A common concern for nurse leaders in today's healthcare organization is abundant data but little information. Success of care delivery and daily operations can be enhanced with the right information technology to support evidence-based decision making. For too long, nurse leaders have struggled to find appropriate and timely information on which to base decisions about care delivery. With an urgent focus on care processes, now is the time to innovate, taking existing information tools and transforming them into appropriate decision support tools for nurse leaders and clinicians. 1
Break out of data silosUseful information about nursing care and patient outcomes most often dwells in data silos. Nursing departments can have sophisticated staffing software programs containing information about patient acuity or volumes and recommended staffing levels, but these data aren't typically combined with data about nurse competency and certifications, which are most often stored in human resource databases. To complicate matters, financial data are kept in cost accounting systems; patient satisfaction results, in vendor systems; and patient safety data, in quality management systems. The result is massive amounts of disconnected data that can't easily be used to guide care delivery.To compound this disparate data issue, much of the data are retrospective. Nurse leaders and clinicians deal in the here and now but are expected to use data that are weeks or months behind. Given the rapid turnover in patient census, increasing acuity levels, and rapid changes in technology and knowledge, the archaic multisystem data feed is at best inadequate and at worse dangerous.Several authors describe the use of technology solutions (dashboards, balanced scorecards, or report cards) in healthcare as a solution to the problem of having disconnected data. 2-4 Data elements need to be defined in standardized ways for use in dashboards. 4 Current technology can be used to integrate existing data into a configurable user interface. 5 This means that customized screens can be developed for the needs of different healthcare leaders. Balanced scorecards can provide a way for leaders to monitor progress toward strategic goals (financial, quality, satisfaction, and growth) and promptly diagnose problems to design corrective interventions. 3 It's this latter role of scorecards that can provide decision support for care delivery.
Designing decision support toolsNurse leaders and clinicians need tools to guide decisions about care delivery each day. Paramount among these decisions-especially in a time when care delivery processes are being examined-is determining the right number and type of nurses needed for a group of patients. Although acuity systems can provide guidance, resulting recommended staffing levels may not have been tested for their effects on patient and organizational outcomes. To date, no such system has been described in published literature.