Sometimes I think I am just the luckiest person. I love the NHS and nursing; and working in informatics is exciting and challenging. When I was 18 and embarked on my career I never imagined it would take me all over the world but last week I was so privileged to escort a group of NHS nurse leaders to look at informatics in Chicago, USA.
The study tour was arranged by HIMSS who do an amazing job of supporting nurses who have an interest in informatics as well as their wider activities. The trip was part of a year long plan of activities in the UK – we have also had free open webinars and a summit to discuss the approach taken to technology in nursing in the US. You can read more about HIMSS here.
The experience and background of the nurses in the group was broad – mental health, general nursing, midwifery and education were all represented along with commissioning and those with a leadership role in informatics. They were competitively selected from around 35 applications – there were 9 nurses in the group. The group also represented the 4 countries of the UK.
This isn’t everyone but its nearly all the people from the trip
The experience proved an interesting one. The following are my key learning points:
1 Where is the UK compared to the US in informatics development?
I am not sure whether I am reassured or disappointed that I didn’t see anything that surprised me. Certainly in hospital settings the nurses are using more record systems but they face the same challenges as we face at home. They still talk about the challenge of clinical content/records and the time it takes nurses away from patients. The scale of investment, however, is very different. IT is not seen as an add-on but as an essential part of their business and in some areas it has led to significant improvements. I will blog more about this when I have the presentations from each site. The nursing informatics teams in each organisation were much bigger than I see in the UK – with some teams of 10 staff, all nurses!
Mobile working in its many forms is also a matter of debate for them but in the new build organisations we visited they have invested in much better infrastructure leading to more potential for mobile working.
2 The importance of governance and quality improvement
All of the sites we visited were Magnet Hospitals and this was noticeable and I couldn’t fail to be impressed. The staff were happy in their organisations with some directly expressing how they stayed working at that hospital because they loved working there. If you don’t know about Magnet hospitals you can read more here.
What was particularly inspiring about this for informatics was how the governance structures of magnet hospitals had ensured that nurses were empowered to positively affect the decisions taken about informatics. On one site the informatics lead was responsible to the nursing professional practice committee. It makes perfect sense to me – a positive way of governing and empowering those who use the technology.
The same is true of improvement activities – they were driven through professional groups rather than management with great success.
More about shared governance here.
3 Different philosophies
Although I noted the similarities in the implementation of technology in the sites we visited there was also a major different in how they viewed patients/service users. We asked many questions about patient access to records, information ownership and patients’ involvement in services; it was clear from the responses that in the UK we are much more focussed on patients and their involvement. In some areas (not all) the care was very medicalised and neither the patients nor the nurses seemed to be centre stage!
Over the next couple of weeks I will also write up some comments about each of the sites we visited.
A big thank you to HIMSS who were superb but also the brilliant nurses on the trip who asked many searching questions and worked hard to understand what they saw and heard. I also confess to laughing until I cried on some occasions – there is no better company than nurses!
Trump International Tower, Chicago