Shelby Case, Kelly Conrad, John Fernandez, Madison Guziak, and

Sascha Spiegel

1
 Banner University Medical Center
Trauma ICU
Focus: Switch from EPIC computer system to
Cerner

2
 Microsystem: Democratic Leadership
Decentralized Decision Making
Management was supportive and helpful
The quick transition left nurses feeling frustrated

Marquis, B.L, & Huston, C.J. (2017). Leadership roles and management functions in nursing theory and application (9th ed., pp. 46,
304-305). Philadelphia, PA: Wolters Kluwer Health / Lippincott Williams & Wilkins.
3
 Organizational culture is the values and
behaviors that contribute to the unique social
and psychological environment of an
organization
Adequate resources not provided to support
change
Supportive culture between management and
staff within the microsystem
Quality and Safety is a main priority on the unit

Marquis, B.L, & Huston, C.J. (2017). Leadership roles and management functions in nursing theory and application (9th ed.,
pp. 306). Philadelphia, PA: Wolters Kluwer Health / Lippincott Williams & Wilkins. 4
 Patient-Focus
o The nonprofit mission of making health care
easier, so life can be better keeps us focused on
what matters most our patients
Staff-Focus
o Microsystem: Collaborative Care
o Focusing more intently on inter-professional
education will reinforce a team approach to
patient care
o Trauma ICU staff is very mindful of their patients
Banner Health. (2017). Patient care. Retrieved from https://www.bannerhealth.com/patients/patient-care
Banner Health. (2017). Research. Retreived from https://hccd-
qa.bannerhealth.com/services/research?locationname=banner-university-medical-center-tucson 5
Banner Health. (2017). Continuing interprofessional education (CIPE) activities. Retrieved from
 Care is coordinated by a multidisciplinary team
of medical professionals. This means that
experts in a variety of areas come together to
discuss the patients condition and determine the
best plan of care, customized to specific patient
needs.

Trauma ICU at Banner UMC has a

multidisciplinary team of physicians, nurses,
nurse practitioners, patient care technicians,
respiratory therapists, and many more
Banner Health. (2017). Academic medicine difference. Retrieved from https://www.bannerhealth.com/services/academic-medicine
6
 Designed to improve physician and nurse
workflow, our solutions help you save valuable
time and focus on meaningful delivery of care.
Use of EHR
o Provides stream-lined care
o Improves workflow and communication
o Reducing costs
o Safe sharing of information
Cerner Corporation. (2017). Hospitals & Health Systems. Retrieved from https://www.cerner.com/solutions/health-
systems
HealthIT.gov. (2017). What are the advantages of electronic health records?. Retrieved from
https://www.healthit.gov/providers-professionals/faqs/what-are-advantages-electronic-health-records 7
 The Magnet Model provides a framework to achieve
excellence in nursing practice and serves as a road map
for organizations seeking Magnet Recognition.

Process of delivery of healthcare improvement (Cerner)

was rushed, leaving staff overwhelmed with decrease in
direct patient care time.

Process Improvement Steps in Practice

o Identify standard - Switch to Cerner
o Data collection - Audits, surveys, feedback
o Corrective Action possible increase in future
trainings
American Nurses Credentialing Center. (2017). Magnet. Retrieved from
http://www.nursecredentialing.org/Magnet/FindaMagnetFacility
Marquis, B.L, & Huston, C.J. (2017). Leadership roles and management functions in nursing theory and application (9th ed., pp.
46, 304-305). Philadelphia, PA: Wolters Kluwer Health / Lippincott Williams & Wilkins. 8
 Performance patterns are one of the 9 success
characteristics of
Change in an organization can result in fatigue and
employee
There is a positive relationship between nursing
informatics competency and job satisfaction and
performance
o Banner Trauma ICU nurses felt inadequately
prepared and therefore incompetent
Cerner effects on Staff Performance
Australian Public Service Commission. (2014). Chapter 6 - Change management and employee performance. Retreived from http://www.apsc.gov.au/about-
the-apsc/parliamentary/state-of-the-service/state-of-the-service-2013-14/sosr-2013-14/theme-two-effectiveness/chapter-6/change-management-and-
employee-performance
Lee, J., Gang, I., & Yu, S. (2015). The Influence of Nursing Informatics Competency on Job-Satisfaction and Nursing Performance. The Korean Journal of Health
Service Management, 9(1), 109-122. doi 10.12811/kshsm.2015.9.1.109
Nelson, E., Batalden, P., Huber, P., Mohr, J., Godfrey, M., Headrick, L., & Wasson, J. (2002). Microsystems in healthcare: Part 1. Learning from high-performing
front-line clinical units. The Joint Commission Journal on Quality Improvement, 28(9), 472-493. Retrieved from 9
https://www.ncbi.nlm.nih.gov/pubmed/12216343
 Banner bought University Medical Center (UMC)
Consistent EHR at all Banners Cerner go live October
10th change fatigue + decreased EHR competency
decreased staff performance
Goal: Increase the microsystem nurses information
technology competency to improve patient outcomes
Adequate education using computerized documentation
heavily influences a nurses ability to navigate and utilize
electronic medical records. (Mountain, Redd, OLeary-
Kelly, & Giles, 2015, p. 166).
Hwang, J., & Park, H. (2011). Factors associated with nurses informatics competency. Computers, Informatics, Nursing,
29(4), 256-262. doi 10.1097/NCN.0b013e3181fc3d24
Mountain, C., Redd, R., OLeary-Kelly, C., & Giles, K. (2015). Electronic medical record in the simulation hospital: does it
improve accuracy in charting vital signs, intake, and output? Computers, Informatics, Nursing, 33(4), 166-171. doi
10.1097/CIN.0000000000000144 10
 Education was inadequate
More frequent and given by clinicians
Successful microsystems ...have responsibility
for the ongoing education and training of staff
and for aligning daily work roles with training
competencies. (Foster, Johnson, Nelson, &
Batalden, 2007, p. 339).

Foster, T., Johnson, J., Nelson, E., & Batalden, P. (2007). Using a Malcolm Baldrige framework to understand high-performing
clinical microsystems. Quality Safety Healthcare, 16, 334-341. doi 10.1136/qshc.2006.020685
11
 Thorough education intervention
Literature: Significant factors associated with informatics
competency were basic computer skills and formal
informatics education formal nursing curricula are
needed to improve the nurses' competency in managing
and using healthcare information (Hwang and Park,
2011).
Timeline/presentation:

Switch to Cerner is Mandatory Transition to Cerner

announced to education classes 6 months occurs within
1 month
Microsystem for Cerner begin Microsystem

Hwang, J., & Park, H. (2011). Factors associated with nurses informatics competency. Computers, Informatics, Nursing,
29(4), 256-262. doi 10.1097/NCN.0b013e3181fc3d2 12
 Australian Public Service Commission. (2014). Chapter 6 - Change management and
employee performance. Retreived from http://www.apsc.gov.au/about-the-
apsc/parliamentary/state-of-the-service/state-of-the-service-2013-14/sosr-2013-
14/theme-two-effectiveness/chapter-6/change-management-and-employee-
performance
American Nurses Credentialing Center. (2017). Magnet. Retrieved from
http://www.nursecredentialing.org/Magnet/FindaMagnetFacility
Banner Health. (2017). Academic medicine difference. Retrieved from
https://www.bannerhealth.com/services/academic-medicine
Banner Health. (2017). Continuing interprofessional education (CIPE) activities.
Retrieved from https://www.bannerhealth.com/health-professionals/for-
physicians/cme/cipe-activity
Banner Health. (2017). Patient care. Retrieved from
https://www.bannerhealth.com/patients/patient-care
Banner Health. (2017). Research. Retreived from https://hccd-
qa.bannerhealth.com/services/research?locationname=banner-university-medical-
center-tucson
Cerner Corporation. (2017). Hospitals & Health Systems. Retrieved from
https://www.cerner.com/solutions/health-systems
Foster, T., Johnson, J., Nelson, E., & Batalden, P. (2007). Using a Malcolm Baldrige
framework to understand high-performing clinical microsystems. Quality Safety
Healthcare, 16, 334-341. doi 10.1136/qshc.2006.020685
13
 HealthIT.gov. (2017). What are the advantages of electronic health records?.
Retrieved from https://www.healthit.gov/providers-professionals/faqs/what-are-
advantages-electronic-health-records
Hwang, J., & Park, H. (2011). Factors associated with nurses informatics
competency. Computers, Informatics, Nursing, 29(4), 256-262. doi
10.1097/NCN.0b013e3181fc3d2
Lee, J., Gang, I., & Yu, S. (2015). The Influence of Nursing Informatics Competency
on Job-Satisfaction and Nursing Performance. The Korean Journal of Health Service
Management, 9(1), 109-122. doi 10.12811/kshsm.2015.9.1.109
Marquis, B.L, & Huston, C.J. (2017). Leadership roles and management functions in
nursing theory and application (9th ed.,pp.46, 304-306). Philadelphia, PA: Wolters
Kluwer Health / Lippincott Williams & Wilkins.
Mountain, C., Redd, R., OLeary-Kelly, C., & Giles, K. (2015). Electronic medical
record in the simulation hospital: does it improve accuracy in charting vital signs,
intake, and output? Computers, Informatics, Nursing, 33(4), 166-171. doi
10.1097/CIN.0000000000000144
Nelson, E., Batalden, P., Huber, P., Mohr, J., Godfrey, M., Headrick, L., & Wasson, J.
(2002). Microsystems in healthcare: Part 1. Learning from high-performing front-line
clinical units. The Joint Commission Journal on Quality Improvement, 28(9), 472-493.
Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12216343 14