QUESTION: Can you tell me a little about your background and experience? How long have you been with SHC?
ANSWER: The majority of my clinical career was in the ICU setting, primarily Cardiovascular Surgery and then later Neurosurgery. My career at SHC started on D3 in 2005. Pauline Regner, Patient Care Manager, and Katrina Sullivan, Assistant Patient Care Manager, recruited me and convinced me that I would be a good fit for their Intermediate ICU. I have never regretted a day since and am thankful for their persistence that started my journey. This year I will be celebrating my 15th year at SHC and throughout that time I have had many different opportunities such as, serving in the APCM role on D2, Relief Administrative Nursing Supervisor, Nursing Quality Coordinator, Nursing Quality Manager, then the Director of Nursing Quality. However, my interest and enthusiasm with the Electronic Health Record (EHR) and my current role started when I was asked to be a Super User in 2007 to help implement a new EHR called EPIC. I have been hooked ever since. Many of the leadership roles and jobs I was employed in involved some aspect of optimizing or refreshing nursing documentation and how we collect and utilize nursing data.
In 2020 when the new position for the Director of EPIC Optimization and Reporting was established, I could not pass up the opportunity. To establish a department dedicated to optimizing nursing documentation and building reports that support all the work that Nursing does is a much-needed service. I have always been an advocate of efficiency while providing good quality and safe patient care. Nurses need to be able to work smarter and not harder. Nursing documentation should not be a burden or an obstacle in providing good quality care to our patients. The great quality of care that nurses provide at Stanford should be reflected in Nursing documentation. By working with efficient tools to document timely and effectively, we can leverage the technology to help us work smarter not harder. The EHR should be a tool to help nurses make good sound decisions that support our professional practice while providing excellent quality patient care. I am excited about this new role and the opportunity to collaborate with our bedside nurses, nurse leaders, and professional practice experts both here in Palo Alto and Valley Care to get this work done. Having a dedicated department to this work also give us an opportunity to better align with the SHC Medical Informatics and SHC Technology and Digital Solutions departments.
QUESTION: Can you highlight your role as the Director of EPIC Optimization and Reporting and support of PCS and SHC?
ANSWER: The Director of EPIC Optimization and Reporting is responsible for reviewing, facilitating, planning and implementing EPIC optimization in partnership with the SHC Information Technology teams. My role is key in staying attuned to the needs of clinicians across the enterprise to improve and optimize efficiency in documentation of care while maintaining quality standards. I work very closely with Gretchen Brown, the Associate Chief Nursing Informatics Officer (ACNIO) to strategize enterprise wide on EPIC documentation and implementation of new EPIC modules while enhancing existing EPIC modules to solve the problems that are prioritized in the Nursing and Enterprise strategic goals. My role as Director of EPIC Optimization and Reporting is also responsible for EPIC quality reporting and integration of metrics from other technical platforms to improve quality outcomes identified by the organization and Patient Care Services (PCS). Additionally, to utilize the data not only to optimize how we store and access, but to create great visualization tools and dashboards to help all levels of PCS better understand the data and know what to take action on.
QUESTION: What is your role in the COVID-19 Pandemic response at SHC?
ANSWER: Due to the “shelter in place orders”, the cancelation of all elective surgeries, and the temporary closure of some clinics and other departments, the organization quickly felt a surplus of staff and employees that needed work outside of their normal departments.
This quickly became a problem that needed an urgent response and solution. I was assigned the Clinical Lead and part of a team assigned to finding a solution to the staffing surplus problem. Salem Paschal, Director of Clinical Inpatient Access was assigned the Operational Lead of this project and Austin Wilson, Sr. Program Manager who was responsible for managing the project were incredible partners and teammates for the project. Together we created the Contingency Staffing Operational Center (CSOC), better known as the Labor Pool.
The Contingency Staffing Operations Center (CSOC) was the centralized team that assisted the organization to maximize utilization of staffing resources across the organization by matching essential staff resource gaps to the appropriate resource surpluses across the enterprise. I also worked with Moses Albaniel and Darvin Antonio from the Professional Practice & Clinical Improvement team, who are experts at nursing data collection and visualization to get the CSOC fully operational online. We also created a staffing projection model that would help guide staffing decision making if and when a surge would occur.
It was an incredible experience to see how the organization could quickly mobilize and come together to help support our efforts.
QUESTION: What challenges are you facing in improving user experience and productivity of EPIC?
ANSWER: The first component in trying to improve user experience is to try and develop an understanding of what users need to do their day to day activities and what value does it add. It also helps to understand user’s abilities and limitations. Another component is to understand and evaluate where nurses spend most of their time in EPIC and compare to similar organizations to evaluate efficiency. Once we have a clear understanding of user experience, we can develop and design a systematic approach to evaluating all aspects of nursing documentation to ensure documentation matches our professional practice, reflects the most current evidence-based practice and industry standards, and incorporates nursing research wherever possible. To do this work effectively, we will need help from our end users to find solutions to reducing documentation burden and developing a systematic process for reviewing and refreshing the EHR. Leveraging technology to work better for the end user is a far better satisfier and experience than prioritizing the end user working for technology.
QUESTION: When you are away from work, what activity do you enjoy in your spare time?
ANSWER: My husband and I are both Cajuns from South Louisiana. We love to travel and meet new people. We have a saying in our culture when we meet new people, “we were always friends, we just haven’t met before.” This is why we love learning about and are fascinated by different cultures and beliefs, traditions, and social customs. Learning about different cultures broadens our perspectives, bringing a new level of understanding, admiration, and respect for others, as well as deepening our shared experience in the world. This is also why we both love living in the Bay Area, a melting pot of different cultures and traditions to explore.
If you’d like to get in touch with Patrice to discuss EPIC reporting or for other questions, she can be reached at PDuhon@stanfordhealthcare.org.
Article By: Patrice Duhon, MSN, RN & ORPCS Team