FOR THE CHIEF NURSE EXECUTIVE, CHIEF INFORMATION OFFICER AND INDUSTRY PARTNERS TO WORK TOGETHER TO LEVERAGE TECHNOLOGY TO ENHANCE CLINICAL OUTCOMES

Introduction identified challenges were more aligned than expected. When focusing on how to leverage Technology is crucial to the health care the relationships between nursing, information environment of the future. The integration of and clinical technology, and industry partners, technology into health care is occurring at a four principles emerged as ways to ultimately rapid rate and when leveraged appropriately, enhance clinical outcomes. These principles will be a major asset for health care reform; include: especially when used to enhance clinical outcomes. Success will be affected by the . Establish a culture of collaboration between presence of collaboration between the clinical the CNE, CIO, and industry partners. information technology (IT) department and the nursing department. This success can be . Build relationships and trust. further enhanced by including information . Create strategic and operational alignment. technology industry partners in strategic and . Establish a culture of collaboration for operational initiatives. innovation and transformation.

This document outlines the basis for establishing a successful relationship between Each of these principles were expanded to the chief nurse executive (CNE), chief provide a roadmap for how relationships can information officer (CIO) and industry partners. be developed in hospitals and health systems These principles were developed during a Day to leverage clinical and information technology of Dialogue that brought together CNEs from to the greatest degree possible. the American Organization of Nurse Executives (AONE), CIOs from the College of Guiding Principles Healthcare Information Management Guiding Principle #1 – Establish a culture Executives (CHIME) and industry partners of collaboration between the CNE, CIO and from Hill-Rom. Their task was to develop industry partners. guiding principles that outline how these three stakeholders can work together to achieve Goals enhanced quality outcomes for the patients and families we all serve. . Gain senior leadership commitment to work Each of the three stakeholders has a in collaboration to achieve the organization’s perspective on how they perform their work IT goals. Leadership should lead the way by and what they require to most effectively meet focusing on the critical goals for success, their goals. However, they don’t always share measuring what is important, and rewarding these perspectives, which could enhance their positive results. relationships. One starting point is to clearly . Create and articulate the model for articulate their varied perspectives so that communication and governance for IT there is mutual understanding and initiatives within the facility/system. This appreciation of goals and challenges. By gives the CNE and CIO clarity for how sharing goals and challenges during the Day communication will occur and how decisions of Dialogue, the workgroup that drafted these will be made—fostering transparency and principles discovered that among the knowledge of the process. It also assists stakeholders individual goals had more in industry partners to participate as an common than was originally realized and the FOR THE CHIEF NURSE EXECUTIVE, CHIEF INFORMATION OFFICER AND INDUSTRY PARTNERS TO WORK TOGETHER TO LEVERAGE TECHNOLOGY TO ENHANCE CLINICAL OUTCOMES

effective member of the team. Guiding Principle #2 – Build relationships . Identify a champion to take resonsibility for and trust between the CNE and the CIO. ensuring that the needed structures and support for collaboration are in place. Goals Building the infrastructure to support collaboration doesn’t happen by chance. . Create opportunities to “walk in each other’s Structure can assist the team in staying on shoes.” Because both roles are complex and track and working together. demanding, mutual appreciation for the . Establish role clarity and expectations. This challenges each faces is beneficial for provides necessary guidance for individual treating mutual understanding of how the responsibility and operationalizes the CNE and CIO can support each other. structure to support the collaboration. . Create shared values, camaraderie, Individual staff members should know their traditions and rituals. These are aspects of responsibilities and what they are culture that build strong relationships. For accountable for achieving. The full team example, attending outside meetings as a should understand who is responsible for CNE/CIO team provides the opportunity to different aspects of the projects to work together in a different way. streamline work processes. . Create a relationship competency . Create a common vision for the culture to compact—a “how to” for building and clarify expectations, structure and roles for maintaining collaboration. This compact all involved. Clearly highlight the path for provides an intentional agreement for how how parties will work to achieve the CNE and CIO will work together. collaboration as a means to leverage IT to . Role model integrity in every interaction as enhance clinical outcomes. The partnership a foundation for trust and success. The of the CNO and CIO should support ability and commitment to being truthful with collaboration within the staff teams and with each other is a critical component of the industry partners, delineating how to demonstrating trust. work together. . Plan and execute a trust building program using internal and external resources. Activities to Achieve These Goals Schedule protected time to deliberately work . Articulate an IT strategy that establishes on relationship building and don’t assume it metrics for success. will happen without focused intention.

. Coach/mentor staff to help and develop Activities to Achieve These Goals collaboration skills.

. Publicly identify, promote and reward . Develop templates or tools to help behaviors that drive collaboration. understand each other’s role and . Be cognizant of the skills/behaviors that responsibilities and define what current create organizational excellence and metrics and priorities are driving each collaborative practices. other’s work. . Leverage meaningful use to drive positive . Converge both clinical and IT scorecards organizational change. FOR THE CHIEF NURSE EXECUTIVE, CHIEF INFORMATION OFFICER AND INDUSTRY PARTNERS TO WORK TOGETHER TO LEVERAGE TECHNOLOGY TO ENHANCE CLINICAL OUTCOMES

and goals to develop organizational targets at all levels can understand. for alignment. . Assure strategic plan has alignment at each . Lead by example in displaying trust and level of the organization via goals, metrics, collaboration. and effective communication of initiatives to . Focus on what is working and build on achieve the plan. success. . Share departmental IT strategic plans . Invest the time to develop relationships and across the organization to promote trust. understanding among and between stakeholders. . Do not assume that trust happens without intentional effort. . Communicate well and often to highlight and drive alignment. Guiding Principle #3 – Create Strategic and . Create incentives to drive performance to Operational Alignment of IT Solutions. ensure alignment with strategy. . Position IT as a key enabler of the strategy. Goals . Create opportunities for face-to-face events to keep stakeholders focused on the overall . Hold regular evaluations of IT operational strategy and its success. plans and adjust tactics as a team. . Include key stakeholders in the planning Guiding Principle #4 – Establish process for IT solutions. This includes staff collaboration for innovation and at all user points—especially staff who are transformation. the end users of solutions. Start at the beginning of IT planning so the solutions are Goals validated by end users up front and not at the end of planning. . Create organizational budget plans that . Develop an inclusive roadmap for IT identify resources to implement innovation strategic planning that includes industry projects. Without financial support, partners. All have a stake in the success of innovation can be pushed to a lower priority IT implementation, and each brings a level, behind initiatives that have funding. different perspective. A team of CNE/CIO/ . Create rewards for innovation and quantify industry partners can integrate and align the impact. Goals for innovative projects along the planning map at appropriate and should include measures of success that key points. can be used to establish impact. . Tie every IT project to the organization’s . View suppliers and industry partners as strategic goals and plan. strategic partners. . Communicate consistently and effectively . Seek out new ideas and new people to on a cross-functional basis to maintain bring creativity and new thinking to the work. alignment of goals and objectives. . Use small tests of change for rapid cycle testing to experiment with innovation. This Activities to Achieve These Goals also encourages participation of all stakeholders and vets innovations at the . Translate strategies into stories so that staff point of service. FOR THE CHIEF NURSE EXECUTIVE, CHIEF INFORMATION OFFICER AND INDUSTRY PARTNERS TO WORK TOGETHER TO LEVERAGE TECHNOLOGY TO ENHANCE CLINICAL OUTCOMES

Activities to Achieve These Goals Summary These guiding principles speak to the need for . Bring in expertise from other industries to a strong collaboration between the CNE, CIO help stimulate new ideas. and industry partners. Together, these . Create structures to provide protected time professionals can work to positively impact to think and innovate. patient care and quality outcomes. . Leverage industry partners to aggregate Collaboration is not a specific project; it is an ideas into technology solutions. ongoing cultural value. CNEs, CIOs and industry partners all have the same goal of . Leverage generational influences within the improving patient care at the most effective organization. and efficient levels. Clinical and information . Develop incentives that encourage technology are both essential enablers for innovation. clinical transformation. . Promote pilot programs that help rapid cycle testing become more prevalent. Although the CNE/CIO/industry partners form . Encourage collaboration at the point of a critical team, it takes the entire organization service to stimulate innovation and facilitate to affect positive quality outcomes. Health care movement throughout the organization. leaders with common goals can work together to achieve these objectives, both with . View IT work-arounds as a driver for incentives and intrinsic motivation. Due to the innovation. converging challenges of health care reform, . Share successes and promising practices in now is the time to address these important a collaborative fashion. issues. Working collaboratively, CNEs, CIOs and industry partners can serve as leaders to leverage technology to enhance clinical outcomes.

Next Steps Prior to the release of these guiding principles, AONE first addressed the role of nurse leaders in technology with the development of the AONE Guiding Principles for Defining the Role of the Nurse Executive in Technology Acquisition and Implementation (2007) followed by the AONE Guiding Principles for the Nurse Executive to Enhance Clinical Outcomes by Leveraging Technology (2009).

In 2012, AONE outlined the emerging informatics role with the release of the position paper: Nursing Informatics Executive Leader.

FOR THE CHIEF NURSE EXECUTIVE, CHIEF INFORMATION OFFICER AND INDUSTRY PARTNERS TO WORK TOGETHER TO LEVERAGE TECHNOLOGY TO ENHANCE CLINICAL OUTCOMES

The inception of the nursing informatics Day of Dialogue participants executive leader role began with the (March 2011) increasing attention and focus on patient safety and quality reform, as well as AONE technology enablement introduced over the Pam Thompson past 10 years. The evolution of the nursing Chief Executive Officer informatics executive and other similar American Organization of Nurse Executives emerging roles appear to be running parallel (Washington, D.C.) with the shift from volume-based, fee-for- service delivery models to data-driven, value- Dawn Straub based models. New roles to address these Director, Nursing Professional Practice & needs are emerging at a rapid pace, including Development positions such as the chief nursing informatics The Nebraska Medical Center officer (CNIO and chief medical informatics (Omaha, NE) officer (CMIO). Pat Conway-Morana The intent of these new guiding principles is to Member begin a discussion on how to effectively work American Organization of Nurse Executives together to leverage technology with the three (Falls Church, VA) identified stakeholders—chief nurse executives, chief information officer and B.J. Bartleson industry partners. Although these stakeholders Director, Patient Care Services are critical, they are certainly not the only key Shriner Hospitals for Children, Northern leaders that are instrumental in the process. California Other C-suite leaders play a key role, (Loomis, CA) including the chief medical officer (CMO). Further resources will continue to be LaMont Yoder developed and will expand to include other Chief Nursing Officer key leaders. Vanguard Health Systems, Phoenix Baptist (Phoenix, AZ)

CHIME Kathleen Youngbar Vice President and Chief Information Officer Mercy Health Services (Baltimore, MD)

Novlet Bradshaw Vice President and Chief Information Officer Rex Healthcare (Raleigh, NC)

Raymond Adkins Chief Information Officer Peninsula Regional Medical Center (Salisbury, MD)

Linda Reed Vice President and Chief Information Officer Atlantic Health (Morristown, NJ)

Patricia Lavely Senior Vice President & Chief Information Officer Memorial Health, University Medical Center (Savannah, GA)

HILL-ROM Melissa A. Fitzpatrick Vice President and Chief Clinical Officer

Jan Mosholt Vice President, Sales and Service

Matt Crane Vice President, Strategic Relationships

Adam McMullin Vice President and General Manager

Tim Germann Vice President, Business Development

Scott Hoerner Director, Professional Partnerships and Clinical Operations