Data-driven decision making
By Maura Sullivan Hill
Nursing informatics emerged in the early 1980s, even before the widespread use of computers and digital information in medicine, Bobay says. “Nursing research was driving the idea that we needed data to describe what we were seeing in hospitals and nursing units, and then use that data to improve patient care.”
Bobay, who first encountered nursing informatics in the 1990s while working as the nurse educator in an emergency department, is a firm believer in data-driven decision making and evidence-based nursing. “In the past, nurses have often done things because that’s the way we’ve always done them,” she says. “For example, most nurses turn patients in bed every two hours to prevent ulcers, but I have not seen any evidence that two hours is the magic number. Maybe it depends on the patient; maybe it should be three hours. Either way, we need evidence to improve our practice.”
Before nursing informatics, most nurses conducted research with what Bobay calls convenience samples: patients on the floor the nurse was working with, or a small subgroup of patients with the same diagnosis from their hospital. But the increase in data available through electronic health records changed everything.
“Now, here at Loyola, we have data going back to 2007 on every patient that has been seen in the health system. That’s more than seven million patient encounters,” she says. “When we had small samples, it was hard to find statistically significant results. But with larger samples, if there is something there, we can find it with research.”
This year, in the spirit of that research effort, Loyola launched the Center for Health Outcomes and Informatics Research (CHOIR) to educate and engage medical professionals in the fundamentals of health outcomes research and data-driven health care, with a goal of improving outcomes and health equity, as well as lowering health care costs.
“We want to ask questions differently than people are used to,” says Bobay, who is spearheading the project. “We want input from physicians, nurses, public health experts, psychologists, statisticians, economists, computer scientists, and social workers—to ask questions in an interdisciplinary way and work together.”
Their first step is a 25-week lecture series covering topics from clinical trials to grant writing to sample size in research projects. While some other schools have begun to explore informatics in more depth, CHOIR is a unique endeavor, says Bobay. “A few schools have similar centers, but we are leading the way to create something here that includes nurses, which not all schools do.”
Bobay and her CHOIR colleagues are optimistic about the potential and opportunity that this new center provides. “Given the diversity of our community, we certainly can explore some health care disparities and, hopefully, find the most medically effective and cost-effective ways to help people,” Bobay says. “It is a great opportunity to do research and make a difference. This is why most of us went into the field—it’s why I went into nursing, and this center is why I came to Loyola.”