Measuring Capacity to Care Using Nursing Data presents evidence-based solutions regarding the adoption of safe staffing principles and the optimum use of operational data to enable health service delivery strategies that result in improved patient and organizational outcomes. Readers will learn how to make better use of informatics to collect, share, link and process data collected operationally for the purpose of providing real-time information to decision- makers. The book discusses topics such as dynamic health care environments, health care operational inefficiencies and costly events, how to measure nursing care demand, nursing models of care, data quality and governance, and big data.
The content of the book is a valuable source for graduate students in informatics, nurses, nursing managers and several members involved in health care who are interested in learning more about the beneficial use of informatics for improving their services.
- Presents and discusses evidences from real-world case studies from multiple countries
- Provides detailed insights of health system complexity in order to improve decision- making
- Demonstrates the link between nursing data and its use for efficient and effective healthcare service management
- Discusses several limitations currently experienced and their impact on health service delivery
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1. Dynamic Health Care Environments 2. Operational Inefficiencies 3. Measuring Nursing Care Demand 4. Measuring Nursing Work 5. Identifying Skill Mix Needs 6. Nursing Models of Care 7. Staffing Resource Management 8. Workforce Planning 9. Digital Health Ecosystems 10. Digital transformation strategy 11. Measuring Health Service Quality 12. Residential
Community Aged Care Management 13. Current and Future Vision
Evelyn Hovenga brings global experience, strong scientific and professional leadership in
Health and Nursing Informatics, she is widely published. Her experience and expertise covers
many factors of health and nursing informatics, especially standards development pertaining to
health terminology and electronic health records, including knowledge management, ontology
and semantic interoperability. Evelyn undertook all her graduate studies whilst working
full-time as a divorced mother of two daughters, and was awarded a doctorate in Health
Administration from the University of New South Wales.
Her healthcare industry background began as a Nurse in paediatrics, obstetrics, general medical
and surgical, organ imaging and ended as an operating room suite unit manager. This was
followed by a new appointment as a Health Service Management (Workstudy) Consultant for the
Victorian Government Health Commission, where her career progressed to her
taking on the role of senior nursing advisor and researcher for a Ministerial enquiry into nursing
in that State. Evelyn developed a nursing acuity system in response to a need to address major
nursing industrial unrest over workload, nursing career structures and pay. This acuity system
was in use by over 100 hospitals in three Australian States for close to fifteen years. It was
outlawed in Victoria by the then Minister of Health, as the information made available to nurses
was used by them to manage their workloads. He considered this to be in conflict with his new
policy to reduce surgical waiting lists. Evelyn then worked privately as a consultant and
undertook numerous additional patient acuity studies and nursing productivity reviews in
Victoria and other Australian States.
Evelyn met up with her co-author, Cherrie Lowe when undertaking major research for the
Private Hospitals Association in Victoria and Queensland, where Cherrie was a Director of
Nursing of a private hospital, when they recognised their shared vision and entrepreneurial
mindsets. The research project's aim was to establish a nursing career structure.
Evelyn accepted an invitation from the Director of Nursing of the London Hospital, Maureen
Scholes, who had established a Nursing Informatics working group for the International
Medical Informatics Association, to represent Australian nurses internationally as a member of
that working group. This provided her with an international network of other nursing informatics
researchers, with opportunities to collaborate with them. She was elected to Chair
this group following her successful hosting of the International Nursing Informatics conference
in Melbourne (NI'91). Profits made were used to establish the Health Informatics Society of
Australia, of which Evelyn is a founding and lifelong member. She is a founding Fellow and life
member of the Australasian College of Health Informatics, and the International Academy of
Health Sciences Informatics. She was awarded fellowships by the Australian College and
Nursing, the Australian Computer Society and the Australian College of Health Services Executives.
Evelyn again diverted from her career path by accepting a University appointment to develop
post graduate programs in health informatics and administration, and establish a research
centre. Evelyn became a founding member of a newly established Health Informatics Standards
Development Committee (IT/14) by Standards Australia. She has participated in many
standards development activities as a volunteer for Standards Australia, ISO TC215 and HL7
Australia, and continues to work with the openEHR foundation at the University College of
London. One of her Post Doctoral fellows, Dr Sebastian Garde established the first ontology
based online clinical knowledge repository under her guidance. Evelyn was an external advisor
for the EU funded NIGHTINGALE, TELENursing and ICNP development projects during the
1990s and has witnessed many new technical advances during her career. She retired as a full
professor in 2007 and is continuing her work in her current positions.
Cherrie Lowe is a registered nurse, midwife, an innovator and business manager, who brings
local, national and international health service executive management, research, software
development and system implementation experiences. Her health industry experience includes
past roles as a Nurse Educator, Quality Manager, Director of Nursing, Director of Clinical
Services, hospital accreditation surveyor and medico-legal expert witness.
Her executive level industry experience began as a Director of Nursing for Mercy Health and
Aged Care where she maintained an efficient nursing service and improved the hospital's profit
margin assisted by making use of her patient acuity system. Cherrie initiated the development
of a hospital promotion campaign, complete with television video that significantly increased
the hospital's bed occupancy. The success of this campaign achieved the Australian Council on
Healthcare Standards (ACHS) quality award for large hospitals.
As Director of Clinical Services for Ramsay Health Care she played a major role in managing
the transition of a large Commonwealth funded veteran hospital to Australia's largest private
hospital where she developed a strong, efficient and dynamic nursing service and allied health
team. Cherrie assisted in the expansion of clinical services, including: Cardiac, Gynaecology
and Neurosurgery. She again achieved the ACHS Quality Award for large hospitals and the
hospital was also awarded the Employer of the Year Award for large organizations in Brisbane.
Cherrie was again responsible for generating a significant profit margin for that organisation by
maintaining a high level of efficiency in clinical services, an achievement made possible
through the use of her patient acuity system.
During her years as a nurse executive, Cherrie managed her family, undertook her post graduate
studies as an external student, was a surveyor for the Australian Health Care Council, developed,
tested andmade use of a patient acuity system, and undertook various consultancies. She partnered
in business with a software developer and her system was fully computerized taking advantage of
ongoing technical developments. Cherrie shared her research findings with other Directors of
Nursing who then worked with her by facilitating ongoing research and development activities in
their facilities. This research was presented at a world informatics conference in San Antonio in
1994. During the mid 1990s both Cherrie's and Evelyn's patient acuity systems were used by
numerous Queensland hospitals. The Queensland Government funded a validation study enabling
a comparison to be made between these two systems using the same patient populations which
validated both systems, as the use of their systems provided comparable results.
The success of Cherrie's automated and highly interoperable TrendCare system led her to
assume the CEO, researcher and developer role on a full-time basis. Her primary focus has
always been to take on the many ensuing challenges to benefit the nursing and midwifery
professions As recognition Cherrie received a Nursing Excellence award from the Royal
College of Nursing for her contribution to nursing in Australia.
Developing and continuously improving the reliability of an evidence based patient acuity
and workload management system for nursing and midwifery has been a challenging
undertaking, and during the past 25 years Cherrie has had to overcome many barriers.
These include (1) convincing nursing and midwifery leaders, colleges and unions that nursing
services need to collect and present their own evidence of nursing demand in order for
nursing services to be adequately resourced, (2) convincing health service senior executives,
including CEO's, finance managers and chief information officers of the methodologies that
are best suited to measuring nursing demand and the value of nursing demand measurements
for effective budget management and accurate costings of episodes of care, (3) Convincing
nurses and midwives generally of the importance of collecting nursing and midwifery data so
that safe staffing and fair workloads can be a reality. These barriers have been overcome in
some countries but are still ongoing in others.
Developing a viable small business, while trying to provide an affordable software product to
health services that are financially stretched, has tested Cherrie's business skills. Transforming
a small local business to an international business with a customer footprint across six countries
in the health care environment is testament to her determination, commitment and sound business strategies.
Cherrie has won the AustCham Business Award in Singapore, the Australian national and
state Microsoft eHealth iAwards for innovation in IT development and the Australian national
ICT exporter of the Year Award.