Healthcare Decision Support: A Modern Tool for Today's Chief Nursing Officer

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As she took a short morning walk prior to starting her busy daily schedule, Faye Spencer, Pennington Health’s Chief Nursing Officer (CNO), reflected on her long journey as a nurse. When she first graduated from her nursing program, nurse executives were commonly referred to as nursing directors and typically focused on assuring that inpatient nursing care was effective, safe, and compassionate. Their primary responsibility was keeping inpatient care running 24/7, 365 days a year.

As acute care hospitals steadily merged into health systems as part of clinically integrated networks often affiliated with outpatient care providers to support cross-continuum care, the nursing profession’s scope substantially expanded, as it impacts patients’ overall health and well-being. Now more than ever, health systems clearly recognize that nursing is core to achieving critically important strategic objectives, including clinical, operational, financial, growth, market share, and patient satisfaction goals. With over three million members nationwide, nursing is the largest, most trusted workforce in healthcare. Nurses are critical assets every health system must leverage, which can’t happen without effective, innovative leadership.

Because of these important trends, today’s health system CNOs are essential C-Suite members, working collaboratively with chiefs of medicine, finance, strategy, business development, IT, and quality, among others in the organization to achieve strategic and operational goals. Like all CNOs, Faye knows she needs a solid plan in place to assure that precious nursing resources are directly aligned with the organization’s overall strategic objectives.

Healthcare Decision Support Helps CNOs like Faye Address the Unexpected

Faye is currently working with the CMO to address an unexpected rise in potentially preventable readmissions, which was recently highlighted by Pennington’s executive decision support system (Figure 1). This issue must be addressed because it could lead to substantial financial penalties. In that capacity, she is responsible for addressing all nursing components that influence readmissions—inpatient care, the discharge process, and post-discharge care, including Pennington’s care management program—to ensure the system’s performance returns to pre-established targets.

Figure 1: Executive decision support system alerts CNO to rising readmissions

Faye is also working with the CMO on the system’s Comprehensive Care for Joint Replacement Model program to eliminate care variation throughout the bundle’s entirety so Pennington can provide efficient care and maintain a solid bottom line. Given that CMS has indicated that the number of care bundles and pay for performance programs will continue to grow, Faye must successfully eliminate inappropriate care variation throughout the system’s broader nursing enterprise. Health systems preparing to manage in an increasingly risk-based environment must count on highly reliable nursing leadership and care.

Due to the aggressive reimbursement cuts every healthcare organization faces, and the increased pressure to tightly manage total cost of care, CNOs must also be vigilant in designing and sustaining care models that use nursing resources as efficiently and effectively as possible.

Faye has been working with the CMO and CFO to address growing payroll expenses at a couple of hospitals due to the excessive use of temporary nurses—an issue called to her attention by the CEO because it’s impacting days cash on hand. Faye knows she must eliminate costly turnover and using temporary nurses as much as possible to keep costs low and productivity high. She must also assure that all nursing professionals are working at the top of their licenses in all settings to eliminate non-value-added work. Pursuing the type of transformative care model design that accountable care calls for is no longer optional—it’s a necessity.

Healthcare Decision Support Puts CNOs Ahead of the Healthcare Transformation Curve

As healthcare rapidly transforms, it’s easy to be overwhelmed by the new normal. This new reality might even feel like it is light years away from what brought CNOs into nursing in the first place. However, it is important to remember that the purpose of a CNO—and nurses in general—has not changed. Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations. This purpose is well aligned with quality and patient safety improvement goals, and reducing costs wherever possible. What has changed are the tools and skill sets needed to achieve those aims.

As any nurse manager on the executive track knows, their performance requires skill and aptitude well beyond their initial training as nurses. Faye has had to develop a strong leadership team skilled in facilitation, lean principles, and data-driven quality improvement. The CNO and her leadership team must likewise have expertise in finance and IT, while also carrying on nursing leaders’ traditional functions. The modern nursing leader must be as comfortable talking about techniques to improve productivity and reporting, and the strategic importance of an IT initiative, as they are about patient care initiatives.

Nurses need to view healthcare as a data-driven science rather than solely a proficiency-based art. This requires paying increased attention to business intelligenceanalytics, and the software tools required for success. This is why Pennington’s executive decision support system, which Faye and other C-Suite members use daily to manage Pennington’s multifaceted strategies, is so important. The executive decision support system provides data to clinical and operational leaders, enabling them to focus on the right opportunities, address unexpected challenges, and realize outcome improvements.

All modern health systems accept—and, increasingly, embrace—the reality that data-driven improvement and the use of advanced analytical tools is critical to improving the quality of care and reducing escalating healthcare costs. The opportunity to capitalize on the vast amount of clinical, financial, satisfaction, and operational data captured and stored in all health systems has become a reality. As healthcare organizations take on more risk for managing their patient populations, they need more data on how well they are performing, including the ability to identify patterns, and determine which treatments are most effective for which patients and which operational processes are most efficient.

Leading Effectively in a Complex Care Environment with Healthcare Decision Support

By exploiting its fully integrated, executive decision support system, Faye and other members of Pennington’s C-Suite team can effectively lead in an increasingly complex care environment. They can promote best practices and utilize collaborative decision making among operational leaders, clinical providers, and staff, while also promoting care standardization.

As a result, patient care is improving as quality and safety are enhanced. An integrated executive decision support system allows all care providers and leaders to view care, regardless of where it’s received, across the continuum. Equally importantly, costs are decreasing as care providers gain access to real-time data that can prevent the unnecessary duplication and variation that cost systems millions of dollars. Pennington’s future is bright—and Faye knows it.

Additional Reading

Would you like to learn more about this topic? Here are some articles we suggest:

  1. Healthcare Decision Support Helps CFOs Achieve Their Top Goal: Timely, Accurate, Agile Decision Making
  2. Why CMOs Need Healthcare Executive Dashboards to Lead High-Performing Systems
  3. Why the Executive Dashboard Is a Healthcare CEO’s Best Advisor
  4. Leading Wisely in Healthcare: Why the Next Generation Executive Decision Support System is an Industrywide Imperative
  5. Leading Wisely: Better Executive Decision Support
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