How can chief nursing informatics officers advance their organization’s IT mission with nurses? Make sure they have a strong connection with the chief nursing officer, give nurses a seat at the IT planning table, volunteer for projects that aren’t necessarily in the CNIO job description, and generally stay visible, says award-winning CNIO Mary Beth Mitchell, RN, of Texas Health Resources.

“You have to advocate for your customers,” she says. “When I was a nurse, my patients were my customers, and now, the nurses are my customers. It doesn’t mean they get everything they want, but it does mean I’m out there listening to my users and responding to them. You can’t just sit in an office and do this job.”

Mitchell’s most recent honor is the HIMSS 2015 Nursing Informatics Leadership Award, to be presented at March 3 at this year’s HIMSS Conference and Exhibition in Las Vegas. She oversees nursing adoption, utilization and optimization of the organization’s Epic EHR, as well as other information technologies used by the nursing staff.

Mitchell is THR’s first CNIO and has defined the role in a way that sets the bar high. During her tenure, THR has been recognized as an EMRAM Stage 7 organization by HIMSS Analytics, and has won HIMSS’s Davies Award for using health information technology to substantially improve patient outcomes while achieving return on investment.

All that success has come directly from good communication. Mitchell assumed the CNIO role in 2010 after working almost 15 years in other roles at THR, along with a two-year stint at Tenet Healthcare. She spent her first two months on the job just talking to nurses and finding out their IT-related pain points.

When she heard consistent complaints about the form used for taking admission histories, she convened a group of nurses, one from each of THR’s hospitals, to meet with the IT staff once a week for six weeks at THR’s corporate offices to redesign the form and its related workflow.

Nurses collaborate on care at Texas Health Presbyterian Hospital Dallas. (Photo credit: Quynh Tran, Texas Health Resources)
Nurses collaborate on care at Texas Health Presbyterian Hospital Dallas. (Photo credit: Quynh Tran, Texas Health Resources)

“At the end of the six weeks, the nurses said, ‘We have other things to work on!’ ” Mitchell says. “So I went back to their CNOs and said, ‘Let’s do another six weeks.’ ”

Five years later, the group—now known as the Nursing Informatics Council—is still meeting one day a month. Mitchell no longer runs the meeting, having handed it over to one of the five nurse informaticists who work for her, and it has expanded to about 30 people, including representatives of specialty areas like respiratory therapy and pharmacy. Some members attend by phone if their schedules are too busy, but Mitchell believes that meeting in person has a lot of value.

“Everyone [in IT] knows that when they’re designing something, they have to run it by the Nursing Informatics Council,” Mitchell says. “The council does all the testing, and in return they also advocate for the new technology” with the nursing staff in their institutions.

The Nursing Informatics Council also gets recommendations from several ad hoc groups for special areas like mental health and neonatal intensive care.

Mitchell has a seat on THR’s CNO council, where she keeps the system’s nurse executives informed about the progress of IT project that affect their staffs, and writes IT policies for them to approve.

Mitchell and her staff also present frequently at THR’s Nursing Congress, a group of about 150 that includes staff representatives from each hospital as well as a number of specialty areas. The Congress meets every other month to discuss issues related to nursing.

She recently used that meeting to demonstrate an inpatient portal that had been unenthusiastically received at its two pilot sites. She received useful feedback on which features the nurses thought would be most important to their patients and which ones weren’t performing as well as they needed to.

Occasionally Mitchell has to elbow her way into a project to advocate for clinicians’ interests. For example, she’s assigned herself to work on THR’s secure messaging project, ostensibly run by the IT department.

“The more things I can put my hands on, the more things I can influence,” she says. “You have to be willing to step in and identify opportunities, assert yourself, take the bull by the horns. If they don’t want you there, they’ll tell you.”

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