Five questions with clinical: Supporting a successful mobile program

Don't let IT and clinical disconnects create gaps in mobile program planning. Learn why understanding the needs of the end user is key to successfully implementing IT solutions in clinical settings.

Last week I had the chance to sit down with Claire Reilly, CNIO, here at Imprivata. Claire is currently the VP Clinical Operations and Chief Nursing Informatics officer at Imprivata where she advises on the clinical practice of healthcare IT security. She trained at Peterborough and Stamford School of Nursing in the United Kingdom, then pursued her Masters in Health Informatics, at The University of Central Lancashire, United Kingdom. Claire brings over 35 years of experience in the healthcare industry as an Emergency Room RN, where she has practiced worldwide including Qatar, United Kingdom, Massachusetts, Bermuda, and Saudi Arabia, contributing to our global marketing clinical practices.

We discussed how a disconnect between IT and clinical can create gaps in mobile program planning, highlighting the importance of understanding the needs of the end user – primarily nursing staff – when implementing IT solutions in clinical settings. This includes the applications used by nurses and the workflows those apps support.

To understand the needs of nursing staff and eliminate gaps in mobile program planning, IT teams must involve clinical early and often in the process.

Three primary takeaways

Out of the conversation came three primary takeaways that every IT and mobile team needs to understand:

• Takeaway 1: The key to successfully integrating IT in clinical settings lies in understanding the end users’ needs and workflow and the footprint
• Takeaway 2: Clinical staff must be thoroughly trained on new technologies for a successful deployment which needs to include the development, planning and deployment of the said technology
• Takeaway 3: IT solutions that aren’t integrated into existing clinical workflows/footprints will end up disrupting workflows

Successful implementation and adoption of new IT solutions in clinical settings requires understanding and accommodation. The end users know their jobs and how to do them well, and mobile technologies must support these existing workflows in order for adoption and for the business to see a return on investment.

The mobile program Q&A

Rachel: When it comes to mobile, what baseline tools does IT need to implement to allow nursing to be successful?

Claire: The relevant applications you make available to a nurse on a mobile device, the more successful and adopted the program will be. Nursing needs an EMR or EHR, a unified communication tool, plus or minus whatever they use as a secure messaging platform, as they aren’t always one and the same. And then you need early warning scores if they aren't already integrated into the clinical communication and collaboration tools.

Nurses need to be able to chart. We need to be able to do med administration. We need unified communication. We need to make sure we've got the right folks no matter what phone they have. We need to get the message to the right person quickly. These capabilities maximize your mobile investment.

It's really about reducing the number of tools on the clinical toolbelt and consolidating wherever you can. That's what'll drive usability and adoption. For each tool, it's also critical for IT to understand exactly how it's being used. Often times, IT and security are unaware of how end users leverage tools — communicating PHI vs. quick chats vs. role-based escalation of alerts. Knowing exactly how the clinical team will use each app helps IT set the appropriate parameters around things like security, session windows, etc.

Rachel: When and how should IT and mobile teams be integrating clinical end users into the planning process?

Claire: Early and often. Failing to involve clinical teams in the planning and implementation stages is a recipe for failure. With mobile, you have to look at the workflow, and you have to look at the footprint. Where is the clinician going to pick up the device? Where are they going to return it? Does what you’re asking of them align with their workflow? If not, it's going to be a challenge, not just in terms of adoption and usability, but you're also going to run into lost and misplaced devices.

A float nurse might pick up a device in the ICU and end up in the ED. We can't block them from putting that device there if we don’t want them to take it home. But IT so often makes that decision, and then the phones just don't return.

Rachel: What are the top reasons you see for why a clinician isn't using a mobile phone that's been provided to them?

Claire: If it's locked away, if the phones are nowhere near place where I do handover , if the technology doesn't work, if there's Wi-Fi challenges, that's another big deal. Also, security. If it takes too many actions to get into the device, get into my apps, get into the tools that I need, it's not happening. A nurse is going to find workarounds because at the end of the day, what they care about is getting to the patient and delivering care, not technology best practices, not security. It's about patient safety and saving lives.

Rachel: Can you share some best practices to support effective training of clinical end users?

Claire: It's important to focus on a handful of “power users” or “champions” who can help educate, drive early usage, and share their experiences with others. These are usually vocal, well-respected, well-known users who are connected with many teams and groups, really amplifying the importance of the new workflow or solution.

From there, training everyone – at scale – really requires a "train the trainer" approach. You know, as in, many hands make light work. And it's especially true in a hospital setting, where you may only be able to grab a handful, four or five clinicians at a given time to train them up. Creating a network of knowledge allows for more flexibility.

Also, train clinicians at a time when it's convenient for them, so they can really learn the workflow and absorb the information. Trying to grab them for five minutes at the start of a shift is NOT it. I'd also recommend having other supporting materials on hand to share around, like a trifold pamphlet, and some small posters or leaflets that quickly describe what the workflow looks like and what to expect. Steps like that go a long way in helping to prevent confusion after the implementation team has gone and it's in everyday use.

Rachel: What's most important for IT to understand from the clinician's point of view?

Claire: Your mobile program has to be easy and efficient. And if you make it efficient, I'll keep it secure for you.

Looking to understand more about how to best support clinicians when moving forward with a mobile program? Take a look at our quick checklist to get started.