Nancy Yates, CNIO, Providence St. Joseph Health, Chapter 2

One of the most important components of the CNIO role is to help steer the organization toward standardization without negatively impacting the user experience. It can be challenging in any situation, but when you’re dealing with a merger that’s created a 50-hospital experience, the stakes become even higher. Fortunately for Providence St. Joseph Health, it’s an area Nancy Yates knows well. In fact, ensuring that nurses and physicians have the tools they need to deliver care has been a passion of hers for years.

In this interview, Yates talks about the strategy her team is employing to move to an integrated EHR platform, which includes applying lessons learned to subsequent rollouts, involving informatics in usability discussions, and striking the right balance in being nimble. She also discusses the digital rounding initiative that’s become a game-changer, the mobility platform her team hopes will improve interactions between nurses and patients, and the advice she offers for aspiring nursing leaders.

Chapter 1

Chapter 2



* Providence’s Question Bank – “It’s important to be able to benchmark against ourselves.”

* Arming nurses with mobility

* Leveraging IT to improve clinician-patient interactions

* “We’re getting closer. We’re not there yet.”

* From “clunky” DOS-based systems to EHRs

* Advice for pursuing nursing leadership roles

* “The beauty of nursing is that it’s so dynamic and flexible.”



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Bold Statements

It allows us to send messages to dietary and housekeeping so we’re constantly helping to improve the care experience. And it’s efficient — nobody has to pick up the phone. The more we can arm nurses with mobility, the more time they’re going to be able to spend with their patients.

Where it makes sense, we’ll use it to give the patient some control in their care. That’s going to go a long way toward helping them feel that they are part of the care team and are understanding their care.

I think the tools are evolving and getting better. If we took the EHR away from people today, they would scream and yell and jump up and down, but there are still opportunities to make it better.

If I was going to be the best nurse I could be, I needed to figure out how to make this technology work for me, instead of me working for the technology.

Whatever clinical specialty your heart is drawn to, let that be your foundation. And as you begin to use the tools, if you have a knack for making them work better and you’re one of those people that really gets into it, then informatics is for you.

Gamble:  You talked about wanting to tweak here and there at some points, but is it difficult to maintain the balance between standardization and flexibility?

Yates:  It can be, but as long as you continue to manage expectations, it can be done. We continue to evolve; we started off with 10 standard questions, and as the group started using the tool and we started seeing the data, the decision was made to have fewer standard questions and have some flexibility to be nimble.

Cipher has helped us create what we call the Providence Question Bank. Now we’re at six core questions because, again, it’s important to be able to benchmark against ourselves so we can see who’s moving the mark and what are they doing that’s helping to create a best practice. Then we start to really see the correlation between “these are all the patients who received a good quality round while they were in the hospital using the tool,” and the HCAHPS Score, so we can determine what they’re doing that’s better or different than anybody ...