Transforming the Clinical Workspace - GTD?
Posted by admin | Filed under Health Care
Nurses are a busy lot.
They race around attending to patient needs, interacting with other members of the health care team, and trying to manage the documentation burden. They are bombarded with tasks from many different directions, and held accountable for completing them in a timely fashion. All this in a work environment created by non-clinicians, using tools thrust upon them, and retrofitted with technology that didn’t exist when the work environment was originally designed. To make matters worse, little to no room exists for improvisation, as uniformity and control are believed to be the safest route to regulatory compliance and meeting financial goals.
The problem is multiplied when you consider the expense of ongoing staff training. Hospitals have so many competing priorities, staff training can be sparse. Add the ongoing nursing shortage, and it might not be possible to relieve nurses from their shift work to participate in training sessions even if offered.
These environmental factors weigh heavily on nurses. Their strong desire to provide exceptional, error-free care in this context creates an environment of pressure and stress that leads to all sorts of adverse effects, including lateral violence, job dissatisfaction, high rates of attrition, and lowered job performance.
So how do we improve this situation? Some key changes that should be considered in all institutions is to include nurses on building committees, involve them in work flow and process improvement activities, and find ways to encourage improvisation and innovation at the bedside.
What to do about the flow of information? It certainly is dynamic and from varied sources. Some pieces of data require action, some need to be saved for later reference. It would be useful if the system could prompt when action is necessary. There is a need for a system to reliably store this. What does this sound like? How about GTD? I was re-reading David Allen’s book a few days after attending the Genesys/MI-HIMSS meeting, and realized that GTD is perfect for clinical organization. It’s what we are doing already, yet in an informal manner and with ineffective tools. I am currently reviewing “Getting Things Done” from a nurse’s perspective, and am excited to think of the application of these methods to clinical nursing practice.
Do you think the GTD methodology could help you organize and plan your shift? What pitfalls can you envision?
Thanks to MI-HIMSS and Genesys for putting on the meeting last week. Ann Hendrich discussed the findings of a large study she has been conducting on how nurses spend their time full-text available here, which was the inspiration for this post.
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