1. THE POWER OF INFORMATICS Adoption – Analytics - Outcomes Anthony Pearson, RN-BC Clinical Informatics Liaison Children’s Health System of Texas

2. Conflict of Interest Disclosure Anthony Pearson, RN-BC has no real or apparent conflicts of interest to report. 2

3.  Discuss the advantages of real-time, Inpatient population-specific nursing workload acuity data delivered within the EHR, without additional input burden on direct care nursing staff.  Describe the insights a workload acuity system brings to clinical leaders – from the charge nurse through Chief Nursing Officer -- by objectively quantifying patient “busyness” by EHR orders and documentation  Review strategies & options for real-time and historical reporting tools to improve operational awareness using patient workload acuity and EHR staff data. 3

4. 4 METHODS 2012 Selection Committee formed Began investigating patient acuity systems 201 3 Narrowed the field to 4 vendors Steering Committee formed Epic selected as vendor: “come build with us” 2014 Epic developers came on site for “immersion” visit Implementation Committee formed 100% Nurses Direct care nurses, CNS, Clinical Ed, IS Nurse analysts 2015 Maturation from implementation to full scale rollout Validation, Validation, Validation Reliability, Reliability, Reliability

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9. 9 Data, data everywhere

10. But not a drop to drink.

12.  A scoring system: 1) driven by the patient’s chart 2) to objectively quantify changes in a patient’s care needs during hospitalization 3) to understand & trend relative “busyness” / workload / clinical demand of a patient 12

13.  an ED or Ambulatory tool  a direct physiologic monitor  a crystal ball  a substitute for personal knowledge, nursing judgment, or critical thinking 13

14.  1) testing for shift assignment making  2) correlating scores with staff perspective  3) close CNS collaboration  4) Statistical & subjective re-analysis after adjustments to scoring system 14

20. How might one “bucket” a scoring schema?

21. Medications Orders Assessments Nursing Care A.D.T. Risks

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24. 24 May want to recheck the staffing and care area

25. At the Nurse Level

26. At the Unit Level

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28.  Alignment with Organizational Priorities  Multiple research articles opportunities  Contribute to the body of nursing science  Magnet journey: source of data  Become recognized as a “resource site” 28

29.  Discuss the advantages of real-time, Inpatient population-specific nursing workload acuity data delivered within the EHR, without additional input burden on direct care nursing staff.  Describe the insights a workload acuity system brings to clinical leaders – from the charge nurse through Chief Nursing Officer -- by objectively quantifying patient “busyness” by EHR orders and documentation  Review strategies & options for real-time and historical reporting tools to improve operational awareness using patient workload acuity and EHR staff data. 29

30. 30  Debbie Schumann, RN-BC, MBA, BSN, CPHIMS − Chief Nursing Informatics Officer (CNIO) − Children’s Health System of Texas − debra.schumann@ childrens.com  Anthony Pearson, RN-BC, BSN − Clinical Informatics Liaison − Children’s Health System of Texas − anthony.pearson@ childrens.com

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