For baseball fans, HIT means one thing—the bat connecting with the ball, which then (with any luck) flies in the right direction to culminate in the game-winning home run for your team. For football fans, HIT means the intentional body contact used to flatten the opponent’s team members, including the quarterback, to prevent them from scoring a touchdown.
For those of us in health care, HIT means health information technology, which includes intentional forceful actions to install information technology and thus improve outcomes. Examples include patient monitoring systems in critical care areas, bar-code medication administration, and “smart” pumps for I.V. therapies to prevent errors and injuries.
Today’s healthcare organizations and work settings can’t escape the slamming impact of new or replacement HIT solutions that are now part of every practice environment. Increasing numbers of smaller healthcare organizations are joining medium and large organizations in using HIT or computerized information or documentation systems to record and manage clinical data and patient care information, procure and distribute supplies, and assign resources and staff through nurse staffing/scheduling and patient acuity systems.
But HIT can also have a downside: long lines at the locked medication or supply dispensers, unauthorized access to personal and health information, and time wasted moving through multiple computer screen displays to find the information needed to make decisions.
As nurses, some of us might prefer to avoid the whole mess of computers and information systems and the accompanying practice and workplace changes. But that’s not an option. We must be part of the solution and lead efforts to address the associated structures, processes, and outcomes—and then implement changes for success. Rather than viewing the oncoming HIT revolution and its accompanying changes as a predicament, we can be the engineers who guide the HIT effort toward the best safety and quality outcomes. Rather than being done unto, we must figure out how to best leverage HIT to work for us instead of against us.
A HIT toolkit
You already have a HIT toolkit—the nursing process (which helps us do the work the right way the first time), as well as an appreciation for the standards, guidelines, critical paths, and timelines needed to set the stage and action plan. You recognize the importance of evaluation, metrics, and feedback to improve processes and outcomes during the seemingly eternal HIT journey. And you have the change-management skills and the compassion for those struggling within the limbo of leaving the old behind and developing new ways of doing business.
The challenge of moving from paper charts to computerized systems for clinical documentation requires us all to examine the “we’ve-always-done-it-that-way” workflows and every chart form imaginable. We must dispose of the skeletons in the closet as we streamline reporting and communication pathways. The new HIT solution undoubtedly will include a new presentation of the agreed-on, official system-sanctioned assessment form, not a unit-based or unique version.
Your piece of the action
Most importantly, every nurse has a piece of the HIT action, whether it means:
• leading or serving on a team that plans and defines requirements
• using standardized terminologies to codify nursing practice components
• attending system training classes
• assuming the role of superuser
• partnering with others, including advanced-practice registered nurses and administrators, to lead the clinical practice transition work.
It’s been said that nurses are the glue that holds the HIT projects together, just like the teamwork evident in all of our professional practice settings. Remember your important advocacy role representing the needs and concerns of patients and staff members on the continuous journey to improved quality and safety through HIT. Improving patient outcomes is our most important business.
Rebecca M. Patton, MSN, RN, CNOR
American Nurses Association