810 Office of Nursing Services Informatics (ONSI) Overview - PowerPoint by beS2jkQq

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									810 Office of Nursing Services Informatics
             (ONSI) Overview
               August 9th, 2010
              8:00am – 9:15AM




                                         1
                  Faculty
            Office of Nursing Services

• Murielle Beene, MS, MPH, MBA, RN-BC, PMP
  Chief Nursing Informatics Officer

• Bonny Collins, PA-C, MPA
  Director, Nursing Informatics Services




                                             2
         HOUSE KEEPING



                   Cell Phones
       Please turn off or change to vibrate
If you must answer a call or text message , please
                  leave the room.



                                                3
      HOUSE KEEPING
              Please,
No questions during the presentation.

Questions written on a 3X5 card will
  be answered at the conclusion of
  the presentation, time permitting.

  All questions and answers will be
  posted on the web including those
       not answered during class.

                                        4
            Learning Objectives
At the end of this presentation, participants
  will be able to:
• State the strategic goals of Office of
  Nursing Services Informatics Team (ONSI)
  and the relationship to VA Nursing
  Outcomes Database (VANOD)
• Explain upcoming ONSI initiatives and the
  impact on the VANOD SC role
• Identify VANOD data currently available
                                            5
    ONS Informatics Contacts
• Chief Nursing Informatics Officer:           Murielle Beene
• Director of Nursing Informatics Services:    Bonny Collins
• Director of Nursing Applications Development:Alicia Levin
• ONSI Nursing Informatics Specialists:        Diane Bedecarré
                                               Mimi Haberfelde
                                               Pamela Pickett
                                New Nursing Informatics Specialist
• ONSI Health Systems Specialist:              Mark Balch
• ONSI Program Support Assistant:              Kyvette McDonald
• VSSC Analysts/Programmers                    Monica Kluger
                                               Shawn Loftus

• VANOD Website: http://vaww.VANOD.med.va.gov
• Email: VHA CO ONS Informatics



                                                                6
                   A Big Thanks to our
                VANOD Conference Faculty
Name                             VISN/Facility
Veronica Foster-Jones            V20, Seattle
Renee Olszewski                  V2, Syracuse
Toni Phillips                    V8, North Florida/South Georgia
Dale Ryan                        V8, West Palm Beach
Jennifer Batt                    V1, Buffalo
Virginia (Kim) Fitz              V1, Albany
Carole Crabtree                  V 9 , Lexington
Lynn Shuler                      V18, Prescott
Anthony Noska                    V12, Chicago
Betsy Shortle & Nancy LaPointe   Decision Support Svcs (DSS)
Karen Harris                     V8, Lake City (FL)                7
                                                                                                                                        Health
                                                                                                                           Departmen
                                                                                                                                       Human
                   Secretary, Department of Veterans Affairs (VA)                                                             t of
                                                                                                                                       Services
                                                                                                                            Defense
                                                                                                                                        (HHS)

  Office of                          Under Secretary for Health, VHA
Information
      &
Technology                                                                                                Deputy Under
   (OI&T)             Principal Deputy Under Secretary for Health                                          Secretary for
                                                                                                          Operations &
                                                                                                          Management
                                                            Office of                                    (DUSHOM) 10N
                                                                                       Patient Care
               Office of Health Information (OHI)           Nursing                     Services
                                                            Services
                                                              Office of
               Enterprise   Health Data   Clinical Health     Nursing                        Medical
              System Mgmt   Information    Informatics       Services
                 (ESM)         (HDI)      Office (CHIO)     Informatics                    Informatics
                                                              (ONSI)

                                                  Shape &
                                                   advise
                                                   ONSI




                                                                      Knowledge Transfer
                                                                        (frequent calls)
                   ONSI Coordinating Council (ONSICC)                                                      VISNs 21 Health
                                                                                                         Infomatics Positions
                   (Representatives from Facility CACs,
                   ADPACs, VANOD Site Coord, BCMA
                        Coord, ESM, NRAG, etc.)


                                                                                                          152 Medical Centers
                                                                                                           Health Informatics
                                                                                                               Positions


                                              Nursing Informatics Field Alliance (NIFA)
      152 Facilities: Clinical Applications Coordinators (CACs); ADPACs; VANOD Site Coordinators; BCMA Coordinators;
      Health, Medical, a/o Nursing Informaticists; DSS Coordinators; CIS/ARK Coordinators; CliO FlowSheet Coordinators



                                                                                                                                                  8
ONS Informatics (ONSI) Vision
  • Front Line                                      • Nurse
    Nurses                                            Managers &
                                                      Executives

                    Tools &              Tools &
                 Environment          information
                  to support           to manage
                 patient care           resources
                            Veteran


                                  Data needed
                  Information
                                   to develop
                 necessary to
                                  evidence for
                   establish
                                  patient care
                     policy
                                     & policy
  • VACO &                                          • Researchers
    Program
    Offices


                                                                    9
        VA Major Initiatives (T-13)
1.  Eliminate Veteran homelessness
2.  Enable 21st century benefits delivery and services (e.g., backlog reduction)
3.  Automate GI Bill benefits
4.  Implement Virtual Lifetime Electronic Records (VLER) to enhance partnerships
    with DoD and others
5. Improve Veteran mental health
6. Build Veteran Relationship Management (VRM) capability to enable convenient,
    seamless interactions
7. Design a Veteran-centric healthcare model and right-sized infrastructure to help
    Veterans navigate the healthcare delivery system and receive coordinated care
8. Expand healthcare access for Veterans, including women and rural populations
9. Ensure preparedness to meet emergent national needs (e.g., hurricanes, H1N1
    virus)
10. Develop capabilities and enabling systems to drive performance and outcomes
11. Establish strong VA management infrastructure and integrated operating model
12. Transform human capital management
13. Perform research and development to enhance the long-term health and well-
    being of Veterans
     Stakeholders – Front Line
             Nurses
Prioritized at Sept 2009 ONS   1. Clinical Observations Database, Patient
    Informatics Meeting            Flow Sheets (CliO) and Clinical
                                   Information Systems/Anesthesia Record
                                   Keeping (CIS/ARK)*
                               2. Patient Assessment Documentation
                                   Templates*
                               3. Nurse Shift Handoff*
                               4. Kardex
                               5. Daily Plan
                               6. Emergency Department Information
                                   System Tracking*
                               7. Mobile E-documentation
                               8. Bed Management System*
                               9. Bedside Smart TV
                               10. Nursing Resource Management System
                               11. Electronic Proficiency Tracking
                               12. Specialty Certification Tracking
                               13. Nursing Hours Per Patient Day (HPPD)
                                   in DSS/VANOD*
                               14. Contract Agency Database to capture
   *Funded FY10                    hours
                               15. Mandatory Overtime and Adding Point of
                                   Care*
                                                                        11
Stakeholders – Nurse Managers
          and Execs
                               1.  Nursing Resource
Prioritized at Sept 2009 ONS       Management System (RMS)
    Informatics Meeting
                               2. Patient Assessment
                                   Documentation Templates*
                               3. Electronic Proficiency
                                   Tracking
                               4. Bed Management System*
                               5. Emergency Department
                                   Information System
                                   Tracking*
                               6. Mobile Electronic
                                   Documentation
                               7. Clinical Information Support
                                   System
                               8. Bedside Smart TV
                               9. Nurse Call System
          *Funded FY10         10. Smart Phones for Nurses

                                                             12
 Stakeholders – Researchers
                               1.    Nursing Resource Management
                                     System
Prioritized at Sept 2009 ONS   2.    Mandatory Overtime and Adding Point
    Informatics Meeting              of Care*
                               3.    Nursing Hours Per Patient Day in
                                     DSS/VANOD
                               4.    Electronic Proficiency Tracking
                               5.    Clinical Information Support System
                               6.    Specialty Certification Tracking
                               7.    Contract Agency Database
                               8.    Clinical Observations Database,
                                     Patient Flow Sheets (CliO) and
                                     Clinical Information
                                     Systems/Anesthesia Record Keeping
                                     (CIS/ARK)*
                               9.    Patient Assessment Documentation
                                     Templates*
                               10.   Nurse Shift Handoff*
                               11.   Daily Plan
                               12.   Bed Management System*
                               13.   Bedside Smart TV
       *Funded FY10            14.   Emergency Department Information
                                     System Tracking*
                               15.   Mobile Electronic Documentation 13
Stakeholders: VACO and Program
             Offices
                               1.   Nursing Resource Management
Prioritized at Sept 2009 ONS        System
    Informatics Meeting        2.   Clinical Observations Database,
                                    Patient Flow Sheets (CliO) and
                                    Clinical Information
                                    Systems/Anesthesia Record
                                    Keeping (CIS/ARK)*
                               3.   Patient Assessment Documentation
                                    Templates*
                               4.   Emergency Department Information
                                    System Tracking*
                               5.   Bed Management System*
                               6.   Clinical Information Support System
                               7.   Nursing Hours Per Patient Day in
                                    DSS/VANOD*
                               8.   Specialty Certification
                               9.   Mandatory Overtime and Adding
                                    Point of Care*


          *Funded FY10

                                                                      14
ONS Informatics (ONSI)




                         15
Initiatives in Progress
         • Patient Assessment &
           Reassessment
           Templates
         • Prototype for
           Interdisciplinary Patient
           Care Plan
         • Shift Hand-off Report
         • Flow sheets
         • Post Fall Assessment
           Note

                                   16
                                      Reassessment
                                       (Shift Note)




                                       End of Shift
       Patient                           Report                         Care Plan
     Assessment




Key Data Elements from Patient Assessment, Reassessment & Care Plans



    Embed in Files:    Clinical Observations (CLiO),      Health Factors, Vital Signs



                    Local Reports
Examples: Summary & Detail Display of Patients
   with:                                                            Extracted Data
1. Admission Assessment done within 24 hrs                           for National
2. Skin risk assessment done within 24 hrs                             Reports
3. Fall risk assessment done within 24 hrs
4. List of patients at risk for pressure ulcers, falls,
   etc.
   Flow Sheets – VA Developed
• Data point/click entered

• Automatic download of data from monitoring equipment

• Standardized terminology catalog of thousands of terms to select
  from to create customized flow sheets (same terms as the Patient
  Assessment)

• Data stored in a Database – available for re-use

• Data not disrupted by patient movement – can be used in all care
  settings

• Status: In final testing

                                                                     18
            Flow Sheets –
     Commercial off the Shelf (COTS)
• VISN standardized purchase of Clinical Informatics
  (CIS), Anesthesia Record Keeping (ARK) and Analytics
  COTS products

• Point/click data entry in ICU, PACU, OR, Step Down unit
  (need license for care setting)

• Automatic download of data from monitoring equipment

• Sophisticated applications, lots of bells & whistles

• Data does not transfer from ICU to floor as computable
  data; captured as PDF picture

                                                           19
             Site Coordinator Role
• Make sure relevant stakeholders are
  engaged in implementation and
  education
• Partner with ONSI to organize facility
  data validation efforts for clinical
  indicators
• Attend the monthly VANOD Site
  Coordinator and Nursing Informatics
  Field Alliance (NIFA) calls
• Work with your facility to implement
  templates & products when released.
  Participate in data validation efforts in
  collaboration with ONSI



                                              20
Initiatives in Progress
   •   Standardized Documentation
        – Standardized terminology, developing a catalog of
           clinical terms to use in all applications
        – Structured Language, e.g. Clinical Care Classification
           which link observations to interventions to outcomes

   •   Information Modeling
        – Preserves the content/intent of the standardized terms
            from above, e.g. allergy is a term and penicillin is a term
            – allergy to penicillin is a simple information model

   •   Availability of data to be used between applications
       “Interoperability”
         – If data are entered into a patient assessment the
            relevant information should be „pushed forward‟ into
            care planning, or available for decision support
            algorithms (not buried in a data silo, or free text in a
            progress note)
                                                                       21
        Site Coordinator Role
• Learn about structured
  languages, esp. Clinical
  Care Classification (CCC)

• Be aware of the national
  priority to standardize
  clinical terminology.
  Corollary – look for national
  products before building
  local templates, reminders

                                  22
       VA Nursing Outcomes
           Database
Goal is to provide meaningful data to
 improve the delivery of clinical care,
 organizational management, and research
 opportunities




      http://vssc.med.va.gov/products.asp?PgmArea=17
                                                       23
VANOD




        24
     VANOD Business Principles
   No additional data collection burden to front line
    clinicians

   Leverage existing data sources

   Create new data sources when necessary

   National roll-up of data for reporting

   Provide facility tools to understand and validate
    data
                                                        25
               VANOD Goals
• Robust data – as granular as possible (Time &Leave
  unit, shift, day of week, point of care/unit)

• Timely

• Comparable – VHA, VISN, Facility, Unit Types

• Comprehensive slate of nursing-sensitive indicators

   • Structure, Processes, outcomes

• Relates nurse staffing and nursing process to patient
  outcomes


                                                          26
      Types of Data Currently
            Available
Administrative Reports –
Demographics & Financial -
• Age & retirement eligibility
• Role: direct care, hospital support,
  administration, etc
• Level of education
• Skill mix: NP, CNS, RN, LPN, LVN, UAP
• Hours & dollars – worked & other categories
• Overtime and comp time earned

                                                27
       Types of Data Currently
             Available
Administrative Reports (cont)-
• Nursing Executive Report – consolidated view of multiple
  indicators
• Nurse Staff Injuries – reported incidents
• Nursing Staff Turnover – quit, retirement, termination
  rates
Clinical Reports
• Skin Risk – process & outcomes
• Managing Scanning Failures- BCMA
Satisfaction Reports
• RN Satisfaction – Practice Environment Scale (PES)
• All nursing staff – All Employee Survey (AES)

                                                        28
Conceptual Model for Nursing Roles
   Administration
        Hospital Support Staff
           •Case Manager
           •Infection Control Nurse
           •Nurse Educator
           •Wound Care Nurse
           •Etc.

                    Direct Care
                       •Charge Nurse, CNL
                       •Staff Nurse, LPN, UAP


                               PATIENT



                                                29
ADMINISTRATIVE INDICATORS –
FINANCIAL AND DEMOGRAPHIC




                              30
Which Staff Are In the VANOD Database?
VANOD includes:
• Nursing Skill Mix (RN, LPN, NA) in all Cost Centers AND

• All Non-Nursing skill mix in the Nursing Cost Center, e.g.
ward clerks, health technicians, etc.


Employee Count                                  FY09
Nursing Skill mix in any Cost Centers at the    76,074
end of FY09
 13% of Nurses are NOT in the nursing cost center (8241)

                                                               31
How Staff are Identified in our Data Systems
 Data Element       Entered     VistA File     Example
                      By:
Name & SSN             HR         PAID       Nancy Ratchett
Budget Object       HR/Fiscal     PAID           1064
Code- designates
licensure
Occupation Series      HR         PAID           0610
Code-broad
employee grouping
Assignment Code-       HR         PAID            88
specialty
Cost Center            HR         PAID           8241
T&L                    HR         PAID            268
Primary             Nursing       Nurse       Acute care
Assignment-                      Package      Medical Unit
Nursing Package
                                                              32
  VANOD Annual Summary
VHA 3 year Trend Data for quick
  reference for
key data in the three categories:
• Administration: Staff Demographics &
  Distribution; Nursing Staff injuries
• RN Satisfaction
• Nursing Processes & Patient Outcomes


                                         33
    Would you like to know…?
What % of: (can go down to T&L unit)

• Nursing Hours worked by direct care staff?
• Direct care staff who are RNs?
• Direct care RNs who have at least a Bachelor‟s
  Degree?
• Hours worked were earned by Overtime or Comp
  time?
• Staff eligible to retire?
• What is the trend of Sick Leave used by T&L?

All of these are available in VANOD

                                                   34
% of VHA Nursing Staff Eligible to Retire
         (pp6 March FY10)

  26% of all VHA
     nurses are
  eligible to retire




                                       35
NURSING STAFF INJURY



                       36
           Nursing Staff Injury
Purpose:
 • Provide descriptions of injuries reported
 • Facilitate data-driven targeting of identified (or
   potential) occupational problems
 • Promote best practices in nursing occupational health
   and safety
 Data Source:
 • Automated Safety Incident Surveillance Tracking
   System (ASISTS)
 • Linked to HR/PAID data
 Level of Granularity:
 • T&L Unit where employee assigned

                                                       37
     Would you like to know…?
• Which type of injury is the most frequently reported by
  direct care staff?

• Do our older nurses report the most injuries?

• Are more injuries reported on weekends when staffing
  may be shorter?

• Is there a time of day when we should implement a lift
  team to prevent lifting and transfer injuries?

  These data are available in VANOD

                                                            38
   FY09 Type of Injury by Nursing
 Blue bar represents VHA
           RNs:
                         BOC
In FY09 – slips, trips /falls
    most common injury,
         followed by
   lifting/repositioning
           patients




                                39
NURSING STAFF TURNOVER




                         40
               Nursing Turnover
Purpose:
• Ability to track and trend employee losses
    –   Total Loss Rates and Voluntary/Quit Loss Rates
Data Source:
•   HR Records
    • Facility Nature of Action forms

Level of Granularity:
•   Facility – not yet down to T& L Unit

                                                         41
What % of RNs leaving the VA Quit
 Compared to Other Reasons?
                             Yellow line= Total Loss
                               rate FY06: 11.5%
                                  FY09: 7.5%




     Blue line = Quit Rate
   FY06: 7.1% FY09: 4.4%




                                                   42
 Caveats to Administrative Data
• Employee Count is not the same as FTEE

• All Time is a cumulative number – is that really
  what you want? Better to select a specific time
  frame (FY, FQ, FM, Pay Period)

• All Nursing Roles – includes nursing personnel
  and non-nursing personnel – choose wisely

• T&L Units are not standardized, not comparable
  across the system
                                                     43
 Caveats to Administrative Data (cont)
• Level of Education comes from PAID – Make sure PAID
  data are updated regularly

• Education – HR counts Highest Level Achieved, may not
  be the highest nursing degree obtained

• Nursing Injuries – Locations where injuries occurred are
  defined by hospital, e.g. hallway

• Nursing Injuries- Unreported incidents or incidents not
  signed off by Safety Officer will not be in ASSIST

                                                             44
HOURS PER WARD DAY OF
  CARE (DSS REPORT)




                        45
     Administrative Reports – Hours of
    Direct Nursing Care per Ward Day of
            Care (HPPD) from DSS
Purpose: Answer the question, “What is the average number of direct
  nursing hours of care provided for each patient per day in an
  inpatient bed?”

   Provides information about nurse staffing
   Evidence based indicator of patient outcomes

Data Source:
  DSS extractions
  DSS staff mapping



Level of Granularity:
  DSS Department (nursing unit)


                                                                      46
    Caveats to DSS HPPD Data
• DSS reports provide a good approximation of HPPD IF staff
  and units are mapped accurately
• DSS system was not designed to produce these data so there
  are some limitations to the data:
   – Reports do not capture contract or agency hours
   – Hours are attributed to the mapped unit; if the hours were
     worked on another unit (staff floated) the report doesn‟t
     attribute hours to the “correct” unit (unless they are
     mapped)
   – Hours off the unit for meetings, education are not
     subtracted from direct care (they should be)
   – Nurse manager hrs are included (ideally they wouldn‟t be)
VeHU Class offered

                                                              47
CLINICAL DATA




                48
   Managing Scanning Failures
Purpose:
• To provide local and national reports for the Bare Code
  Resource Office (BCRO) to identify systems issues
  (process or technical)

 Data Source:
• Managing Scanning Failures
  (from file #53.77 Failure to Scan Log from all VistA sites)

Level of Granularity:
  Facility


                                                            49
    Would you like to know…?
• The % of bypassed wristband scans?

• The % of bypassed medication scans?

• Which medications were the most frequently
  identified as unable to scan at your facility?

Yep, they‟re available in VANOD



                                                   50
    Clinical Reports – Skin Risk
Purpose
• Provide information about skin risk nursing
  processes and patient outcomes
• Determine care burden related to high risk for
  breakdown or pressure ulcer cases
 Data Source:
• VANOD Skin Assessment and Re-Assessment
  templates
Level of Granularity:
• Bed-section>Treating Specialty>Patient
                                                   51
   Would you like to know….?
What % of :

• Patients were at risk for skin breakdown on admission?


• Patients at risk on admission who had a prevention plan put
  into place?

• Patients developed a Hospital Acquired Stage 2 or greater
  Pressure Ulcers (HAPU) by admitting treating specialty?

• Are your trends improving?


                                                                52
    VHA Med-Surg Skin Risk
Assessment Performance Measure




               VHA results have steadily
           increased over time - March 2010
                  average was 90 %




                                              53
RN (AND OTHER)
 SATISFACTION




                 54
    Satisfaction: RN Satisfaction
Purpose:
               Survey
• Linked to patient satisfaction and impacts
   recruitment and retention
 • Identify opportunities for improvement
 • Support the Magnet Journey
Data Source:
 • Annual RN Satisfaction Survey- (Practice
   Environment Scale/Nursing Work Index)
Level of Granularity:
• Inpatient units and outpatient work settings

                                                 55
    Would You Like to Know…?
•   How is RN overall Satisfaction trending over time?
•   Which work settings had the highest scores –
    Clinics; Cross-Settings; or Hospital?
•   What % of VHA direct care RNs were very
    satisfied? Very dissatisfied?
•   In which work settings were direct care RNs most
    satisfied?
•   Facility level question: How did your units
    compare to facility overall average scale scores?
•   How did your facility compare to other facilities?


                                                     56
                                                                          FY10 RN Satisfaction Survey
                                                                            PES National Averages
                                            Higher Scores = More Favorable Perceptions of the Nursing Practice Environment

                                                                         FY07         FY08       FY09             FY10
                            4.0

                                                                                                                  RN Manager, Staffing &
                            3.5                                                                                    Participation greatest
                                                                                                                   correlation with RN
                                  3.1 3.1 3.1 3.1                                                                       satisfaction
Scale Score (Min=1/Max=4)




                                                               2.9 3.0                2.9 2.9
                            3.0                      2.9 2.9
                                                                            2.8 2.8                         2.8 2.8
                                                                                                      2.7
                                                                                                2.7                                2.7 2.6             2.6 2.6
                                                                                                                         2.5 2.5             2.5 2.5
                            2.5




                            2.0




                            1.5




                            1.0
                                    IT Support      RN/MD Relations         Quality of Care     RN Manager                  Staffing          Participation


                                                                                                                                                        57
                                                           FY10 RN Satisfaction Survey
                                          What is your current overall level of satisfaction with your job?

                                                                   FY07          FY08           FY09       FY10

                         45.0
                                       Somewhat & Very
                         40.0          Satisfied trend increasing;                                          37.6 36.9
                                                                                                                        39.3
                                                                                                                               38.4
                                       Not Very and Not At All
                         35.0
                                       decreasing – THAT‟S                                                                                          31.2 30.4
Percent of Respondents




                         30.0          GOOD!
                                                                                                                                             26.2
                                                                                                                                      25.0
                         25.0

                                                       19.6 19.2
                         20.0
                                                                          15.9
                                                                   14.4
                         15.0
                                                                                   11.6 11.5
                                                                                               10.6 10.3
                         10.0
                                6.1 6.1
                                          4.5 5.0
                          5.0

                          0.0
                                Not at all satisfied   Not very satisfied         Neither satisfied nor    Somewhat satisfied           Very satisfied
                                                                                      dissatisfied

                                                                                  Response Category

                                                                                                                                                            58
    All Employee Survey (AES)
Purpose:
   – Measure the satisfaction of all VA staff by obtaining
      annual feedback
   – Identify opportunities for improvement
   – Provides opportunity to evaluate RN and non-RN staff
      satisfaction via one common overall satisfaction
      question
Significance:
   – Employee satisfaction impacts recruitment, retention
      and organizational performance
Data Source:
   – Annual AES Satisfaction Surveys administered by
      National Center for Organizational Development
                                                             59
       How Satisfied are VHA LPN &
       UAPS compared to the RNs?


                                       LPN           NA
RN I        RN II   RN III




                             Satisfaction trend is
                              from left to right –
                               going up for all
                                 skill mixes              60
        What Can You Do Now?
        Data Validation Issues
Data quality is only as good as the data that went
  into the system -
• Use the data validation reports or tools
  available from the database (obsolete codes?)
• Check to be sure nursing staff are correctly
  categorized in the database (and if not, fix it!)
• Engage other stakeholders – e.g. DSS
  Coordinator for HPPD data; wound care nurse
  for skin risk data – to be looking at the data


                                                 61
       What Can You Do Now?
     Be Critical Consumers of Data
Exercise: What do these data represent?

Sample: “FY09: VHA had 64,140 Direct Care RNs”

• Full Time Employee Equivalent (FTEE) or Employee
  Count?
   – If Employee Count – does that include full-time, part-
     time, and/or intermittent?
• Full year or end of year snapshot?
• Nursing Cost Center or in ANY Cost Center?
     What Can You Do Now?
   Once You Are Back At Station -
• Form a partnership with your facility resources (AdPAC,
  DSS, nurse recruiter, HR, wound care) to look at reports
• Identify questions or problems as an opportunity for
  improvement
• Communicate and share information with leadership and
  staff
• Encourage data use for managing resources or tracking
  patient care improvements
• Learn more about customizing your own reports---Take
  self-guided VSSC online-tutorials or a live class


                                                             63
  Unit Level Data – Short-Term
 Nursing Unit Mapping Application
Nursing Unit Mapping Application (NUMA)
Facility tool to update Nursing Unit Names for:
• FY11 RN Satisfaction Survey
• Early next year, clinical data at unit level
  (skin!)
• SC Role – Work with your Nursing AdPAC
  (Nurse Location Package) and DSS
  Coordinator so that data are updated in all 3
  locations – NUMA, Nurse Location File, DSS
  tables
                                                  64
    Unit Level Data – Interim Solution
     PAID Enhancement for VANOD
•  Purpose: This is an interim solution for the problem of
  capturing accurate staffing workload data.
   Modification to the Electronic Time & Attendance
     application (ETA) to transmit more granular data,
     including:
       • Location where nurse actually worked, Regular
         and Overtime hours
       • Hrs nurse off the unit and reason, e.g. committee,
         education, etc
       • Overtime hrs: mandatory or voluntary
       • Type of work, e.g. sitter, orientation, etc.
• Current Status:
                                                              65
   Resource Management System-
            Long Term
New Service Request – Resource Management System

  A Staffing and Scheduling package -to enable capture of
  units where nurses work and to differentiate direct vs
  indirect care hours
   – Goal – to get staffing and clinical data at the same
     unit level using standardized unit type descriptors

• SC Role- Communicate importance of data capture with
  facility leadership. Participate in facility efforts to alter
  current timekeeping processes.




                                                              66
Questions?




             67

								
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