Susan Marino, CNIO, Hartford HealthCare, Chapter 2

It was five years ago that Hartford HealthCare began its journey to become an integrated system, and five years ago that the organization named Susan Marino as its first CNIO. The timing is no coincidence; in fact, it was a deliberate move by leadership to appoint someone with a deep knowledge of both nursing and informatics to help establish governance, guide the training process, and most importantly, ensure that the front-line staff was able to work as efficiently as possible. In this interview, Marino discusses the “never-ending” Epic rollout that’s becoming a game-changer at Hartford, how hear team is working to optimize the system without placing too much burden on physicians and nurses, and their biggest priorities for the coming year.

She also talks about her own journey, reflecting on the hurdles she faced early on and the “one win at a time” approach she took to bring nursing to the decision-making table, and emphasizes the importance of leveraging technology to increase satisfaction among nurses.

Chapter 1

Chapter 2



* Establishing governance to prepare for Epic

* Executive leadership engagement

* Clinical councils: “Our goal was to build a product with a system-wide focus”

* Standardized workflows & process to reduce variation

* Mandatory training “to ensure operational readiness”

* No training, no access, no kidding

* Replacing consultants with super users – “It was a remarkable program.”



LISTEN NOW USING THE PLAYER BELOW OR CLICK HERE TO SUBSCRIBE TO OUR iTUNES PODCAST FEED

Bold Statements

While we did have a need for some variation based on complexity of care services that only practiced at one hospital, the goal absolutely was to reduce variation and create efficiencies.

It was really important to have things like, ‘no training, no access. No kidding.’ Everyone was required to go to training. We couldn’t have folks showing up on their floors trying to get through this system that was significantly different than what we had been on.

We developed internal strengths to be able to beef up so that every time we got to the next hospital, our own internal folks who enjoyed that personal development, who enjoyed going to that next organization as an expert, really understood our workflows and how the system really supported the patients in each specific area. It was a remarkable program.

We are regionally stationed so that we can be available on day-to-day basis within our organizations, not only working on the next project or initiative, but also supporting individuals who are struggling, and supporting the ongoing engagement of our super users and credentialed trainers.

Gamble:  When you talk about all the things that are priorities now, things like the virtual health, optimizing the system, and population health, what started all of that was the transformation to Epic, which dovetailed with the organization’s own transformation going from individual hospitals to a health system. Can you talk about really what was required from a governance standpoint to make sure the systems that were being put in place were going to be as effective as possible for the users?

Marino:  Right. That’s a great question, and I have to say that governance was absolutely a success factor in being able to move this huge project along. It starts with several different layers. Certainly you have an executive team layer where you have the top decision-making and work to eliminate key barriers and risks to the organization. We have a leadership team that has worked throughout the last four to five years, meeting once a week to actually take on critical issues of the week,