The most interesting session for me today at HIMSS was the awkwardly titled “Building and Apply a Better Nurse Staffing to Outcomes Model.” It was presented by Nancy Barton (MSN, RN) from Northeast Georgia Health System (NGHS) and Ken Colbert from Quadramed, a software vendor that I associate with acuity systems, although they have a much bigger portfolio than that.
The name of the session quickly made sense as they talked. NGHS did a study on nurse staffings and made statistical correlations to patient outcomes. The unique aspect of what they studied was a specific look at two negative patient outcomes–patient falls and prescription medication errors–and staffing levels against workload.
The “workload” aspect I found to be especially compelling. Staffing to patient volumes is the default model for nurse-to-patient ratios. But, just like a midnight census value, patient volumes don’t always show acuity or, as the presenters covered in detail, patient turnover during the course of a shift. They used real data to show two periods of time where traditional staffing metrics were mostly the same but one quarter had double the percentage of negative events. It took drilling into the detail data to see what was the root cause.
My takeaways:
1. Implementing staffing ratios in hospital scheduling systems that are volume driven are good, better than nothing, but not optimal. Patient care can be positively impacted by understanding and accounting for workload in the staffing model.
2. Having good data at a granular level is invaluable to measure improvements to change. One example NGHS had was a test change that proved out to make no impact to outcomes at all.
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Outside of sessions, the tradeshow floor here in New Orleans is huge. HIMSS continues to be a massive show, almost too big to get a “feel” for what are the big trends.
An idea that has been paid a lot of lip service recently, “interoperability”, finally had some of the big software vendors put their money where their mouth is as it was announced today that Cerner and McKesson (among others) are working together towards a sharing data better. http://www.heraldonline.com/2013/03/04/4664839/cerner-mckesson-allscripts-athenahealth.html That certainly seems like big news to me!
And I’m hearing a lot about patient engagement and patients wanting access to their own medical records. They should have them, of course! It’s just getting the data out of the proprietary IT systems and into patient’s hands. Did you know that Medicare patients can get a smartphone app that let’s them see their EHR? Me neither… But they can.
Both of these topics whisper to me that the workforce management landscape is changing too, albeit more subtly. WFM systems will be expected to play nice and pass data smoothly as they interact with financial and clinical systems. (Rabbit trail question: How will SaaS vendors do that?!) And on the employee side, they will expect to be able to manage their own lives better (i.e. work schedules and more) with technology. Nothing earthshattering, but it’s time these concepts get paid something more than lip service.
I’m making notes of other gems I hear at the HIMSS conference. Follow me on Twitter @FlandersChris or @Axsium to see more of them!