Nursing Leadership, 24(2) June 2011: 8-11.doi:10.12927/cjnl.2011.22457

Nursing News

Announcements

Registered Nurses Launch Expert Commission on Health System Renewal

The Canadian Nurses Association has officially launched its National Expert Commission on health system improvement, entitled The Health of Our Nation – The Future of Our Health System. The commission's mandate is to generate policy solutions that contribute to a transformed health system – one that is better equipped to meet the changing health needs of Canada's population.

The commission will be co-chaired by two exceptionally capable and respected Canadians: Marlene Smadu and Maureen A. McTeer. Smadu, a past president of CNA and current vice-president of the International Council of Nurses, is an accomplished nurse educator, researcher and government adviser. McTeer is a health law expert and author, as well as adjunct professor, Faculty of Common Law, University of Ottawa. A diverse roster of Canadian thought leaders with complementary backgrounds, experience and expertise will round out the commission.

The commission will consult with nurses, other healthcare leaders and the public to weigh evidence and advice on how to accelerate a positive transformation of Canada's publicly funded, not-for-profit medicare system. It will seek ways to reduce pressures on our hospital-focused acute care system by building capacity beyond it.

The commission will engage in consultations throughout next year. It will table its final recommendations in June 2012, in time for negotiations on the successor to Canada's health accord, which expires in 2014.

Education of Next Generation of Nurses to Include Effective Clinical Use of Information and Communications Technologies

A new initiative announced by the Canadian Association of Schools of Nursing (CASN) and Canada Health Infoway aims to prepare nursing students for practice in modern, technology-enabled clinical environments. Canada's nursing faculties and students will be involved in a three-year effort to strengthen learning on effective uses of information and communications technologies (ICT), now essential tools in clinical practice.

CASN, in partnership with Infoway, aims to support faculty and nursing students with the knowledge, tools and support they need to teach and practice in a technologically enabled practice setting. The program will engage educators, informatics experts and students at the 91 nursing degree–granting colleges and universities across Canada. Key program components will focus on the development, evaluation and sharing of curriculum-based resources and e-learning tools.

Infoway's investment in the CASN nurses-in-training program is supported by the $500 million in new funding provided by the government of Canada in its 2010 budget. This project is the second initiative of its kind launched by Infoway and is designed to enhance the effective clinical use of ICT among future healthcare providers.

Infoway Invests $380 million to Help Physicians and Nurse Practitioners Implement EMR Systems

With its newest investment program, Canada Health Infoway is funding electronic medical record (EMR) systems in community-based practices and outpatient settings throughout Canada. Infoway president and CEO Richard Alvarez provided details about the $380-million fund, which is designed to focus investment at the points of care where the benefits of health information technology can deliver immediate value to patients and clinicians.

Infoway's investment in electronic medical records is part of the $500 million in new funding provided by the government of Canada in its 2010 budget. Through this program, Infoway will co-fund EMR systems for physicians and nurse practitioners, working through funding programs in provinces and territories throughout Canada. Infoway support will allow provinces and territories that have programs in place to expand their current programs. In jurisdictions planning to introduce a formal EMR program in the near future, Infoway will assist with start-up costs.

Infoway will also invest in clinical peer support networks so that health professionals using EMR systems can learn from others' experience and share best practices, innovation projects and other efforts to accelerate clinical value from the use of information and communications technologies. As well, support will be provided to qualifying information technology vendors needing to upgrade their current product lines to meet Infoway's privacy, security and interoperability standards.

Infoway's investments in EMR systems will be tied to the extent to which health professionals derive clinical value – for example, using an EMR for functions such as entering patient information including notes, allergies, immunizations and prescribed medications, or viewing lab tests. Additional clinical value will be derived from using the more advanced functionality of the EMR and supporting greater interoperability of the EMR with external systems.

Canada Health Infoway is an independent, not-for-profit organization funded by the federal government. Infoway jointly invests with every province and territory to accelerate the development and adoption of information and communications technology projects in Canada. Fully respecting patient confidentiality, these secure systems will provide clinicians and patients with the information they need to better support safe care decisions and manage patients' health. Accessing this vital information quickly will help foster a more modern and sustainable healthcare system for all Canadians.

Appointments

Ontario Appoints New Provincial Chief Nursing Officer

Ontario has appointed Debra Bournes as the new provincial chief nursing officer (PCNO). The PCNO helps to advance a nursing agenda that will benefit both nurses and patients. Bournes has been a nurse since 1990 and most recently has worked as director of nursing, new knowledge and innovation, at the University Health Network in Toronto. She has been a leader in healthcare research and administration for more than 15 years. Her research in nursing recruitment and retention has been widely presented and published, and has led to collaboration among several provincial healthcare organizations and nursing unions. In 2009, she received the Leadership Award for Nursing Research from the Registered Nurses' Association of Ontario for her work on developing a research culture among health professionals.

Linda Miller Appointed Executive Director of CHIEF

COACH: Canada's Health Informatics Association is pleased to announce the appointment of Linda Miller, a former Alberta Health and Wellness deputy minister, CIO and assistant deputy minister (ADM) of information strategic services, as the new executive director of CHIEF: Canada's Health Informatics Executive Forum. A strategic leader, astute executive and team player, Miller has a wealth of experience in dealing with complex, large-scale systems (e.g., the provincial EHR), developing and implementing policy, working in highly complex multi-stakeholder environments and influencing national health and information technology direction within the realities of healthcare delivery. Miller holds a master's degree in health services administration, a baccalaureate in nursing and a certificate in information technology management from the University of Alberta.

St. Michael's Hospital Appoints New Director of Nursing Practice and Education

Heather Campbell, former director of Practice & Regulatory Policy at the College of Nurses of Ontario, recently joined St. Michael's Hospital in Toronto as Director of Nursing Practice and Education.

Awards

Nurses Recognize Top Employers

The Canadian Nurses Association (CNA) announced the winners of the 2011 CNA Employer Recognition Award. This prestigious prize honours employers who have shown an exceptional commitment to supporting registered nurses pursuing and maintaining national certification in a range of nursing specialties/areas of nursing practice.

This year's top prize winner is Toronto's Centre for Addiction and Mental Health. The facility demonstrated exceptional commitment in encouraging certification among its nurses, who then integrate their knowledge into practice and maintain a high degree of competency in the delivery of mental health nursing care. The Centre also provided outstanding educational support for participants of the CNA Certification Program by hosting an annual two-day intensive workshop by nurses specializing in different areas of mental health, thereby boosting nurses' chances of successfully earning their credential.

Honourable mentions were awarded to:

  • Fraser Health (British Columbia), where a high proportion of participants linked their participation in the CNA Certification Program to their annual continuing competence requirements for the renewal of their RN licence;
  • York Central Hospital (Ontario), which created an environment where nurses are supported and encouraged to share their wealth of knowledge with colleagues; and
  • Winnipeg Regional Health Authority (Manitoba), which supports, rewards and recognizes nurses who are experts in their specialties and who provide excellent patient care and mentorship.

CNA also honours employers whose innovative tools and incentives support RNs' pursuit of certification. This year's Innovation Award recipients are:

  • Thunder Bay Regional Health Sciences Centre (Ontario), which strategically positioned itself for a funding opportunity in collaboration with the de Souza Institute and the Regional Cancer Program for nurses preparing for and/or renewing their CNA certification credential in oncology; and
  • Horizon Health Network, Saint John Regional Hospital (New Brunswick), which incorporated CNA certification into the professional development pathway for all newly hired RNs, enabling them to achieve certification within four years of hire.

Ontario Hospital Association Honoured with Prestigious Award

The Ontario Hospital Association (OHA) was presented with the prestigious Best Event Produced by an Association award, announced during the 14th Annual Canadian Event Industry Awards, a national program that recognizes outstanding achievements in Canadian special events. The OHA was recognized for its progressive annual conference and exhibition, HealthAchieve, which has grown from being the association's annual convention to one of the largest healthcare shows of its kind in North America. The show also won a total of four awards in various categories at the International Association of Exhibitions and Events (IAEE) Art of Show Competition in 2010, which recognizes excellence in promotional materials for the exhibitions and events industry.

HealthAchieve attracts more than 7,000 healthcare and business leaders and over 300 exhibiting companies from across the globe. Show participants and exhibitors have praised the HealthAchieve as an excellent opportunity to learn about the latest innovations in technology and health care, hear from world-class speakers and experts from around the world, and network with colleagues from Ontario and beyond. For more information about HealthAchieve, visit www.healthachieve.com.

Executive Director of St. Michael's Li Ka Shing Knowledge Institute Receives Prestigious Health Services Award

The Canadian Health Services Research Foundation (CHSRF) today presented the 2011 Health Services Research Advancement Award to Dr. Andreas Laupacis, executive director of the Li Ka Shing Knowledge Institute of St. Michael's Hospital in Toronto.

Laupacis, who is also a professor in the Faculty of Medicine at the University of Toronto, is past president and CEO of the Institute for Clinical Evaluative Sciences and was the first chair of the Canadian Expert Drug Advisory Committee. For more than 30 years, he has been a leader in bridging research to policies that improve the health of Canadians. Together with Dr. David Sackett and Robin Roberts, he introduced and developed the concept of "number needed to treat," a measure of treatment effectiveness that has come to be a vital component of the clinical and research lexicon. He is currently working with a team of physicians, policy advisers and researchers to maintain an interactive website – www.healthydebate.ca – that provides factual, easy-to-understand information designed to engage citizens in dialogue about important healthcare issues.

CHSRF's Health Services Research Advancement Award recognizes an individual, team or organization that has contributed significantly to advancing the health services research community in Canada and evidence-informed decision-making in the health system. Winners of the award receive $15,000 for use in the advancement of health services research.

Special Report: Realizing the Research Potential of HOBIC: Where to from Here?

The ability to identify and measure patient outcomes affected by nursing practice in the same way across all healthcare settings opens up immense potential for using health system performance research to improve healthcare.

In Ontario, the Health Outcomes for Better Information and Care (HOBIC) program has amassed a rich database that currently includes over 500,000 assessments from 188 participating sites. Now, researchers at the Health System Performance Research Network (HSPRN) and the Institute for Clinical Evaluative Sciences (ICES) are exploring the data's potential to answer important questions about the effectiveness of nursing practice, and our healthcare system as a whole, in improving health outcomes.

In March 2011, HSPRN brought together stakeholders from acute care hospitals, long-term care and home care settings to look at early research results and to discuss strategies to support HOBIC's ongoing implementation.

Early research focuses on readmissions

One of the first research projects undertaken at ICES looked at changes in function and symptoms throughout an acute hospital stay. Significant improvements were shown across most measured outcomes. A second project examined the relationship between HOBIC discharge assessment data and readmission to acute care, with a particular focus on therapeutic self-care. The study used linked HOBIC data with Acute Care Discharge Abstract Data. Not surprisingly, individuals with a recent emergency visit or acute hospital stay, or who had more medical complexity, were more likely to be readmitted. However, the data also indicated that individuals with high therapeutic self-care scores had an almost 10% lower readmission rate – indicating that improving individuals' self-care knowledge and skills before discharge could significantly reduce acute readmissions.

HOBIC is also shedding light on the critical issue of transitions between healthcare settings by gathering standardized health status information across the care continuum. HSPRN/ICES researchers are currently using HOBIC assessments to track patient health status and outcomes between acute care and complex continuing care, long-term care and home care.

Tapping HOBIC's clinical potential

The results of an online survey of nursing leaders conducted by HSPRN researchers in 2011 were discussed at the conference. This exchange provided an opportunity for previously unconnected organizations to share their experience with HOBIC. Workgroups conducted during the conference emerged with several new ideas for improvements to the value derived from HOBIC. Participants identified a number of areas in which they felt HOBIC data could provide added value to clinical care, such as:

  • Identifying what home care services are required based on a patient's acute care discharge assessment;
  • Creating risk profiles based on the research that shows readmission rates are higher for some conditions (nausea, dyspnoea); for example, when is a nausea score too high for a patient to be discharged?
  • Identifying predicators relevant to specific sectors, e.g., predictors for acute readmission.

Participants also suggested that delegating reports to organizations (rather than extracting data themselves) and development of inter-organizational learning collaboratives would enhance the value of HOBIC data.

Making HOBIC more effective

HOBIC's value to nurses, nursing leaders, researchers and health system decision-makers is highly dependent on the quality and quantity of the data. Event participants offered a variety of suggestions to enhance HOBIC's value and to improve the quality and completeness of data for both nurses and researchers. A number of themes emerged that validated survey results:

  • Engage nurses by demonstrating HOBIC's value;
  • Improve quality of data;
  • Address IT issues;
  • Improve reports;
  • Establish standardized quality indicators and benchmarks; and
  • Make the connection to the quality agenda.

Looking ahead

HOBIC's success as a tool for research, policy and provider practice hinges on its success as a clinical tool. Consistent, comprehensive and long-term data collection is required, and more work is needed to achieve that goal. HOBIC offers the potential to track patients' progress within specific episodes of care and across the healthcare system, to identify interventions and programs that are improving health outcomes, and to evaluate how well the system is managing care overall.

Note: Conference material is available at www.hsprn.ca/activities/conf_03182011.html.

 


Comments

Elaine Rose wrote:

Posted 2011/05/07 at 12:49 PM EDT

Nurses recognize top employers. I would love to see this award information from the CNA shared with all of the public. I have been out of the country for much of June so may have missed it in the news, but I think identifying top healthcare employers is every much as important as identifying the top 50 companies to work for.

 

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