The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.
This is the fourth in a short series of posts on “The CIO’s Best Friends,” those BFFs who are critical in ensuring CIO effectiveness. This time we cover the CNO – CIO relationship.
The CNO and I started our jobs about the same time. We knew we needed one another to be successful. With an electronic health record implementation looming, our partnership would be imperative.
As organizational rookies, we became kindred spirits. We commiserated, encouraged, and partnered. Through my CNO’s coaching, I learned we needed more clinicians inside of IT. “Got clinicians?” he prodded often. “If you don’t, you should.”
I wondered how many credentialed clinicians a healthy IT department should have. I now think 25% is a good target. Whatever your starting point, push to raise the percentage. Include a mix of MDs; RNs; radiology, medical, and pharmacy techs; pharmacists; therapists; and a smattering of other less common specialties. While many organizations have a CMIO, equally critical is a CNIO.
My CNO taught me that once you have clinicians on your team, you’ve got to ensure their successful transition into IT. Here are some things to think about in order to succeed.
Challenges for Clinicians Moving Into IT
Adapting to the office environment
- Cubes vs. nursing station reduces the sense of teamwork
- Use of meeting rooms is equated with loss of casual social interaction
- Taking work home
- Going out to lunch vs. grazing between patient care tasks
Difficulty recognizing accomplishments/results
- Need to understand the bigger picture (see beyond the patient)
- IT systems are configurable with gray areas; reduced workflow focus
- No more rapid results (average patient LOS is three days)
- Used to implementing changes quickly
- Giving up precision and timing on tasks
Loss of familiarity generates stress. The clinician must:
- Learn new tasks, find new resources, and create a new employee network
- Learn basic IT software (no more IVs)
- Fight pressure to already understand IT on the first day of work
- Assimilate IT language/acronyms
Facilitation skills are not in the typical nursing repertoire
- Scheduling appointments
- Creating agendas
- Taking minutes
- Using a meeting room to solve problems instead of on-the-spot interactions
Common Conflict Areas and Issues of Concern for Clinicians
- IT staff is generally unaware of clinician’s former environment and the required adjustments
- Lack of training for clinicians in IT subjects
- Clinicians are expected to already know what to do
- Downtime scheduling affects issues regarding patient care
- Clinicians have an inherent desire for more testing on software applications (like testing a drug before giving it to a patient)
Bridging the Gap and Investing in Clinicians
- Increase depth of typical IT orientation
- Pair new clinical staff with experienced IT person; identify future clinician leaders
- Document and publish referable guidelines
- Create Web-based training on IT tools
- Ensure clinicians don’t get sucked into traditional IT mentality
Project management training
- Create project management processes that nurses can relate to
- Help clinician visualize the big picture and break it down into tasks
- Develop a facilitation/leadership class
- Provide continuing education credits (CEU)
- Create internal training opportunities specific to clinical IT
- Develop clear development pathways, like a clinical ladder
- Clarify the position’s responsibilities
Spend time with your CNO. Actively partner. If you can’t afford a CNIO to bridge the nursing and IT gap, assign another clinician as a part-time liaison.
Over the years, we moved from 5% clinical staff to nearly 25%. I believe one reason we successfully implemented and adopted clinical applications was due to our staff mix.
Embrace the significance of melding clinicians with IT. Be intentional with it, maximize the value, and encourage further adoption. A healthy mix leads to a high-performing healthcare IT organization. I’m so glad I listened to my CNO.
Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.