Texas Initiative: Road Map for Conducting a Statewide...

Texas Initiative: Road Map for Conducting a Statewide Study on

Nurse’s Use of EHRs April 14, 2015

Mari Tietze, PhD, RN-BC, FHIMSS

Susan McBride, PhD, RN-BC, CPHIMS

DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

Conflict of Interest Mari Tietze, PhD, RN-BC, FHIMSS

Has no real or apparent conflicts of interest to report.

Susan McBride, PhD, RN-BC, CPHIMS

Has no real or apparent conflicts of interest to report

© HIMSS 2015 2

Learning Objectives 1. Provide an update on the Texas Initiative by sharing strategies about

the statewide activities

2. Summarize lessons learned in the planning, development and

implementation of health IT for Texas

3. Outline a sustainable health IT roadmap for other state, chapter,

regional and local leaders to consider

3

1. Provide an update on the Texas Initiative by sharing strategies about the statewide activities

History

Charges

Survey Results

TNA/TONE Health IT Task Force • Charge: Determine implications of health care informatics for nursing practice and education in Texas

• Include nationally-based Technology Informatics Guiding Education Reform (TIGER) initiative

Introduction

TNA = Texas Nurses Association

TONE = Texas Organization of Nurse Executives

5

Vision: To enable nurses and interprofessional colleagues to use

informatics and emerging technologies to make healthcare safer, more

effective, efficient, patient-centered, timely and equitable by interweaving

evidence and technology seamlessly into practice, education and

research fostering a learning healthcare system.

http://www.thetigerinitiative.org/

http://www.thetigerinitiative.org/

© Texas Nurses Association, 2015

HIT Taskforce Membership

Task Force Members

– Julie Brixey

– Nancy Crider (co-chair)

– Mary Anne Hanley

– Linda Harrington

– Susan McBride

– Elizabeth Sjoberg

– Laura Thomas

– Mari Tietze (co-chair)

TNA

– Cindy Zolnierek [pres.]

– Laura Lerma [educ.]

– Kat Hinson [comm.]

– Collene Lewis [admin.]

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Composed of TNA and TONE Member from

practice and academia


Web site

8 © Texas Nurses Association, 2015

http://texasnurses.site-ym.com/?page=HIT




Charge 1: Survey/Benchmark

Clinical Information Systems Implementation Evaluation Scale (CISIES) Survey*

1) Launched September 23, 2015, statewide

2) Over sampled rural hospitals in an effort to insure representation

3) To date over 1,000 responses received

4) Included a committee-developed** EHR “maturity-index”

5) Preliminary results to follow


* = Gugerty, B.

** = McBride, Tietze, Thomas

Charge 2: Publication/Commun./Network

Support the tool kit content/survey

1) Establish/support local nursing informatics chapters –

DFW ANIA

Gulf Coast ANIA

2) Coordinate publication schedule with TNA communications staff

3) Contributed to Ebola Outbreak awareness campaign


Charge 3: Toolkit

Content for toolkit

1) Use CISIES survey responses to guide toolkit content

2) Create and place on TNA and TONE Web sites

.

Two CNE Webinars are being proposed based on trends in the industry:

1) “Workflow versus Work-Arounds to Optimize EHR Patient Safety and Quality.”

2) “Interoperability of Electronic Health Records.”


Charge 4: Policy/Legislation

Renew the 2010 resolution and add the following content:

1) Interoperability

2) Meaningful Use

3) Interprofessional Education/Collaboration

4) TIGER competencies initiative


TNA/TONE Survey Results

Preliminary as of February 23, 2015

© Texas Nurses Association, 2015 13

First page

of the

TNA/TONE

state wide

online

survey


Demographic information about EHR functionality (5 of 24 items)


: Meaningful Use Maturity Index for Nursing

Clinical Information System Implementation Evaluation Scale

16

Response Trend and Demographics


Study Responses Sept 2014-Feb 2015

TNA-TONE

Push #1

TNA-TONE

Push #2


Demographics of Respondents

Of 525 (45.3%) are:

• 86.6% are Full time

• 83.2% are RNs

• 74.3% are direct care 50% of the time or more

• 71.1% are staff nurses

• 66.2% are working day shift

• 56.4% are acute care and 10.2% are ambulatory

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N = 1,178

Rural and Urban Represented


Urban respondents were 52.7% acute care

& 11.5% ambulatory

Rural respondents were 52.7% acute care

& 10.2% ambulatory

Meaningful Use Maturity Index for Nursing



Meaningful Use Maturity Index

for Nursing

Sample of 3 of the

24 Item scale aligned with

Meaningful Use Stage 1 Measures

0.889 Cronbach’s Alpha

Mean of 56.53 (SD 13.85)

Range 0 - 72

Content Validity using Lynn’s (1986)

method

Lynn, M.R. “Determination and Quantification of

Content Validity.” Nursing Research Vol. 35 No. 6

(1986)

Sample Results of Clinical Information System Implementation Evaluation Scale© (Gugerty, B.)



CISIES 37 Survey Questions

Cronbach’s Alpha 0.881

49.8% Strongly agree or Agree

That the system is more efficient

than the old way of doing things

16.2% disagree or strongly

disagree

System is more efficient than the old way

The 251 “agree” and 258 “strongly agree”:

• 41% reported having been in nursing < 5 years & 24.4% 6-10 years.

Respondents represented:

• Hospitals with a bed size range of 0-968.

• 56.1% acute care and 11.2% were ambulatory.

• 21.7% are 31-40

• 25.7% are 51-60

• 9.8% are 61 or older

System has improved my practice

n = 949

The System allows me to spend more time on other aspects of patient care

The 365 “agree” and 255 “strongly agree”:

• 41.6% reported having been in nursing < 5 years

• 25.8% in nursing 6-10 years.

Respondents represented:

• Hospitals with a bed size range of 0-968.

• 60.6% acute care and 10.5% were ambulatory

• 23.6% are 31-40

• 25.9% are 41-50

• 25.1% are 51-60

• 9.2% are 61 or older

2. Outline a sustainable health IT roadmap

for other state, chapter, regional and local

leaders to consider

• Partner with nurse executive organization

• Partner with academia [deans and faculty]

• Listen to practicing nurses

• Focus on competencies/skills such as TIGER Initiative

• “Connect the State”

• Include policy-based stakeholders

• Cross-pollinate with other national committees

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3. Summarize lessons learned in the

planning, development and

implementation of health IT for Texas

• Carefully select partners for research/surveys

• Be realistic about Internal Review Board (IRB) activities

• Address data ownership issues explicitly

• Test and double test all survey items

• Plan for succession early on

• Include adequate number of committee member to do the work

• Budget for at least one face-to-face meeting per year

• Consider strategy to engage with more legislative committees


Questions • Mari Tietze contact information • [email protected] • 214-636-4751

• Susan McBride contact information • [email protected] • 817-319-6440


Index Card

1. We would like to include as many colleagues as possible in future

efforts.

2. If interested, please list your name, address, organization and email on

the index card provided.

3. We will keep you posted on further analysis and next survey

development phase.

Thanks!

mailto:[email protected]

mailto:[email protected]

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