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  1. Kirkley, Debra PhD, RN
  2. Rewick, Demi RN


As members of organizational committees to evaluate and select clinical information systems, nurse executives must identify a system that not only has the core functionality to support necessary changes in workflow and optimize nurse productivity and patient safety but that also is embraced by the nursing staff. There are specific features that nurse executives must demand to help nurses at the bedside reap the greatest benefit from the technology.


Ten years ago, executives at PeaceHealth, an integrated delivery network serving 3 states in the Pacific Northwest, set out to achieve a demanding goal: improve the quality of patient care by analyzing and reorganizing workflow and processes system-wide. A key component of this strategy involved selecting an integrated clinical information system-one with the functionality and technical capabilities to support the wide-ranging needs of all clinical groups.


From the beginning, PeaceHealth made a commitment to involve nurse executives, managers, and staff members throughout the design, selection, implementation, and training phases of the project. The decision was a major factor in the organization's success; instead of focusing primarily on computerized physician order entry (CPOE) and the effect of the implementation on physicians, PeaceHealth recognized the importance of gaining the front-line support and valuable insight of the nursing staff.


As members of PeaceHealth's steering committee to evaluate and select a system, nurse executives and managers led the charge to find technology that would support the nursing staff in providing care throughout inpatient, ambulatory, and home care settings. After a yearlong evaluation process, PeaceHealth selected IDX LastWord, an integrated enterprise clinical information system. The organization's efforts were successful, reducing the number of adverse drug events (ADEs) and resulting in more time for nurses to spend on patient care-not paperwork.


The idea that healthcare information technology (IT) can help streamline processes for clinicians while enhancing patient safety and the quality of care is gaining momentum. From reports such as To Err is Human, 1 which cites IT as an important tool that can help to reduce medical errors, to concerns about the nursing shortage driving efforts to increase productivity, numerous industry-wide issues have converged to create a critical mass of support for the adoption of clinical information systems.


Recognizing the enormous potential to save patient lives and manage staffing issues, what role can nurse executives play in helping their organizations reap the greatest benefits of clinical information systems? The answer is complex, because successful implementation depends on creating buy-in at all levels for major changes in workflow, developing clear goals, and communicating those goals and the achieved outcomes to the nursing staff and other clinicians.


Because nurses interact with the software as much as or more than any other group of clinicians, the system must have the core functionality to support nursing workflow to be effective for the organization overall. It is up to the nurse executive to demand the features that will optimize both nurse productivity and patient safety and ensure that staff members embrace the system.