Calling all dreamers, malcontents and restless sleepers who pace the clinical corridors and carry the burden of patient care on the front lines. Let’s face it, the stakes are high and every day clinicians engage in high risk decision making in a very hectic and complex system of care. Multi-phrenic demands and unrealistic expectations can send our cortisol soaring at a moment’s notice and can put even the most seasoned practitioner at risk for clouded judgement. At the turn of a knob to a patient room or during an impromptu call, clinicians want to be sharp, competent, efficient and ready for the unexpected. The problem is not that individual members of the health care team are not working hard enough to provide high-quality, compassionate care, but in part due to the lack of sufficiently sophisticated tools to match the levels of complexity inherent in today’s health care environment.
I recently watched a Microsoft AI commercial that challenged me. The speaker exhorts, “Today, right now, you have more power at your fingertips than entire generations that came before you.” Later the speaker asks, “What will you do with it?” I believe the wisdom is in the room—the clinical room. I believe point of care clinicians should drive the innovation of tools that in turn ignite patient engagement and self-efficacy, as well as real-time learning and innovation. Who could be better fitted with such a task? We just have to dream it and get the right folks to listen. The alternative, to include poor outcomes, error, dissatisfaction, isolation, and burnout--all symptoms of the quality chasm--is unacceptable.
In a new era marked by technological innovation, knowledge explosion, social media overload and growing information complexity, how do we, as clinicians, translate the best medical science into high-quality, safe care where the rubber meets the road at the point of care (POC)? It’s time to wrestle with how emerging challenges affect how we think and what we do. We should expect our practice to be studded with meaningful feedback loops that merge into a superhighway of bidirectional learning that will facilitate best practices, promote patient safety, and arrive at a destination that delivers on quality NOW, not ten years from now. I believe our systems of care can mirror great organizations that already perform in high risk industries such as aviation, and with intelligent design such as Apple.
Every day clinicians grapple with unrealistic expectations resulting from the effects of growing regulatory pressure, health care knowledge explosion, and the rapid, and continuous introduction of new ideas, processes, and information technologies. In the wake of all this activity, clinicians often experience first-hand the harmful effects of a local, quick-fix approach that uses existing technologies and modes of operating within a health system that lags far behind in comparison to other high-risk sectors.
In a four-part series, I invite you to explore with me key areas that promote a more integrated approach to clinical decision support. There is a need to develop innovative tools that mirror the complexity of care at multiple levels, safeguard patient safety, and help prioritize realistic expectations at the point of care. I believe solutions will emerge from successful diffusion of innovative strategies to deliver safe, evidence-based care.
Part one will take a look at knowledge management tools as a vehicle to augment your practice as well as facilitate safe, evidence-based, data-driven decision making, learning and innovation, and clinical practice leadership.
In part two, we will explore the Institute of Medicine’s (IOM) imperative to deliver on safe, evidence-based, data-driven decision making to include challenges in “adjusting to new discoveries, disseminating data in real time, organizing and coordinating the enormous volume of research and recommendations, and providing incentives for choosing the smartest route to health” (IOM, 2012, p. xii).
This unprecedented era in healthcare will require rapid improvement mechanisms and novel methods to guide the health care team through the situational demands of a rapidly changing clinical work environment. Several initiatives including the Institute of Healthcare Improvement (IHI) and Quality Improvement Organizations (QIO) have emerged to support a healthcare business model of value-driven care that is transparent, patient-centered, and safe. Part three, Learning and Innovation, and part four, Clinical Practice Leadership, will take a deeper dive into meaningful ways to engage within your organization and create change at a systems level.
Back to the Microsoft commercial. After the speaker asks the question, “what will you do with it?” he goes on to say something even more profound:
“Think about that. That’s what technology really is. It’s possibility. It’s adaptability. It’s capability. But in the end it’s only a tool. What’s a hammer without a person who swings it? It’s not about what technology can do. It’s about what YOU can do with it.”
Wow, that puts the responsibility and power in our court. Many of you are already overextended and one more “to-do” is not even possible. To that I say, you have a voice and we can start the conversation now. The wisdom is in the room and if we put our heads together our ideas will drive the innovators, developers and leaders that want to make a difference. Things can change, and at Point of Care our passion is to make a difference. To do things differently and to disrupt the marketplace. We dare to dream. We dare to believe in front line clinicians, like you, who suffer restless nights, endure long hours to meet the need, and are dissatisfied with the status quo. Let’s talk. We are listening.
Institute of Medicine (IOM). (2012). Health IT and patient safety : Building safer systems for better care. Washington, D.C.: National Academies Press.
Microsoft (Producer). (2018, February 9). Microsoft: empowering innovation [Video file].