel and figure it out ourselves.

3. What are some of the patient-centered plans/solutions provided by Elsevier?

To best achieve consistent and high value healthcare, all providers, students and patients must have access to the same current, credible, evidence-based information at all points-of-care, including non-traditional care sites such as the patient home and place of employment.

The challenge is that students, doctors, nurses, and patients interpret and adopt information differently. To help each of them make better decisions, Elsevier has developed a suite of integrated Clinical Decision Support*, Workflow, and Patient Engagement solutions, which present clinical content in formats that best empower the differing groups. Some examples of solutions we are known for include:

ClinicalKey – a powerful clinical search engine that delivers fast and accurate answers from a comprehensive database of evidence-based content to support physicians’ or nurses’ decision making at the point of care (www.clinicalkey.com/info/sea/)

Order Sets – an intuitive, cloud-based tool that enables clinicians and informaticists to author, review and manage order sets in a collaborative environment (www.elsevier.com/solutions/order-sets)

By presenting the same best practices in formats appropriate for differing users, and by delivering this information anytime and anywhere, Elsevier seeks to truly impact entire populations of caregivers, patients, and patient families.

*Note: Refer to www.elsevier.com/clinical-solutions

4. How is big data used in the nursing field?

Big data is used in the nursing field to enable nurses to make better decisions, whether it is caring for a single patient at a local level, or evaluating quality standards and identifying trends to make operational decisions at a broader nurse executive level.

Not having any data to evaluate practice is like throwing a dart in the dark – you won’t know exactly where things stand. But by creating data dashboards, digitalizing data, creating standardized big data and linking it with standardized terminology, we are able to look at trends in nursing and make decisions on nursing practice to improve quality, safety and cost effectiveness of healthcare.

5. What are some challenges of harnessing big data in the nursing practice?

It is not easy to get data out of electronic health records. It requires resources and the expertise of people who have the technical skills to extract data and the analytical skills to build reports.

The other big challenge is with inconsistencies in documentation and terminology, as well as documentation that is not evidence-based, which result in data that is difficult to collect and impossible to compare.

6. What do you think about digital health technology? Do you think it can help in providing more information to advance patient care and practices?

Digital health technology is critical to the future of patient care and clinical practice. A key advantage it provides is that it enables knowledge at the point of care. For example, clinicians and nurses can now use mobile devices to access evidence-based information at their fingertips, wherever and whenever they are needed, to help them make informed decisions. As patients take more ownership over their health and healthcare, mobile apps that integrate with healthcare systems can enable collaboration and empower patients to make shared decisions towards their health goals. Digital health technology can certainly contribute to providing safer, faster and better quality patient care.

About the Interviewee

Michelle Troseth, MSN, RN, DPNAP, FAAN Chief Professional Practice Officer Michelle is the Chief Professional Practice Officer of Elsevier Clinical Solutions. She has over 25 years of experience in co-designing and implementing evidence-based practice and technology infrastructures to support patient-centered care and interprofessional integration at the point of care across hundreds of healthcare settings. Michelle is currently co-chair of the TIGER Initiative Foundation (which stands for: Technology Informatics Guiding Education Reform) Board of Directors; she served as the TIGER Summit Program Chair, and co-led a national collaborative on Usability and Clinical Application Design. She is also the co-chair of the American Academy of Nursing's Informatics & Technology Expert Panel. Michelle is also on the Executive Committee as Treasurer for the National Academies of Practice (NAP) whose mission is to promote excellence in practice of healthcare professionals and quality healthcare for all through interprofessional collaboration in service delivery, research, education and public policy advocacy. Michelle has authored several chapters/articles and speaks on professional practice, evidence-based practice, technology and cultural transformation.

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