People, Processes and Technology

Sep 01, 2019

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Nurses are natural innovators. They create what we sometimes call ‘workarounds.’ I call it innovation.

Alvin Jeffery

Although he’s currently serving as a medical informatics postdoctoral fellow funded by the U.S. Department of Veterans Affairs in Nashville, Tennessee, Alvin Jeffery’s background — he says he always likes to mention this — is as a pediatric ICU nurse at Cincinnati Children’s Hospital. Jeffery, who will soon be starting as an assistant professor at Vanderbilt School of Nursing in Nashville, was recently honored with an AACN Circle of Excellence award at NTI 2019 in Orlando, where he also presented a session. He spoke with us about his varied and interesting career.

Let’s start with something a little philosophical: Where do you think nursing, healthcare and AACN will be in the next 10, 20, 50 years?

I think the biggest challenge I see for acute and critical care nurses and opportunities where AACN could help partner is that there’s so much information coming our way. We have ventilators and IV pumps and monitors galore. And all of these things are providing us with data and information — it’s almost nonstop. We can call this alarm fatigue; we could call it being overwhelmed. I think there are opportunities to release the innovative with our technology solutions, bringing on informatics.

Whether it’s informatics experts, nurse specialists or researchers, we need to ask: “How could we summarize this better, display it in a different way or think about how we think and work as nurses?” And be really innovative in some of our solutions to try to make them more streamlined, so that information flows within our cognitive and physical workflows.

So what is nursing informatics, and how is it changing nursing practice?

I love this question. But this is the point usually at a cocktail party where people start running away from me. So, I’m glad to get undivided attention to talk about this.

I like to summarize it as briefly as possible — not even use the term “informatics.” And I say, we talk about how it is data and information and knowledge … and even wisdom. How do we manage that? How do we use that to improve care? It involves looking at people — whether that’s nurses, physicians or administrative staff. Looking at people and processes. What are the workflows? Where are we getting information? How are we caring for patients?

And then, finally, where does technology play a role in that? So how do people, processes and technology play a role in managing all of the data that we have, the information that surfaces from that, and the knowledge that we have about treating other patients, whether from research studies or expert opinion. All to get back to that individual clinician treating an individual unique patient. We get to that level of wisdom. So people, processes, technology. Managing and providing data information and knowledge to wisdom. That to me, in a nutshell, is informatics.

What’s the biggest change in technology you’ve seen in healthcare? Describe how that advancement intersected with your career.

I think the biggest change I’ve seen in healthcare is on the technology side — and this is probably what a lot of nurses would say — the transition to electronic health records, or EHRs. And it can be a huge source of frustration and a burden, but the potential I see can far outweigh that as we continue to advance.

I’m an informatics researcher, and I look at how we use all the data that nurses and other team members enter into the EHR, and I think there’s just a goldmine of information within that data that we could use to make better decisions for patients and families. And so I look forward to us getting there, and I think we’ll get there in the next few years.

You’ve presented at NTI for a number of years now. What keeps bringing you back?

The community of exceptional nurses. And I know that may be part of the tagline, but every year I come back the community feels a little closer to me. I feel more connected with the nurses. I especially love my peds nurses — we have so much fun in our sessions. I was just talking to a friend a few days ago, and he said, “I’ve never seen you get this excited getting ready for a conference.” Because I know we’re going to have fun. Nurses’ Night Out, Certification Celebration dinner, all these things. And just presenting in front of people and trying to inspire them and help improve their practice and their knowledge. It fuels me, it inspires me and so I absolutely love it.

What can nurses do to positively impact their work environment and the well-being of co-workers?

I remember when I became a nurse educator, one of the first books I read was “Crucial Conversations.” And I realized how flawed so much of my communication had been with my co-workers … even personal relationships. And to just communicate freely and openly and respectfully, and to praise each other even in the small things to say, “That was an excellent job you did for that patient.” Or to say, “Hey, what can I do to help?” I think that would help us build this sense of community. It’s one of the things I love about AACN: the sense of community. And I feel a part of it. I think so many of the other healthy work environment standards would start to fall into place if we could really engage in civil discourse and respectful dialogue with our co-workers.

What advice do you have for nurses who want to innovate to improve patient care?

Nurses are natural innovators. They create what we sometimes call “workarounds.” I call it innovation. And I think we have an innate skill to innovate. So to grow that and to enhance that, I would say two things. One, learn as much as you possibly can, whether that’s going back to school, or reading or going to conferences. Second, network with other people. Communicate with other people, and share your ideas with other people.

What has your experience working with the Department of Veterans Affairs taught you?

My experience with the Department of Veterans Affairs, or the VA, has taught me a number of things. I’ll probably boil it down to two, to be succinct. One is that it’s really great that even though I have a background in pediatric critical care, and now I work in research with the VA, I can say that I’ve never worked with patients. I’ve worked with kids, and I’ve worked with vets. And that just makes it feel so much more connected to me and my purpose as a nurse.

So the second thing I would say is access to education and national data. The VA has been overwhelmingly supportive of my pursuit of a PhD and doing research and informatics, and they give me access to national data to identify and make discoveries that I wouldn’t be able to make at a single institution. And so it’s been a phenomenal place that’s really enriched me as a nurse, as a researcher and hopefully someone that’s going to make some discoveries that will change care across the country or maybe even around the world.

You were presented with an AACN Circle of Excellence award at NTI. What was the experience like?

So exciting. I would say my path to that actually started last year when I nominated someone who received the award. And so I feel — I keep going back to community and connectedness, that opportunity to be in a lineage of my friends and the colleagues that I respect — honored, humbled and excited … so many things. But being a part of a community of exceptional nurses just gives me so much joy and pride in my profession. And it makes me realize that, yes, there’s going to be challenges and obstacles. We’re all facing those, but we’re all in this together, and we all have an opportunity to deliver excellent care and make a difference for patients.