Slide 1
Faculty/Presenter Disclosure
• Faculty: Sally Remus & Diane Salois-Swallow
• Relationships with commercial interests:
– Nothing to disclose.
Building capacity, operational
readiness & sustainability to realize a
‘SMART’ hospital design & build
eHealth 2013
Ottawa, ON
May 29th, 2013
Sally Remus, RN, BScN, MScN
Director, Health Informatics & Practice
Diane Salois-Swallow RN, BScN, M. Ed.,
Chief Information Officer
Agenda
• Who is Mackenzie Health (MH) ?
• MOHLTC mandate
– Design a ‘smart’ hospital
• New structures & nursing informatics roles/skill sets
• Current Issues and Challenges
• Next steps –
– Good old days vs New reality
– Create a climate of operational readiness
– Future possibilities through innovative NI roles
• Questions/Discussion
Who is Mackenzie Health (MH)?
• Large community hospital
serving Richmond Hill,
Vaughan and other parts of
York Region
• Expanding to a two-site
model: new hospital in
Vaughan in planning stages
Existing Mackenzie Richmond Hill Hospital
Mackenzie Vaughan Hospital
Proposed Concept
MH Quick Facts
Current State:
Future State:
• Opened in 1963, Mackenzie
• Mackenzie Health will include two
Health serves 500,000+ residents
hospitals, the future “Mackenzie
in Southwest York Region
Vaughan Hospital” and the existing
Mackenzie Richmond Hill Hospital • Mackenzie Richmond Hill
~ 600 beds
Hospital (formerly known as York
– construction expected to begin in
Central Hospital) - 488 Beds
2015/16
• Second largest employer in
Southwest York Region
• Annual budget of $250 million
– new hospital (second site) scheduled to
be fully operational by 2018/19
• Southwest York Region is known as
one of the fastest growing and most
diverse communities in Canada.
– 1st new hospital to be built in the
Southwest York Region in 50 years.
MOHLTC Mandate:
Design & Build a ‘Smart’ Hospital
MH’s ‘Smart’ Hospital vision :
• ‘Paperless’ environment where all information is digital
• Systems are automated & interoperable
• Communications are multi-modal & digital
• People are equipped for mobility
• All technologies are IP addressable and Interoperable
To do this requires a ‘state of the art’ IT infrastructure ICAT
6
28th March 2012
7
Copyright - Vantage Business Management Services, 2013
ICAT components that maximize
automation include:
• Electronic Patient Record & Other ‘Enabling Clinical Technologies’
• Automated Patient Bedside Terminals & Bedside Infrastructure
• Fully Automated Pharmacy, Laboratory, Materials Management &
Building Systems
• Integrated Tube Transport System & Infrastructure
• Unified Communications
– Integrates voice, data & image into digital/electronic format
• Auto Guided Vehicles (AGVs)
• Enterprise Service Bus (ESB)
8
Operationalizing ICAT & its components
requires answers to the following questions:
 What do the logistics and material’s management distribution
systems/processes look like?
 What do the drug delivery/distribution & drug administration
systems/processes look like?
 What does bedside care look like? (e.g., bedside terminals, etc.)
 What does ‘unified communications’ look like?
 What does specimen collection/analysis and results
processing/reporting look like from bedside to laboratory?
 What does environmental cleaning look like in clinical vs. nonclinical areas ? For example – ‘terminal room cleaning’, etc…
Nursing informatics roles are essential in ‘brokering’ and
‘translating’ in partnership with key clinical stakeholders, the
answers…
9
Mackenzie Health Organizational Structure
Mackenzie Health Organizational Structure
eHealth through informatics & practice @ MH
Medical
Informatics
Clinical
Informatics
Health Information
Management
Health Care Informatics
Nursing
Informatics
Embracing Enabling Technologies & Innovation in Patient Care through Informatics
Adapted from: Englebart, S, Nelson, R. (2002). Health Care Informatics – An Interdisciplinary Approach, p. xviii;
Eysenbach, G. (2001). What is eHealth. J Med Internet Res 3(2):e20.
Nursing Informatics - New Roles and Skills
Sets
Director, Health Informatics & Practice will :
• facilitate the corporate mandate & realization of the new ‘Smart’ hospital
build (MVH) and MH’s eHealth agenda.
• position MH to be an industry leader in launching a transformative
practice leadership model and governance structure that will enable the
delivery of a ‘world class health experience that is patient focused, results
driven, integrated, and sustainable, critically dependent upon information
and communication technologies’ essential informatics skills & knowledge.
• position MH to realize the benefits of patient safety, quality care delivery
models and knowledge driven care by the application of informatics’ skills
& knowledge to execute ‘state of the art’ enabling information &
communication technologies.
Role alignment with industry trends:
• Informatics competencies & certification
– ANA (2001, 2008); HIMSS, COACH-HIMSS
• Employment trends - new informatics’ roles
– Obama Care & Accountable Care Organization
(ACO) Act influencing the emergence of CNIO
roles to compliment CMIO roles
• Academic preparation of nurses
– TIGER, CASN, RNAO
• Industry Reports – 2003 IOM, Amara 2000
Current Issues and Challenges
Creating & sustaining a climate of operational readiness to meet the
build/design characteristics of the new ‘Smart’ hospital (MVH) supported
by a robust ‘state of the art’ ICT infrastructure:
• Introduce and nurture a ‘new way of thinking’, understanding and
endorsement of the MVH ‘smart’ hospital vision
• Introduce transitional clinical system building blocks to meet HIMSS –
EMRAM Stage 6
– CPOE with full closed loop medication administration checking & Physician
documentation
• Introduce transitional ‘state of the art’ technologies that further the
‘smart’ hospital vision:
– ‘Smart’ beds; Nurse Call Bell System that aligns with a unified
communication’s infrastructure
Current Issues and Challenges cont.
• Design and introduce new work flow practices/processes &
policy/procedures that are scalable/flexible to support
successful transition to MVH ‘smart’ hospital.
• Build internal resource capacity to transition successfully
– Workforce preparation –
 Develop all hospital staff (e.g.., nursing /allied health/physicians) with the requisite
informatics skills & knowledge to leverage the state of the art ICT infrastructure
 Recruit/prepare clinical informatics team to design clinical/business systems that meet
the ‘smart’ hospital vision & eHealth agenda/mandates
– Consumer preparation –
 Educate MVH & MRHH communities to understand & leverage new ‘smart’ hospital
services & offerings that will create MH providing a ‘world class health experience’.
o
E.g.., consumer friendly access to self services - patient scheduling/registration ; chronic disease management
The Good Old Days……
16
Create an ‘operational readiness’
climate via a User Engagement Strategy
#2
#3
#1
Reference: Remus & dela Cruz. (2007). CNIA
Conference Proceedings, Toronto, ON
#4
The New Reality!
18
A glimpse into our future possibilities
with innovative nursing informatics
leadership roles …
http://www.youtube.com/watch?v=gxz9ZVvdu
Gc
Thank You!