While working with my colleagues on several clinical communication go-lives in the past few weeks, it became very apparent that the clinical communication workflow is not something in which most informatics nurses have had a great deal of experience. That makes sense, since in the past, nursing’s involvement in communications was to determine how many phones/pagers were needed on each unit. And, for many organizations, telecommunications is a separate unit within the IT infrastructure – distinct from those who work with the EHR and other clinical systems…so much so that clinical informatics team may have never even met the members of the telecommunication team. As informatics professionals, we may not have had the opportunity to educate the telecomm team as to why it is important for us to work collaboratively.
One of my colleagues recently had a conversation with a telecommunication manager who basically said he didn’t care what the clinicians wanted―that he would buy what he thought was best for them. I would love to see the criteria that would be used to make a decision in this facility…something tells me that clinical workflow would be low on the list. This is the kind of thinking that led to the #1 in ERCI’s Top 10 Patient Safety Concerns being health IT configurations and organizational workflow that don’t support each other!1 It is also why inpatient clinicians are still using 1980’s communication technologies instead of adopting newer technologies that could help improve patient safety while supporting clinicians’ cognitive workload.
Now that we are adding secured texting, alerts, and alarms to the communication mix as well as working to improve clinical workflow and patient care activities it is essential that informatics professionals learn about the basics of telecommunication technology and where it impacts the daily work of clinicians. We must gain a deeper understanding of how communication happens in each of our facilities. I have learned it is much more complex and convoluted than we might think or that we remember from our days in clinical practice.
Clinical communication technology must support clinical workflow in order to promote safety, accuracy and efficiency. Therefore, it is imperative clinical informatics partner with telecommunication in the decision making process. So learn everything you can, starting with introducing yourselves to your telecommunication team.
1. ECRI Top 10 Patient Safety Concerns for 2016: www.ecri.org/patientsafetytop10