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Healthy Disruption

Members of the Illinois Organization of Nurse Leaders dissect healthcare reform at annual conference.

In a nod to the current political environment, the 2009 Illinois Organization of Nurse Leaders conference kicked off with a town hall-style meeting on reform, instead of the standard rah-rah keynote.

Jason Hwang, MD, MBA, co-author of the best-selling book, The Innovator's Prescription and executive director of healthcare at Innosight Institute, called upon attendees to enact "disruptive innovations" to save the system from total collapse.

Some recent developments, like the formation of online patient communities and employer-based health clinics, give Hwang reason for optimism about the future of patient care. However, nothing short of total overhaul will fix the American healthcare system, he said.

"We are still stuck in a business model of a century ago," he said. Hwang encouraged attendees to take ideas from other industries to reshape healthcare.

HEALTHCARE BRAIN TRUST: Panelists strategize on the future of the American healthcare system. Susan Campbell, RN, (left) IONL president and senior vice president/system chief nursing officer at OSF HealthCare; Jason Hwang, MD, MBA, executive director of healthcare, Innosight Institute; Tom Clancy, PhD, RN, clinical professor, University of Minnesota School of Nursing; Dave Burda, Modern Healthcare; Therese Fitzpatrick, PhD, RN, assistant clinical professor, University of Illinois at Chicago College of Nursing; and Regina Caffy, president of Wave Integrated Marketing Solutions. courtesy of Illinois Organization of Nurse Leaders

Think Tank

Several nurse leaders joined Hwang on the floor to take questions from participants on specific innovations to renovate the industry.

"I think the largest challenge is chopping complex processes into component parts. We'll find equilibrium over time, but we've become very proficient at optimizing those parts. It hurts the system as a whole," said Therese Fitzpatrick, PhD, RN, assistant clinical professor at the University of Illinois at Chicago College of Nursing.

Panelists and audience members were in complete agreement about the expanding power of nurses in the new healthcare landscape.

"It wasn't so long ago when patients only wanted licensed physicians to provide primary care," Hwang said. "Now, concepts like the retail clinic have become the norm."

Tom Clancy, PhD, RN, clinical professor at the University of Minnesota School of Nursing, outlined a future where primary care physicians would concentrate on the sickest patients. "There's a phenomenal opportunity for nurses to provide care that's safe and customized to their level of expertise," he said.

System Simplification

Clancy recommended hospital leaders take a page out of the State of Montana's history for inspiration. In 1995, he said the state eliminated any form of speed limits. Five years later, courts ruled speed limits had to be clearly displayed. The following year showed an increase of 111 percent in road fatalities, his statistics said. In traffic, as in healthcare, Clancy championed a less-structured system.

He proposed "elegant solutions" for the increasingly complex healthcare institutions. Illustrating the case for elegance in the electronic medical record, he called for developers to consider modeling user interfaces after

"Do you see any white space? Think about it. What's the most widely used computer application in the world? It's Google. Google has one box and that's it," he said.

Furthermore, elegant and order emerges from simplicity. Clancy asked audience members to picture an ice skating rink at Rockefeller Center. Order emerges from the bottom up, he pointed out, because people follow cultural norms. In other words, there are no signs telling skaters to move counterclockwise, but everyone follows the implicit rules.

Toward the end of his example-driven presentation, Clancy said shifting the paradigm toward elegant systems could revolutionize the role of the nurse. He commended the American Association of Critical-Care Nurses Web site's section about nurses developing new care standards and said this is an example of the needed innovation.

"If we would only allow nurses to do what they're trained for, the level of clinical and financial performance would far exceed anything we see today," Clancy said.

Robin Hocevar is senior regional editor at ADVANCE.

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