Today, efforts to transform healthcare delivery aim to improve care, health, and value. Achieving these goals relies heavily on the contribution of nurses everywhere we practice. In the United States, past nursing shortages catalyzed deliberations on how to stretch scarce nursing resources. Current discussions have pivoted to economizing on the use of nurses, not on growing such use. Knowing the positive impact nurses have on keeping patients safe, reducing mortality, and improving health, we find ourselves in a conundrum: Nurse leaders are responding to the imperative to reduce nursing resources, but at the same time are realizing the demand for our services will continue to grow so we can care for an aging population and promote population health.
The challenge of ensuring adequate but affordable nursing care isn’t unique to the United States. The United Kingdom (UK) is also addressing it. A February 2013 report to England’s Parliament (called the Francis Report) revealed rising mortality and patient complaints, and exposed substandard care and systemic failure on the part of the Mid Staffordshire National Health Service Foundation Trust. The report announced 290 recommendations to transform the culture of fear, secrecy, and bullying that plagued that hospital to a culture that puts patients first, sets high standards, and supports a workforce with an aptitude for caring. UK nurses seized the opportunity for improvement. They were vocal about the report and took action to address professional standards of behavior, training of assistants, and personal responsibility. (See www.nursingtimes.net/home/francis-report.)
We find striking similarities between the Francis Report and reports issued by the Institute of Medicine more than a decade ago that spurred the recognition that Americans were dying from preventable medical errors. Nurses have embraced the imperative to make care safer and more sustainable, focusing on removing waste and unnecessary tasks from the work environment and using technology to improve safety and efficiency. Our UK colleagues are pursuing the same path.
In April 2013, about 50 nurse leaders from across England who represented clinical practice, education, management, and policy gathered in Birmingham for the first symposium organized by the UK National Nursing Informatics Strategic Taskforce. Held in collaboration with the UK Nursing Leadership Summit and HIMSS Europe (Healthcare Information Management Systems Society) and sponsored in part by Cerner Corporation, the symposium explored how nurses could gain more time for patient care by using a broad range of health technologies and electronic health records (EHRs). At the symposium, I had the privilege of sharing the results of the 2009 Technology Drill Down (TD2) study conducted by the American Academy of Nursing Workforce Commission, which identified promising technology solutions to improve nursing workflow and return more nursing time to patient care. TD2 recommendations, together with other synergistic work from the Transforming Care at the Bedside project, the Time and Motion Study, and the Proclamation for Change have shaped nursing’s agenda for creating greater efficiency and safety in the acute-care hospital environment through the use of technology.
This issue of American Nurse Today includes a special report that explores how nurses are using technology to enable their practice and create better patient outcomes in the United States and the UK. The first article, “Enabling the ordinary: More time to care,” underscores the nature and value of technology as tools integral to nursing practice. It compares differences in the policy context for health information technology (HIT) imperatives in the two nations and describes how leaders are preparing for the paperless health system of the future.
Be sure to read both the print and the online articles in this report. (Online articles are available at http://AmericanNurseToday.epubxp.com/t/12557.) They provide lessons and success stories in using the EHR and other technologies to promote a culture of safety, streamline operations, and ensure effective point-of-care communication. A collaboration of nurses from two distinctly different health systems, our special report demonstrates opportunities to learn from one another and influence our countries’ HIT agendas in a strong voice that resonates across the ocean and around the world.
Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN