Tracy Shaben RN, BScN, MN
Lead, Clinical Informatics at Alberta Health Services
It’s been 24 years since I applied for my first role in Nursing Informatics. I had just finished by Master of Science in Nursing degree at the University of Alberta and the Klein cuts to healthcare in Alberta eliminated the Clinical Nurse Specialist roles that I had hoped for within the specialty area of Pediatric Nephrology. I decided to move to Northern Alberta knowing that there was always need for nurses in the North and that I could find something that would be “interesting”. Little did I know that this position as Computer Nurse was going to be the first of many experiences within the Healthcare informatics field that I would have the privilege of enjoying. Over the past 20 years, most if not all of the positions have been ones that I have created with partnerships across the care continuum, in a multitude of sites and sectors in northern and central Alberta and the Okanagan region of BC.
In 1993 in Grande Prairie, Alberta, there was a posting for a registered nurse to join the QEII Hospital as this hospital began its journey to implement a clinical information system (CIS) as well as support existing niche software systems including an OR system. Qualifications included a background in education of nurses, interest in computers (nothing about previous experience with computers – it was the early 90’s after all), and interest in learning about the software and a willingness to be involved in developing a training and implementation plan for nurses. All the hospital units including medicine, surgery, ER, pediatrics, long term care and outpatient areas would be included in the roll out.
From this first hospital based role, I moved into a regional management position with rollout of the CIS across the health region then to other health regions using the same software system. I took on consulting roles creating implementation plans, providing hands on experience in roll outs of the software and providing input into the creation of new modules for vendor software including a Public Health module.
In 2004, I moved permanently back to Edmonton and looked at using my experiences to support clinical informatics initiatives somewhere in the clinical arena. I joined a group of 10 nurses in IT that supported all clinical informatics software roll outs. We partnered with IT technical analysts and translated the needs of the clinical staff into system design, developed and provided training, provided change management, and developed ongoing maintenance and support plans from within the clinical areas where the systems were being implemented to ensure sustainability. From mainframe clinical information systems training to niche “best of breed” software implementations, our small group of nurses worked to implement OR, Critical Care, Emergency, Transplant, Nephrology software. We led the training for the first electronic health record in the country (netCARE), a journey that has set the stage for a “new standard of care” for patients in this province.
Right from the very beginning, the world of computers and using these tools to enable clinicians to do their work safely and effectively, has captivated me. Finding out how to translate clinical needs into system design and to minimize disruption and enhance efficiency of the clinical front line staff has been a constant goal of mine. Above all else, my roles and efforts have been focused on getting clinical staff to use these electronic tools to improve patient outcomes and enhance safe patient care.
Obviously the landscape has changed over the past 20 some years. While a large part of the healthcare workforce has not grown up within a technology enabled healthcare environment, the demographic is changing as our new graduates come into the workforce. Bridging the gap between both groups is a challenge but one that is necessary to support the successful use of technology in the delivery of effective, safe patient care. From a focus on the use of the computer and its functions in the 90’s to today’s focus on the use of information to enable better decisions in the care of patients, our conversations have become increasingly focused on quality and safety initiatives and less about the tool itself. For me, getting our clinical leaders and our jurisdictional healthcare agencies engaged in discussions on how to use the information being collected for better patient outcomes is critical to moving forward. We need nurses to analyze data and utilize data to make decisions based on this data to support care initiatives and we need to engage with our patients, clients, families in this pursuit.
My involvement in CNIA is another important priority for me. I attended my first CNIA conference in 2005 and so enjoyed meeting like–minded nurses from across the country involved in the same type of work that I was doing that I volunteered to assist with the next few conferences. This participation led to me taking on the position of Treasurer which I have held for the past 6 years.
As a result of my membership in CNIA, I have had the privilege of participating in many national nursing informatics initiatives including Canada Health Infoway’s Peer to Peer engagement activities, CASN and CNA initiatives to develop Nursing Informatics Competencies and revise the Nursing Informatics Position statements. I continue to support the need for standardized terminology and data sets both at a national and local level including ICNP, C-HOBIC, SNOMED-CT and other data and documentation standards.
I have also been involved with provincial jurisdictional initiatives to represent registered nurses on provincial EHR initiatives and ongoing development of eHealth policy. Locally, I am currently part of large long term roll out of an ambulatory software system across the Edmonton zone. This role as every role before it, encompasses a multitude of responsibilities from specific clinic “elbow” support to high level governance and stakeholder engagement activities and involves working with many groups identifying issues and finding resolutions to these issues.
Its been an absolutely amazing journey for me and no doubt there are many more experiences to come…. I can’t wait!