If you believe that technology is the “holy grail’ of healthcare, if you believe that it will make all our problems disappear, you have to think again.
Technology alone will never suffice our current needs to improve our healthcare delivery system. If you notice, whenever technology solves an old problem, it also creates a new one. For example, the digitization of our medical records can surely improve coordination and efficiency in healthcare, but it can also raise extreme concerns on security. Technology, indeed, has a lot to offer, but it also has inherent limitations that we should supplement and resolve. This is why whenever somebody complains about it, my usual response is; “there are three important things that we need to keep in mind to ensure significant benefit from technology. These are policy, policy and policy”.
Technology and policy should be like Bonnie and Clyde or Batman and Robin in any technology solution. The limitations of technology should always be supplemented by a robust policy and procedure. That is why a good nursing informatics practitioner should be well-versed in formulating effective policies.
It is, however, difficult to formulate one which can comprehensively cover all facets of issues that we need to resolve. We need to be precise in our language. We need to be realistic and responsive to the circumstances involved. We need to be sentient to the needs of the organization. There’s a lot of things that we need “to be” in formulating policies that a neophyte nursing informatics professional may find challenging.
In my quest to find the most straightforward guide to policy making, I stumbled on an article written by an experienced CMIO, Dr. Dirk Stanley. He created an easy to understand formula on policy statement creation. This is a long post but I assure you that it is worth spending your time. Here’s what he has to say about it:
Secret weapon of the Informaticist : Good policy writing
- “Newbies” – Generally focused on the technology, the software, the bells-and-whistles
- “Grizzled Veterans” – More focused on governance and change management.
- Minion will bring money to store at 7am.
- Minion will purchase (1) large coffee with cream and sugar.
- Minion will purchase (1) chocolate glazed donut.
- Minion will transport coffee and donut (described above) to office.
- Minion will await arrival of Dirk’s Blog Reader.
- Minion will give donut and coffee to Dirk’s Blog Reader, on their arrival.
[ who/what ] will [ what ] [ how ] [ when ] [ where ] [ why ]
[ who/what ] = The person/thing that is being standardized
[ what ] = The standard that is being applied to the who/what above
[ how ] = How the standard will be achieved (“according to procedure below” is OK!)
[ when ] = Optional, only use if it helps clarify when the standard should be applied
[ where ] = Optional, only use if it helps clarify where the standard should be applied
[ why ] = Optional, only use if it helps clarify the purpose of the standard
Try it out! Here are some examples of good policy statements :
- All patients will receive low-fat meals.
- All patients over age 60 will receive a pneumonia vaccination before discharge.
- All policies will be clearly written, according to the procedure outlined below.
- All order sets will be evidence based and built according to the procedure outlined below.
- Patients should receive low-fat meals because it helps prevent heart disease. (Wordy, and never use the word “should” in a policy – “Will” is a stronger word!)
- Pneumonia vaccines are helpful in preventing pneumonia, and so this will be given to any susceptible patients over age 60 before they are discharged by the nurse. (Too unclear and wordy!)
- It is imperative that policies should be written in a manner consistent with easy comprehension. Policies should be developed in a clear, logical manner. Policies will be kept in the policy manual after approval. (Too wordy, vague, and starts to put procedure into the policy statement!)
- All order sets will be evidence-based. (Nothing pointing a reader to the procedure below which, hopefully, explains how to build them in an organized fashion.)
- [ who ] will [ what ] [ when ] [ where ] [ how ] [ why ]
- [ who ] will [ what ] [ when ] [ where ] [ how ] [ why ]
- [ who ] will [ what ] [ when ] [ where ] [ how ] [ why ]
- [ who ] will [ what ] [ when ] [ where ] [ how ] [ why ]
- [ who ] will [ what ] [ when ] [ where ] [ how ] [ why ]
- … and so on …
[ who ] = Person who will actually perform the task
[ what ] = Task they will perform
[ when ] = (usually optional) when / until when they will perform it
[ where ] = (usually optional) Where they will perform it – Only use if needed for clarity
[ how ] = (usually optional) How they will perform it – Use only if needed for clarity
[ why ] = (usually optional) Why they will perform it – Use only if really needed (rare)
Think of it as a recipe – In fact, most recipes are procedures! From Allrecipes.com you can find this New York Cheesecake Recipe and easily convert it to a procedure :
- Baker will preheat oven to 350 degrees
- Baker will grease a 9-inch springform pan
- Baker will, in medium bowl, mix graham cracker crumbs with melted butter
- Baker will remove mixture from medium bowl and press mixture onto bottom of springform pan
- Baker will, in a large bowl, mix cream cheese with sugar until smooth
- Baker will blend in milk
- Baker will mix in eggs one at a time
- Baker will mix in sour cream, vanilla, and flour until smooth
- Baker will pour filling into prepared crust
- Baker will place crust and mixture into preheated oven for 1 hour
- Baker will turn oven off and let cake cool in oven with the door closed for 5-6 hours
- Baker will remove cake from oven and chill in refrigerator
- preheat oven to 350 degrees.
- grease a 9-inch springform pan.
- in a medium bowl, mix graham cracker crumbs with melted butter
- remove mixture from medium bowl and press mixture onto bottom of springform pan
- in a large bowl, mix cream cheese with sugar until smooth
- blend in milk
- mix in eggs one at a time
- mix in sour cream, vanilla, and flour until smooth
- pour filling into prepared crust
- place crust and mixture into preheated oven for 1 hour
- turn oven off and let cake cool in oven with the door closed for 5-6 hours
- remove cake from oven and chill in refrigerator
- approach Ginger Rogers on dance floor.
- listen to current music
- choose dance style that is appropriate for current music.
- lead dance that is appropriate for music.
- follow dance led by Fred Astaire.
- demonstrate amazing dancing.
- smile for audience.
- observe talented dance performance by two dance superstars.
- applaud after dance performance is completed.
Thank You Dr. Stanley. You can find his blog on the link below.
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