1. Sensmeier, Joyce MS, RN, BC, CPHIMS, FHIMSS

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Leaders from the nation's nursing practice organizations, nursing informatics specialty organizations, educational institutions, informatics/technology businesses, government agencies, and other key stakeholders gathered October 30 through November 1 at the 2006 TIGER Summit to create a 3-year local and global action plan for bridging the quality chasm with information technology.

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The Summit, "Evidence and Informatics Transforming Nursing," came at a time when the nation is working full-speed to realize the 10-year goal of electronic health records for its citizens. This is a critical juncture for nurses, who make up 55% of the healthcare workforce, number more than 3 million, and who must become more aware and involved at every level of the informatics revolution. The inaugural TIGER Summit offered a unique, collaborative, and groundbreaking event, one that is critical for inspiring a vision for the future of nursing that enables nurses to use informatics in practice and education to provide safer, higher-quality patient care. The TIGER Summit has been in the planning for nearly 2 years as a response to the demand for healthcare transformation that was presented by the National Office of the Coordinator for Health IT in July 2004.


The invitation-only TIGER Summit took place at the Uniformed Services University of the Health Sciences (USUHS) in Bethesda, MD, bringing together leaders around a singular exploratory focus: creating a vision for the future of nursing that bridges the quality chasm with information technology (IT), enabling nurses to use informatics in practice and education to provide safer, higher-quality patient care.


Preliminary findings in advance of the final report were released November 2006 and define steps for the next 3 years toward the 10-year vision in all the key action areas listed below.


Management & Leadership: Revolutionary leadership that drives, empowers, and executes the transformation of healthcare.


* Publish TIGER outcomes and execute the 3-year action plan.


* Identify strategies for increasing the power, influence, and presence of nursing through professional organizations in governmental and legal bodies.


* Create specific leadership, management, education, and development strategies.



Education: Collaborative learning communities that maximize the possibilities of technology toward knowledge development and dissemination, driving rapid deployment and implementation of best practices.


* Reform the nursing curriculum through integration of IT, information literacy and informatics and the infusion of technologies for learning.


* Seek funding to develop and implement learning innovations, foster faculty development and ensure necessary infrastructure.


* Increase faculty acceptance of technology through education and training, incentives, and necessary supports.


* Convene a national group to develop strategies for the recruitment, retention, and training of current and future workforces in informatics education, practice, and research.



Communication & Collaboration: Standardized, person-centered, technology-enabled processes to facilitate teamwork and relationships across the continuum of care.


* Convene stakeholders to establish, disseminate, and support a shared vision, core values, and goals.


* Establish demonstration projects to model collaborative relationships across the continuum of care.


* Localize TIGER vision by creating regional sharing (among practice, education, research, and informatics).


* Establish demonstration projects to model collaborative relationships across the continuum of care.



Informatics Design: Evidence-based, interoperable intelligence systems that support education and practice to foster quality care and safety.


* Include multidisciplinary end users in the design and integration/incorporation of informatics that is intuitive, affordable, usable, responsive, and evidence based across the continuum of care.


* Develop guidelines for integrating informatics infrastructure: intelligence systems, IT hardware architecture, data documentation and warehousing, universal database, and portals of knowledge.


* Design systems that promote the mining and use of data for analysis, clinical decision making, and measurement to improve the quality of care.


* Create and implement multidisciplinary, multilingual standards.



Information Technology: Smart, people-centered, affordable technologies that are universal, usable, useful, and standards based.


* Integrate interoperability IT standards to clinical standards (practice and education).


* Educate practice and education communities on IT standards and establish hard deadlines for adoption.


* Strive for secure and reliable access to IT based on needs and standards.



Policy: Consistent, incentives-based initiatives (organizational and governmental) that support advocacy and coalition building, achieving and resourcing an ethical culture of safety.


* Require nurses' involvement in a national health IT agenda, congressional testimony, and participation in policy decisions at all levels toward technology that supports ethical, safe patient care.


* Endorse consistent, agreed-upon IT standards.


* Obtain funding for curriculum expansion, research and practice in nursing informatics, and IT.


* Identify incentives that support the adoption of innovative technologies.


* Support a personal health record (PHR) for every person in the United States.



Culture: A respectful, open system that leverages technology across disciplines, and stresses the importance of trust in working toward a shared goal of high quality and safety.


* Launch a national marketing campaign to foster this culture.


* Integrate technology into the strategic plans, missions, and goals of nursing organizations.



The Summit was sponsored by the following organizations: Agency for Healthcare Research and Quality (AHRQ), Alliance for Nursing Informatics (ANI), American Health Information Management Association (AHIMA), American Medical Informatics Association (AMIA), American Nurses Association (ANA), American Nursing Informatics Association (ANIA), Apptis, Audience Response Systems, Capital Area Roundtable on Informatics in Nursing (CARING), Cerner Corporation, Clinical Information Technology Program Office (CITPO), CliniComp Intl., CPM Resource Center, Eclipsys, Elsevier, GE Healthcare Systems, Healthcare Information and Management Systems Society (HIMSS), IBM, Independence Foundation, Marion J. Ball-Johns Hopkins School of Nursing, McKesson, MITRE Corporation, National Library of Medicine, Robert Wood Johnson Foundation, Siemens, Sigma Theta Tau, Tenet Healthcare, Thomson Healthcare, and University of Maryland-Baltimore County.