E-raamat: Measuring Capacity to Care Using Nursing Data

Evelyn Hovenga, RN, PhD, FACS, FANC, FIAHSI, currently manages eHealth Education, an RTO, and the not-for-profit Global eHealth Collaborative (GeHCo) and continues to work as a digital health consultant. She retired as Professor of Health Informatics in 2007, following a 25-year career in this discipline with a focus on standards development as these apply to EHRs, semantic interoperability, and terminology and is Honorary Senior Research Associate at the Centre for Health Informatics and Multiprofessional Education, University College London (http://www.chime.ucl.ac.uk/). Evelyn started her career as a registered nurse; has health executive, public service, educational and research experience; obtained a PhD in Health Administration (Nursing Informatics); initiated and hosted the first National Health Informatics Conference (HIC) in Melbourne in 1993; is one of the founders of HISA and the Australasian College of Health Informatics; and is a founding fellow of the International Academy of Health Sciences Informatics (FIAHSI), Geneva. She is also widely published. Evelyn is an honorary member of the International Medical Informatics Associations Nursing Informatics SIG as a result of representing Australian nurses from 1984 for many years, as a member and Past Chair of this group. Cherrie Lowe is a registered nurse, midwife, an innovator and business manager, who brings local, national and international health service executive management, research, software development and system implementation experiences. Her health industry experience includes past roles as a Nurse Educator, Quality Manager, Director of Nursing, Director of Clinical Services, hospital accreditation surveyor and medico-legal expert witness.

Her executive level industry experience began as a Director of Nursing for Mercy Health and Aged Care where she maintained an efficient nursing service and improved the hospitals profit margin assisted by making use of her patient acuity system. Cherrie initiated the development of a hospital promotion campaign, complete with television video that significantly increased the hospitals bed occupancy. The success of this campaign achieved the Australian Council on Healthcare Standards (ACHS) quality award for large hospitals.

As Director of Clinical Services for Ramsay Health Care she played a major role in managing the transition of a large Commonwealth funded veteran hospital to Australias largest private hospital where she developed a strong, efficient and dynamic nursing service and allied health team. Cherrie assisted in the expansion of clinical services, including: Cardiac, Gynaecology and Neurosurgery. She again achieved the ACHS Quality Award for large hospitals and the hospital was also awarded the Employer of the Year Award for large organizations in Brisbane. Cherrie was again responsible for generating a significant profit margin for that organisation by maintaining a high level of efficiency in clinical services, an achievement made possible through the use of her patient acuity system.

During her years as a nurse executive, Cherrie managed her family, undertook her post graduate studies as an external student, was a surveyor for the Australian Health Care Council, developed, tested andmade use of a patient acuity system, and undertook various consultancies. She partnered in business with a software developer and her system was fully computerized taking advantage of ongoing technical developments. Cherrie shared her research findings with other Directors of Nursing who then worked with her by facilitating ongoing research and development activities in their facilities. This research was presented at a world informatics conference in San Antonio in 1994. During the mid 1990s both Cherries and Evelyns patient acuity systems were used by numerous Queensland hospitals. The Queensland Government funded a validation study enabling a comparison to be made between these two systems using the same patient populations which validated both systems, as the use of their systems provided comparable results.

The success of Cherries automated and highly interoperable TrendCare system led her to assume the CEO, researcher and developer role on a full-time basis. Her primary focus has always been to take on the many ensuing challenges to benefit the nursing and midwifery professions As recognition Cherrie received a Nursing Excellence award from the Royal College of Nursing for her contribution to nursing in Australia.

Developing and continuously improving the reliability of an evidence based patient acuity and workload management system for nursing and midwifery has been a challenging undertaking, and during the past 25 years Cherrie has had to overcome many barriers. These include (1) convincing nursing and midwifery leaders, colleges and unions that nursing services need to collect and present their own evidence of nursing demand in order for nursing services to be adequately resourced, (2) convincing health service senior executives, including CEOs, finance managers and chief information officers of the methodologies that are best suited to measuring nursing demand and the value of nursing demand measurements for effective budget management and accurate costings of episodes of care, (3) Convincing nurses and midwives generally of the importance of collecting nursing and midwifery data so that safe staffing and fair workloads can be a reality. These barriers have been overcome in some countries but are still ongoing in others. Developing a viable small business, while trying to provide an affordable software product to health services that are financially stretched, has tested Cherries business skills. Transforming a small local business to an international business with a customer footprint across six countries in the health care environment is testament to her determination, commitment and sound business strategies.

Cherrie has won the AustCham Business Award in Singapore, the Australian national and state Microsoft eHealth iAwards for innovation in IT development and the Australian national ICT exporter of the Year Award.