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2. nursing

Welcome to the
Public Health Nursing Summit Series 2012
Session #1 - October 24, 2012
Toronto, Ontario
Collaboration
• Summit is second joint RNAO/PHO effort
• Thanks to our collaborators:
• ANDSOOHA - Association of Nursing Directors and Supervisors in
Official Health Agencies in Ontario
• CHING - Community Health Nurses' Initiatives Group
• Thank you to the members of the Public Health Nursing –
Professional Development Advisory Group
• We also relied on the expertise and enthusiasm of our
panelists and speakers, RNAO’s e-Health champions
RNAO – PHO Public Health Nursing Summit Series 2012
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Thank you to the advisory group!
• Marcia Annamunthodo (PHN,
York)
• Ruth Schofield (McMaster
University)
• Joanne Crawford (PHN, City of
Hamilton)
• Sara Clemens (RNAO)
• Tim Lenartowych (RNAO)
• Audrey Danaher
• Heather Dickson (PHN,KFL&A)
• Diane Dowling (PHN, KFL&A)
• Ian Johnson (PHO)
• Anne Simard (PHO)
• Joyce See (CNO – Halton and
ANSOOHA rep)
Thanks to our support team: Kayla Scott and Rosanna Ho
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Objectives of the Summit Series
• Define e-health concepts and identify their relevance to public health and
public health nursing practice.
• Demonstrate e-health applications through the use of innovative technology
applications.
• Discuss how the public health nursing discipline-specific competencies apply to
their e-health practices in public health.
• Identify the linkages between e-health and the upstream nature of public
health nursing in supporting population health, addressing social inequities
and focusing on the social determinants of health.
• Apply knowledge of discipline-specific competencies during e-health scenarios.
• Generate ideas to support e-health applications in public health nursing
practice.
RNAO – PHO Public Health Nursing Summit Series 2012
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Summit Series: quick snapshot
Today
Oct. 31
Kingston
Nov. 7
Sudbury
• Overview of e-health
• e-health innovations in public health nursing
practice
Join us in person or by webinar
• e-health solutions to improving service
delivery
•http://www.publichealthnursingsu
supports, opportunities, challenges
mmit2012.eventbrite.com/
• E-health solutions to support public health
nursing care for community as client
• Social media and internet literacy
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Knowledge Management: A Public eHealth Innovation
Rita Wilson RN M Ed. MN
October 24, 2012
Presentation Overview
 eHealth concepts and their relevance to public health
nursing practice
 Knowledge Management (KM) as a Public eHealth
innovation to support public health nursing:
 Benefits
 Implementation Considerations
 Lessons learned from others
Public Health Current State of Knowledge
We are drowning in
information but starved for
knowledge. This level of
information is clearly
impossible to be handled by
present means. Uncontrolled
and unorganized information
is no longer a resource in an
information society, instead it
becomes the enemy”
(John Naisbitt)
What is eHealth?
"eHealth is the single-most important revolution in
healthcare since the advent of modern medicine,
vaccines, or even public health measures like
sanitation and clean water".
(Silber, 2003)
What is eHealth?
"eHealth is...the organisation and delivery of health services
and information using the Internet and related
technologies...[it] characterizes not only a technical
development, but also a new way of working, an attitude, and
a commitment for networked, global thinking, to improve
health care locally, regionally, and worldwide by using
information and communication technology.”
(Eysenbach, 2001)
What is Knowledge Management?
Knowledge management is a process used by
organizations and communities to improve how
business is conducted by leveraging data and
information that are gathered, organized, managed,
and shared.
(Association of State and Territorial Health Officials (ASTHO), 2005)
eHealth at WHO
"eHealth is the cost-effective and secure use of information and
communications technologies in support of health and healthrelated fields, including health-care services, health surveillance,
health literature, and health education, knowledge and research“
(World Health Organization (WHO), 2005)
eHealth is the use of information and communication
technologies (ICT) for health. Examples include treating
patients, conducting research, educating the health workforce,
tracking diseases and monitoring public health.
(WHO, 2012)
KM as Public eHealth Innovation
1. Waterloo Public Health Nurse
(PHN) accesses population- based
DATA from hospital EHR discharge
statistical reports to identify
populations with high rates of
tobacco use. (INFORMATION)
EHRs
2. PHN conducts focus group
interviews to assess risk
factors. RNAO SC Nursing
Order Sets are used to
implement appropriate
interventions . PHN
monitors outcomes to
evaluate effectiveness.
Knowledge
Management
3. PHN generates
KNOWLEDGE about which
interventions work best in
which circumstances and
shares KNOWLEDGE with
other PHUs via RNAO
Community of Practice.
Why KM important for PHNs?
 Challenges of knowledge management in public health nursing:
 Breadth of knowledge required
 Staff turnover  lost knowledge
 Inefficient use of technology:
 Standalone systems
 Out-dated technology
 Paper-based tools/processes:
 Referrals, nursing documentation, best practice
guidelines, clinical resources
 Limited capacity for internal and external knowledge sharing
among PHUs
Knowledge Management Framework
Processes
Content
(ASTHO, 2005)
Culture
 Identify how information is communicated
 Internally & externally (i.e. paper-based vs electronic
means)
 Emphasis on collaboration and information sharing
 Attitude towards change
 KM Goal:
 Foster culture of collaboration and knowledge sharing
Content
 Content resources of an organization include:
 Data and information
 What knowledge currently exists and where?
• Tacit knowledge (i.e. skills or expertise)
• Explicit knowledge
(e.g. policies/procedures, research,
best practice guidelines, clinical resources)
 KM Goal:
 Use tacit knowledge to help manage and create explicit
knowledge and build more tacit knowledge
Process
 Identify existing processes established to manage data,
information and knowledge:
 Formal policies and procedures
 Informal practices
– “this is the way we’ve always done it”
 KM Goal:
 Formalized processes to ensure effectiveness of the
creation, management & dissemination of content.
IT Infrastructure
 Identify the nature and current use of existing technology:
 Types of technology
 Rate of adoption
 Levels of expertise in usage and user support
 Maintenance of technology
 KM Goal:
 Effectiveness use of IT infrastructure for the creation,
management & dissemination of content.
Knowledge Management Framework
Processes
Content
The interrelationships of these
components will determine the success
of an organization’s KM strategy. For
example, the nature of the content
(including skills), processes, and
culture will influence the adoption of the
KM technological solution.
Benefits of KM for Public Health Nurses
 Knowledge Management can:
 Provide an efficient way of developing, disseminating and
evaluating best practices (e.g. RNAO’s Nursing Order Sets)
 Increase access to existing knowledge – reduce time spent
“reinventing the wheel”.
 Help an organization to retain knowledge when staff leaves.
 Optimize use of technology to better manage and integrate
existing information through cross-referencing and sharing.
Considerations for Implementing
KM in Public Health Nursing
 Time and resources to conduct current state & gap analyses
 Business processes
 Information flow
 Missing information
 Current knowledge- where and how used
 Existing and required Knowledge Management skills
 Culture
 Many intra-organizational cultures
 Multiple factors affect sharing of data and information
Considerations for Implementing
KM in Public Health Nursing
 Content
 Difficulty identifying and capturing tacit knowledge
 Processes
 Data are typically collected for a single, specific purpose.
 Lack of consistent vocabulary in documentation – hinders
data sharing
 IT Infrastructure
 Standalone systems, out-of-date hardware
 Lack of staff with IT and public health knowledge – need for
PHN with informatics knowledge to bridge “language” barrier
Lessons Learned From Others
 Clear vision and leadership needed
 Success begins with acknowledgment of information assets
 Educate others on potential for improving information
integration and access to shared knowledge
 Tacit knowledge more difficult to capture and manage;
develop an “expertise database”
 Develop optimal means to store and maintain data for
greatest accessibility by PHNs and other stakeholders
within and outside of the agency and within and across
jurisdictions.
Key Messages
 Public eHealth is in its infancy stages
 PHNs can play a key role in laying the groundwork for
using KM as a framework for improving efficiency and
effectiveness
 KM has the potential to:
 Help public health units more fully leverage their
information and knowledge assets
 Improve individual knowledge base
 Facilitate equitable access to knowledge to optimize
delivery of public health nursing practice
“Not to know is bad, not
to wish to know is
worse.”
Knowledge is like money: to
be of value it must circulate,
and in circulating it can
increase in quantity and,
hopefully, in value.
Louis L‘ Amour
Questions
2nd Biennial PHN Nursing Summit
October 24, 2012
Karen Quigley-Hobbs
Region of Waterloo Public Health
CNO
Outline
• Review of E-Health – what does it mean
for nursing
• Standards/Competencies of Public Health
Nursing
• Knowledge Management –the added
value of e-health
• Application to Public Health Nursing
“E” has changed
our personal world
On-line
education
On-line
banking
Skype
BBM/
Face
time
Social
MediaTwitter
“E” has changed
the professional world
Provides access
across miles,
sectors, and
time
Utilization
mechanism for
knowledge
Bridges
communities of
practice
“E” has changed
Knowledge Management
“ in the same way that Gutenberg's printing press
promoted the distribution and dissemination of
information, eHealth stands at the cusp of
doing the same for healthcare and nursing”
“RNAO E-Health for every nurse”
E-health
" the leveraging of information and
communication technology to enhance
professional practice in order to promote
and facilitate the health and well-being of
individuals and families "
e-Health Nurses Network, 2007
Result: Time of
Transformation
Enhancement
of Practice
Information
Management
Utilization of
Information
Technology
Information
Economy
PHN Nursing Competencies
• Public Health and Nursing
Sciences
• Assessment and Analysis
• Policy and Program planning,
Implementation and Evaluation
• Partnerships, Collaboration
and Advocacy
• Diversity and inclusiveness
• Communication
• Leadership
• Professional Responsibility
and Accountability
Public Health &
Nursing Sciences
Key knowledge and critical thinking skills
related to public health and nursing
sciences
• On-line learning
• Applied Research
• Academic Research
Assessment & Analysis
Competencies to collect, assess, analyze
and apply information
• Electronic Medical Records (EMR)
• On-line tests (OLIS)
• Clinic Connect
• iPHIS –Cognos Reports
Case Management
Policy & Program Planning,
Implementation & Evaluation
Effective choice of options to plan,
implement and evaluate policies/programs
• Communication/community action
• Consultations with peers and stakeholders
(i.e pandemic web-site)
• Evaluation-surveys
Partnership, Collaboration
& Advocacy
• Advocate for healthy public policy
• Involve individuals, families, groups and
communities
• Email/messaging/wiki
• Social media
Diversity & Inclusiveness
• Attitudes and actions that result in
inclusive behaviours, practices, programs
and policies
• Reach for different perspectives
• https://www.youtube.com/watch?v=zSY_t
Mh3ntg
Communications
Use Current Technology to communicate
effectively
• Email
• Instant messaging
• Wiki
• Webinar
Communications
Tasks
Communications
Dashboard
Leadership
• Competencies that build capacity, improve
performance, and enhance the quality of
work environments
• Communities of practice
• Workgroups to implement EMR’s
Professional Responsibility
& Accountability
• Range of accountabilities to a variety of
authorities, stakeholders and the
community
• Considerations of ethics, safety, risk and
new knowledge
• On-line learning modules (CNO, RNAO)
• Lit reviews to inform practice
• Online communities of practice
E-health
• Provides the platform to manage the
knowledge that informs our practice
• Enhances our abilities to build Public
Health Nursing Competencies
Knowledge Management
Systems Support
Knowledge
•
•
•
•
Creation
Application
Codification
Transfer
Nursing/Practice
Research
Nursing
Classification
System
Care management
and continuity
Communication
Linking Knowledge Management to
Action in Practice
PH Nursing
Competencies
Knowledge
Management
E-health
New World Order
Technology is nothing. What's important is
that you have a faith in people, that they're
basically good and smart, and if you give
them tools, they'll do wonderful things with
them.
Steve Jobs