March 5, 2014

Nursing Informatics Leaders Find Strength in Numbers

Idea from a Cleveland Clinic nursing leader spawns ongoing statewide Epic user meetings — and forges empowering connections.


Idea from a Cleveland Clinic nursing leader spawns ongoing statewide Epic user meetings — and forges empowering connections.


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Epic has turned to the Ohio Nursing Informatics Organization for help initiating or supporting similar groups in other states.

Marianela (Nelita) Zytkowski, DNP, MS, RN-BC, always enjoyed the national conferences hosted by Epic, developer of Cleveland Clinic’s electronic medical record (EMR) software. The sessions provided new insights for nursing informatics professionals like her, and were always teeming with experienced EMR users from around the United States. But among attendees, it was hard to find others from her home state, Ohio.

“Each state has different regulations that affect how we can and should use EMRs,” says Zytkowski, Cleveland Clinic’s Associate Chief Nursing Officer for Nursing Informatics. “I started thinking it would be helpful to gather all of Ohio’s Epic users so we could network and work through common challenges together.”

Back in Cleveland, Zytkowski sent a survey to every Epic client in the state — 15 healthcare organizations — to gauge their interest in starting a statewide Epic users’ group. All 15responded enthusiastically. And that was the beginning of today’s Ohio Nursing Informatics Organization (ONIO).

A day of networking and idea sharing …

Zytkowski chose a central location, The Ohio State MedicalCenter in Columbus, and asked a nursing informatics leader there if she would host the first meeting, knowing that Zytkowski and Cleveland Clinic would handle the rest of the planning and facilitating. Just weeks later, in November 2012, Epic users from around Ohio converged in Columbus for a one-day networking and idea-sharing event.


Some attendees were chief nursing officers and others were IT people who work with nursing; all were high-level leaders from an Epic-using healthcare organization in Ohio. Also attending was a nurse representative from Epic headquarters in Madison, Wis. “She was able to contribute to our discussions, answer questions and take our input back to the company,” Zytkowski notes.

ONIO’s first meeting included:

  • A roundtable discussion about how nursing and technology are organized at each represented hospital
  • Dialogue about the impact of the Affordable Care Act and “meaningful use” on nursing documentation
  • Review of the reports that Epic can generate
  • Presentation of new features in the next version of Epic technology

Most valuable, perhaps, was that attendees began sharing best practices about how EMRs were used in their organizations …

Turns into quarterly meetings

The one-day seminar was such a success that attendees requested ongoing meetings. Since then, the group has met quarterly and has even welcomed three more Ohio hospitals that recently began using the Epic system.

Meetings continue to be held at The Ohio State Medical Center. Cleveland Clinic continues to initiate new members and house the group’s records. But each member organization takes turns facilitating meetings and setting agendas. Any member can submit agenda items and solicit advice at any time.


All about sharing — even across disciplines

“When Cleveland Clinic nurses were getting ready to start bar-coding patient medications at the bedside,” says Zytkowski, “we wanted to hear how other hospitals were doing it so we could learn from them. A couple of group members gave us excellent recommendations, such as which settings to select in the Epic system and how to silence the scanner so its beeping wouldn’t disturb sleeping patients.”

Everyone shares what they know, she notes. Often, members invite each other for in-person visits to see processes firsthand. The group now invites guest speakers to discuss healthcare trends and regulations across the state. At one meeting, the Ohio State Board of Pharmacy talked about rules and laws governing medication administration from an EMR and the impact of the Bar Code Medication Administration system on patient safety and quality outcomes. ONIO members invited their hospitals’ pharmacists to attend with them.

Spreading the success to other states

ONIO has been so successful that Epic has turned to the group for help initiating or supporting similar groups in other states. Epic has even given the group its own web portal where members can share documents and stay in touch between meetings.

“I think we all feel so much more empowered because of our networking and being able to take information back to our workplaces,” says Zytkowski. “There aren’t many informatics people at any one organization, so this group helps us all feel more connected.”

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