Design Considerations and Workarounds

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“Competencies for Nurse Informaticists” Program Transcript

[MUSIC PLAYING]

PATRICIA BUTTON: You know, in terms of the competencies of nurse informaticians, there's really been a lot of really excellent work done in the past 5 to 10 years, both from the ANA, the American Nurses Association, and the TIGER Initiative. And really outlining what are the key competencies. And I think just an overarching statement about the competencies of informaticians is-- being an informatician is not knowing how to use PowerPoint.

I mean, it's not being computer literate. That certainly is part of it. Much more important is really having an appreciation of the management of data, information, knowledge, from all the different perspectives of how those provide value in the delivery of care.

I would really encourage you to look at the competencies that the ANA and TIGER have sort of keyed in on. And I think what it will really do is help you understand that yes, you need to be computer literate. You need to know how to use a whole variety of applications.

But it's really in the name of understanding what infrastructure is available technically to support the use of these systems in a very productive and impactful way. And in order to do that, there is a whole other layer of competencies in terms of defining use cases, understanding requirements, definitions, understanding how to structure content to make it quote, "computable," ie, that it can be used in a computer system and support the collection of data. So I mean, there really are layers or categories of competencies, again, that both ANA and TIGER have done a fantastic job of outlining.

The skills that serve me very well in this role are understanding what is technically necessary to actually embed content in the software workflow in a way that that will be available sort of at the right time in the clinical process to really impact what clinicians are doing. There's that piece of it. There's very much understanding, and this really is an informatics competency, what is evidence- based content.

It's not what five people sit around a table and say, oh, I think we should do it this way. I think we should do it that way. It's really understanding the role of research in looking at the relationship between interventions or orders and patient and family outcomes.

ROY SIMPSON: Let's review competencies. First of all, we must remember that competencies are defined professionally by a professional organization. And a

professional organization takes in information from other organizations in order to apply certification to those competencies.

So when we look at the American Nurses Association competencies for staff nurse or nurse informatician, we begin to see, if we choose it as a specialty, that it has key characteristics associated with it, for instance, in understanding of databases, how databases are structured, do you understand the scope of practice, what are the characteristics of the scope of practice for a nurse informatician. Ethics is clearly a component of a nurse informatician certification. So we begin to look at those competencies to be established.

When we look at an organization like TIGER, TIGER is not an organization. It is a 501(c) foundation. And it supports the dissemination of information to get out to professional organizations some of the components that need to be in the standard. So we look to our professional organizations to establish our competency, but we look to multiple organizations to feed into the profession to help us establish our competencies.

One of the things that I think sometimes we get confused in competencies and informaticians is that we lose sight of the fact that you need to have nurse competencies, that you need to understand nursing data. You can chart all day sometimes and never put in any information that's about nursing and the patient's well being to be able to impact with nursing care. So we need to be aware that nursing data, on a lot of competency evaluations, that's where most people will fall behind because they see themselves more in a project implementer, that they know project planning, which is not centric to a nurse informatician.

It's not core to their unique knowledge. It's part of their knowledge, but it's not core to their individual knowledge. We shouldn't get confused that someone who does project management or rolls out an implementation program is a nurse informatician. That to be a nurse informatician, you're competent in the nursing knowledge that's needed to be assigned to that profession and that scope of practice.

What competencies do, I believe, are key in being a vice president of nursing for a large HIT vendor or a software developer, ie, which is Cerner Corporation. I think there are a couple. Number one is to know what is and what is not nursing. And I think many times there is a lot of gray areas about what is and what is not nursing.

The second thing is to understand the competencies associated with the profession. What does the profession expect for this type of practice? I think those are key. I think there are nontangible components.

One of them is how to work in a matrix structure. I think a lot of times, so many people are used to line operations. I have 127 people reporting to me. I have 260

people. And in a matrix structure, you're not about how many people report to you, but how many people can you work with to get across a certain concept or a certain type of driver that needs to happen within the organization for culture. Those are really key components.

I think the other thing is that you have to be above reproach. I think that is a key component for anyone in executive leadership. You have to be a part of the discipline, and you have to be knowledgeable of the discipline.

And keeping up with the discipline means you go to school forever. And it's important to understand life-long learning, especially as an informatician. Because we know the data's going to change. We know the professions are going to change. So we need to be aware of that.

Another key component of competency, besides just knowing the scope of practice and licensure requirements and copyrights and infringements and trademarks and all of those things, is to understand that you're always representing your corporation. No matter where you are, 24 hours a day, seven days a week. When you're out and about, you have no other choice but to be on good behavior.

And it's important because I think a lot of people think that you can just separate your job from your personal life and all the other things and with technology, it's kind of voided. I mean, people have Facebooks. When we interview people today, we go and check their Facebook. We pull their credit ratings. There's a whole different host of things today that technology has done that bring your personal life into you as a person when you're hired in a corporation. And I think that's really key as a competency is to be mindful of what your impression is upon those that you work with.

And I think the other thing that is really key is to understand the roles that people have in your organization. That they may not be reporting to you, but you have a responsibility in the corporation to make sure that the work is being done. However you decide to get it done, you have to make sure it gets done. And I think that's a real group process skill. And I think that's different than initial hire.

And of course, you have to know your products. You have to your products backwards and forwards. You have to know what they're going to do, where they're going to go.

And I think one of the other key components is vision. You have to have a vision for where you're going to take whatever you're doing and drive. You can't have change without a vision.