Nurses Peg Interdisciplinary Collaboration as Backbone of Effective Capital Purchases

Posted June 10, 2017

Although getting all of the major players involved with healthcare technology around the same table may seem like a daunting task, it's essential to worthwhile capital purchases, according to Nicole Denham, RN, BSN, PCCN, and Bonnie Matthews, RN, BSN, PCCN—the two principal nursing consultants behind COR (Clinical Operations Renewal), LLC.

Too often, they said during their Saturday morning presentation at the AAMI 2017 Conference & Expo in Austin, TX, the stakeholders in the healthcare arena are working at cross-purposes. For example, while senior leadership may be focused on return on investment and reimbursement, vendors on sales strategy and trumpeting features of devices, and information technology (IT) on device functionality and interoperability, the needs of clinical end-users, including nurses, can get lost in the shuffle.

Clinical insight, they argued, should be the primary driver at every step along the way from capital purchase to project implementation, and good patient safety and systems outcomes are inextricably linked to effective interdisciplinary collaboration. If the clinical team wants to make a capital purchase but they don't bring the right healthcare technology management (HTM) people into the equation, it's not going to go smoothly.

Overall, Denham and Matthews identified these key ingredients to a worthwhile capital purchase:

  • It promotes patient safety.
  • It improves patient outcomes.
  • Given the specific needs of end-users, it's the most cost-effective version available.
  • It's user friendly.
  • It increases workflow efficiency.
  • It values solution over function (i.e., it will resolve the problem at the bedside).

According to Denham, the mean age of American nurses is 48, and many have witnessed a massive surge in technology over the course of their careers. For these nurses, technology used to be "down the hall." Now, it's embedded in their everyday workflow.

Cognitive burden is a very real issue for many bedside nurses, and their perspective on technology may often be one of "what do I need to know right now about this device to help my patients get better." As such, a given piece of equipment may be able to do a lot more than what a nurse has the time or inclination to learn and implement.

Given the diversity of viewpoints, Denham and Matthews have come to be strong proponents of an initial sit-down among key stakeholders—many of whom don't typically come in contact with one another on a daily basis. To get everyone organized and avoid frustration down the road, they’ve learned the vital importance of having a kick-off meeting involving nursing leadership, HTM, IT, nursing informatics, clinical educators, one or more physician champions, risk management professionals, and the device vendor.

Following the kick-off meeting, methodically checking off items on an interdisciplinary task list becomes crucial. Such a list might include:

  • A technical requirement checklist
  • Risk management sign-off
  • Medical record integration
  • Workflow assessment and planning
  • Load testing
  • Security and firewall planning

After the capital purchase has been implemented into the clinical environment and gone live, additional tasks are needed to ensure it functions properly. These may include:

  • Weekly check-ins
  • Roving support and education planning
  • Troubleshooting and FAQs
  • Establishing a process for reporting
  • Postimplementation evaluations (i.e., importance of shadowing)
  • Re-education
  • Re-evaluation of strategies

Predicating the decision to make a capital purchase on patient safety is vital, said Denham and Matthews. This doesn't always mean selecting the "fanciest" product because unless clinicians can master the use of a device in the name of safe and effective patient care, then it isn't a good purchase. Sometimes practical approaches, such as getting everyone around the same table, can be just what is needed.