Health Information and Quality

Clancy states, “nurse informaticists play a vital role in the successful planning, design, and implementation of information technology” (2015, p. 535). The chapter author goes on to say, “the nurse informaticist must have in-depth knowledge of complex systems and strategies to manage (2015, p. 535). Clancy provides a review of General Systems Theory including the differentiation of Open Systems, Complex Systems, and Complex Adaptive Systems. Clancy remarks, “complex adaptive systems exhibit specific characteristics that are different than simple systems and the terminology uses to define them may not be familiar to providers (2015, p. 528). The student/reader is referred to Table 37.2 for the terms, descriptions, and examples for Complex Adaptive Systems. Clancy presents an introduction and overview of information system planning. Of particular interest is the discussion of Wicked Problems. Wicked problems are ï‚· Very difficult to define or formulate ï‚· Not described as true or false but as better or worse ï‚· Have an enumerable or exhaustive set of alternative solutions ï‚· Inaccessible to trial and error; solutions are a “one shot” dealï‚· Unique and often a symptom of another problem Clancy continues stating “wicked problems cannot be solved by the common rubric of defining the problem, analyzing the solutions, and making a recommendation in sequential steps; the reason being, there is no clear definition of the problem. By engaging all stakeholders in problem solving, those people most affected participate in the planning process and a common agreed approach can be formulated. Of utmost importance is understanding the different problem solutions require different approaches” (2015, p. 530). Clancy compares Structured Design and Agile Design. Structured design is classified as traditional. Agile design recognized as “less prescriptive and allows for frequent trial and error. Agile methods clearly define future milestones but focus on short-term successes” (2015, pp. 531 -532). The authors close the chapter by stating, “we are now on the edge of effectively developing and utilizing technology that can provide information to optimize the integration of the nurse with the patient effectively” (2015, p. 330). Learning Objectives ï‚· Define complex systems in the context of General Systems Theory 2‚· Describe complex adaptive systems 3‚· Illustrate challenges and solutions for planning and designing information technology in complex healthcare systems 4‚· Provide examples of tools and methods used to plan and design information systems in complex healthcare processes 5‚· Describe the history of staffing and current scheduling gaps. 6‚· Identify the requirements for an intelligent integrated workload management system (WMS) 7‚· Discuss the new era of healthcare reform and the challenges of staffing and credentialing 8‚· Identify challenges for nursing informatics in the future