Colorado Collaborative for Nursing Research (CCNR) · PDF file... Ann Henderson, PhD, RN-BC, Education Nurse Specialist, Clinical Education ... Pediatric Nursing, SVP, CNO ... PhD,

Colorado Collaborative for

Nursing Research (CCNR)

CCNR Context

1. Nurses are prevalent in health care delivery.

2. Nurses are absent from or obscure in the electronic health record

(EHR).

3. The health care environment is fluid and uncertain—

demonstrating their value is an existential necessity for nurses.

4. The raw data for developing value-added nurse-sensitive

patient-outcome metrics are currently in the EHR, but those

data are not yet being isolated, extracted, and/or processed.

CC

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rocess, 2013

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CCNR Stakeholder Engagement, 2013

1/15/13 College of Nursing Retreat–University of Colorado Hospital (Carolyn Sanders, CNO), Children’s Hospital

Colorado (Kelly Johnson, CNO), Centura Health (Sharon Pappas, CNO)

4/16/13 Colorado Health Foundation (Sarah Andrews)

4/29/13 3 CNOs Breakfast—UCH, CHC, Centura

5/16/13 VA (Judith Burke, Associate Director of Patient Care Services; Catherine Battaglia, Director of Health

Services Research PhD Program)

COMIRB (Alison Lakin, Assistant Vice-Chancellor for Regulatory Compliance)

5/31/13 HealthONE Rose Medical Center (Lynne Wagner, CNO; Telly deBoarts, Magnet Program Coordinator)

6/4/13 UCCS (Nancy Smith, Dean CON; Deb Kenny, Associate Dean of Research)

6/5/13 HealthONE Medical Center of Aurora (Cynthia Latney, former CNO; Bonita Shviraga, Nurse Researcher)

6/6/13 Banner Health (Karen Johnson, Research Director; Ann Coombs, Research Director

Western Region; Kathy Harris, VP Clinical Services; Shelly Fischer, Director Professional Practice)

6/17/13 Jeffco Public Health (Lisa Gatti, Public Health Nurse Supervisor)

7/2/13 Denver Health (Kathy Boyle, CNO)

7/5/13 Center for Nursing Excellence (Karren Kowalski, Director)

7/26/13 3 CNOs Meeting—UHC, CHC, Centura

8/2/13 Exempla Saint Joseph (Deborah Campbell, Director of Professional Nursing Practice)

8/8/13 Catholic Health Initiatives (Catherine Kleiner, National Director of Nursing Research)

8/12/13 PHNAC (Alix Hopkins [Tri-County])

8/14/13 CCNR Infrastructure and Planning Meeting at AMC (Shelly Fischer, Banner; Cynthia Oster, Centura;

Cathy Kleiner, CHI; Kelly Johnson/KC Clevinger, CHC; Regina Fink/Kathy Oman, UCH; Deb Kenny,

UCCS; Deb Campbell, ESJ)

8/15/13 CU School of Public Health (David Goff, Dean)

9/11/13 Kaiser Permanente Southern California conference call (Anna Omery, Senior Director of Clinical

Practice, Patient Care Services; Bradley Howard, Manager Regional Nursing Research)

11/1/13 Nurse Scientist Research Group (Cathy Battaglia, VA; Bradley Howard, KPSC; KC Clevinger, CHC; Deb

Campbell, ESJ; Bonita Shviraga, HO-MCA; Cathy Kleiner, CHI; Kathy Oman, UCH; Cindy Oster, Centura;

John Welton, CU-CON)

11/12/13 COMIRB (Warren Capell)

11/15/13 Banner Health (Kathy Harris, VP of Clinical Services)

11/19/13 Cerner (Amy Garcia)

11/27/13 University of Miami Hospital conference call (JoAnn Trybulski, CNO; Lori Lupe)

11/27/13 MOUs go out to all potential external stakeholders

12/2/13 CHCO—Kelly Johnson, Jason Barell

12/19/13 Exempla Saint Joseph (Mary Shepler, CNO; Deborah Campbell, Director of Professional Nursing

Practice)


1/6/14 Catholic Health Initiatives (Kathy Sanford, Sr-VP and CNO; Catherine Kleiner, National Director of

Nursing Research)

1/8-9/14 Cerner Conference, Orlando

1/9/14 University of Colorado Development (Kathryn Callahan)

1/13/14 Competency and Credentialing Institute; AORN

1/14/14 1st MOU Received—University College Dublin; Catholic Health Initiatives

Nurse Scientist Research Group, (Cathy Battaglia, VA; Bradley Howard, KPSC; KC Clevinger, CHC;

Deb Campbell, ESJ; Bonita Shviraga, HO-MCA; Cathy Kleiner, CHI; Kathy Oman, UCH; Cynthia Oster,

Centura; John Welton, CU-CON)

1/22/14 Colorado Hospital Association

1/24/14 3 CNOs Meeting—University of Colorado Hospital (Carolyn Sanders, CNO), Children’s Hospital Colorado

(Kelly Johnson, CNO), Centura Health (Sharon Pappas, CNO)

2/3/14 Dr. John Bennett, CU Boulder

2/11/14 Beacon Communications (Kiffie Hester, entrepreneur and owner)

2/20/14 Conference call with Cerner (Amy Garcia)

2/28/14 Medical Simulation Corporation

3/10/14 Catholic Health Initiatives (Kathy Sanford, Pat Patton, Camille Haycock, Ann Shepard)

4/2/14 Kaiser Permanente, Waterpark III (Marthie Baker)


Campbell, ESJ; Bonita Shviraga, HO-MCA; Cathy Kleiner, CHI; Kathy Oman, UCH; Cynthia Oster,


5/6/14 Natural Language Processing and Computer Science Meeting with CU Boulder (Kai Larsen, Martha

Palmer, Wayne Ward)

5/9/14 Cerner, trip to Kansas City

5/20/14 UC Health Memorial Hospital (Michelle Smith, Teresa Taylor)

6/5-7/14 University of Minnesota Big Data Conference

6/11/14 Cerner-CCNR meeting in Denver

6/20/14 Kaiser Permanente-CCNR

7/22/14 Kai Larsen/Natural Language Processing group

7/24/14 Nurse Scientist Research Group, (Cathy Battaglia, VA; Bradley Howard, KPSC; KC Clevinger, CHC;

Deb Campbell, ESJ; Bonita Shviraga, HO-MCA; Cathy Kleiner, CHI; Kathy Oman, UCH; Cynthia Oster,


8/4/14 Kindred Healthcare/Tony Disser

8/5/14 University of Wyoming, Mary Burman

9/3/14 Denver Health, Bonnie Adrian

9/4-5/14 AONE/CONL Conference (Amy Garcia, Cerner)

9/11-12/14 Presentation at CHCO

9/23/14 CU School of Medicine, Drs. Heidi Wald and Mark Gritz




10/1/14 University of Wyoming, Mary Burman

10/2/14 Catholic Health Initiatives, Data use meeting

10/13/14 University of Colorado Health North (PVH and MCR) (Janet Craighead, Peggy Budai, Ann Henderson)

10/27/14 Presentation for VA/VISN 19 (Norlynn Nelson)




11/21/14 Penrose/St. Francis, Colorado Springs


1/29-31/15 AACN Doctoral Conference, San Diego, CA (Sue Bakken)

2/19/15 First CCNR Summit, AMC (Regina Alexander-Reis, RN, MS-BC, Supervisor, Health Informatics, VA

Eastern Colorado HCS; Jessica Bondy, MSHA Director, Research Informatics, University of Colorado Cancer Center,

Associate Professor, Biostatistics & Informatics, CU School of Public Health; Jo Comstock, Director, Nursing Informatics/Float

Pool, Kaiser Permanente Colorado; Oliwier Dziadkowiec, PhD, Director, Center for Research and Nursing Scholarship, CU

College of Nursing; Carsten Gorg, PhD, Instructor, Computational Bioscience, CU School of Medicine; Katrina Lawrence, RN,

Admit-Discharge Team, Poudre Valley Hospital; Michael G. Kahn, MD, PhD, Professor, Pediatrics; Director, Research

Informatics, CHCO, Core Director, Biomedical Informatics, CCTSI, Associate Director, Center for Biomedical Informatics &

Personalized Medicine; Sharon B. Kirby, MSN, RN-BC, VP/Chief Nursing Informatics Officer, Centura Health; Cindy Larson,

RN, BSN, Manager, Clinical Informatics, University of Colorado Health; Mustafa Ozkaynak, PhD, Assistant Professor, CU

College of Nursing; Martha Stone Palmer, PhD, Professor, Linguistics and Computer Science, CU-Boulder; Alice Pekarek, RN-

BSN, Director of Clinical Informatics, University of Colorado Health; Tzu Lip Phang, PhD, Associate Professor, CU Denver;

Blaine Reeder, PhD, Assistant Professor, Health Care Informatics, CU College of Nursing; Bob Schell, Director, Research &

Shared Services, OIT, CU Denver; Kathy Smith, RN, MS, PMC, Informatics Nurse Specialist, University of Colorado Hospital;

Bonnie Adrian, PhD, RN, Manager, Nursing Outcomes, Research, & EBP, Denver Health; Marthie Baker, MS, MA, BSN, RN,

Department of Professional Development & Quality for Nursing, KPCO; Cathy Battaglia, PhD, RN, Nurse Investigator, VA

Eastern Colorado HCS, Denver/Seattle Center of Innovation; Diane K. Boyle, PhD, RN, FAAN, Wyoming Excellence Chair in

Nursing, Professor, University of Wyoming School of Nursing; Peggy Budai, RN, MS, NP-C, CNS, Clinical Nurse Specialist,

UCHealth; Deborah Campbell, ND, RN, CNS, NEA-BC, Director, Professional Nursing Practice, Saint Joseph Hospital; KC

Clevinger, PhD, CPNP, CCRP, Director of Research, Children’s Hospital Colorado; Bonnie Clipper, DNP, RN, MA, MBA, CNO,

Medical Center of the Rockies; Ric Detlefsen, MSN, RN, CPHQ, Director, Clinical Quality & Risk Management, PVH & MCR,

Anthony Disser, Sr. Vice-President, Clinical Operations, Kindred Healthcare; Ann Henderson, PhD, RN-BC, Education Nurse

Specialist, Clinical Education & Innovation Center, UCHealth; Kelly M. Johnson, PhD, RN, NEA-BC, Dr. Dori Biester Chair in

Pediatric Nursing, SVP, CNO, Children’s Hospital Colorado; Cathy Kleiner, PhD, RN, CNS, National Director of Nursing

Research, Catholic Health Initiatives, Mary Beth Flynn Makic, RN, PhD, CNS, CCNS, FAAN, Research Nurse Scientist, Critical

Care, University of Colorado Hospital; Kathy Oman, PhD, RN, FAEN, FAAN, Research Nurse Scientist/CNS, University of

Colorado Hospital; Cynthia A. Oster, PhD, MBA, APRN, CNS-BC, ANP, Nurse Scientist, Clinical Nurse Specialist, Critical

Care/Cardiovascular, Centura Porter Adventist Hospital; Melanie F. Sandoval, PhD, RN, Nurse Scientist,

Perioperative/Obstetric Research, University of Colorado Hospital; Karen H. Sousa, PhD, RN, FAAN, Associate Dean of

Research and Scholarship, University of Colorado College of Nursing; Emily J. Tremlett, RN, BSN, CCRC, Clinical Research

Supervisor, SCL Health/Saint Joseph Hospital; John Welton, PhD, RN, FAAN, Professor, University of Colorado College of

Nursing)

3/31/15 UCHealth (Carolyn Sanders, CNO)

4/25/15 CCNR Symposium, WIN Conference, Albuquerque, NM (participation in Symposium presentation by

Catherine Battaglia, VA and Cynthia Oster, Centura)

4/30/15 VA Eastern Colorado Healthcare System (Cory Ramsey, Associate Director of Patient Care Services)

5/26/15 CIVHC (Kristin Paulson, Director of Health Care Programs)

6/4-5/15 University of Minnesota Big Data Conference (Emily Barey, Epic)

6/9/15 PopMedNet (Jessica Bondy, CHORDS Director)

6/10-12/15 AONE/CONL Conference (Amy Garcia, Cerner; Emily Barey, Epic)

6/19/15 Nurse Scientist Research Group (Cathy Battaglia, VA; Bradley Howard, KPSC; KC Clevinger, CHC;

Deborah Campbell, ESJ; Bonita Shviraga, HO-MCA; Catherine Kleiner, CHI; Kathy Oman, UCH; Cynthia

Oster, Centura; John Welton, CU-CON)

6/28/15 Centura Porter Adventist about CUPID/federated data demo (Sharon Pappas, CNO)

7/1/15 CU Legal about CCNR governance documents (Jenny Willits, Katie Goodwin)

7/6/15 UC Health IT about CUPID/federated data demo (Steve Hess, CIO; Alice Pekarek)

7/6/15 CCNR EBP Support Core (Kathy Oman, Regina Fink, Colleen Goode)

7/15/15 Meeting to develop data model for CUPID demo

7/17/15 Children’s Hospital Colorado about CUPID demo (Kelly Johnson, CNO)

7/17/15 Conference call w/Epic (Emily Barey, Nancy Smider, Gregg Springan)

7/27-28/15 PopMedNet Conference, Boston, MA

7/29/15 UCHealth, discussion of data model for CUPID demo (Alice Pekarek)

8/19/15 CCNE (Karren Kowalski)

8/21/15 Nurse Scientist Research Group meeting

8/31/15 Kaiser Permanente So Cal (June Rondinelli)

9/2/15 UCHealth North (Janet Craighead)

9/21/15 UCHealth North (Janet Craighead)

9/28/15 CHORDS about CUPID demo (Jessica Bondy)

9/29/15 UCHealth about CUPID demo (Alice Pekarek, Lenny Larchick)

10/7/15 OIT (Bob Schell)

CCNR Collaborators

• University of Colorado Hospital/UCHealth System

• Children’s Hospital Colorado

• Centura Porter Adventist Hospital

• VA Eastern Colorado Healthcare System

• Good Samaritan Medical Center

• Catholic Health Initiatives

• Kaiser Permanente Colorado

• University of Wyoming School of Nursing

• Denver Health and Hospital Authority

CCNR Vision

The CCNR Vision is to provide the following:

1. a think tank for synthesizing new nursing metrics

and driving nurse-focused research

2. an IT platform for mapping, extracting, and

distributing nurse-sensitive EHR data

3. statistical support for applying advanced analytics

and producing data visualization reports

CCNR Vision 1:

Nursing Think

Tank

CCNR Vision 3:

Nursing Statistical

Support

CCNR Vision 2:

Nursing IT

Infrastructure

CCNR Division 1:

Nurse Scientist

Research Group (NSRG)

CCNR Division 3:

CCNR Statistical

Core

CCNR Division 2:

Common Unified Patient

Indicator Data (CUPID)

CCNR Divisions

Informatics-Enabled

Data Partnerships

User-Driven

Analytics

Nursing

Innovation

Dissemination and

Implementation

Nurse-Sensitive

Patient Outcomes

Intervention

Design

CCNR Methodology: Precision Nursing Triangle

Informatics-Enabled

Data Partnerships:

CUPID

User-Driven Analytics:

CCNR Statistical

Support Core

Nursing Innovation:

Nurse Scientist

Research Group

CCNR Divisions Mapped to Precision

Nursing Triangle

CCNR/

Query

Portal

Data

Partner 1

Data

Partner 2

Results

Results

Query

Query

Data Warehouse Model

Figure courtesy of Jessica Bondy

CUPID / Federated Data

Network Model

CCNR/CUPID Architecture

Central

Repository

Data

Partner 1

Data

Partner 2

Data

Data Query

Researcher Data

Partner 3

Query Launch

Query

Results

CCNR Products

AMIA Poster Presentation, 2014 and 2016

Nursing Outlook Article, 2015

WIN Symposium, 2015 and 2017

Concordium Poster Presentation, 2016

AHRQ/AcademyHealth EDM Forum Grant, 2016

JONA Article, 2017

CCNR Demonstration: TiPSI

• CCNR Summit (Feb 2015): Trajectory in Pain Scores for Inpatients

(TiPSI) is sensitive to nursing intervention

• Grant Funded by AHRQ/EDM Forum (Sep 2015)

• TiPSI Data Model Approved/EHR Mapped (Sep 2016)

• Initial CUPID TiPSI Data Transfer (Jan 2017)

TiPSI: Mapping Data Elements in EHR

Page One

Page Two

Unit 5 /Variable n (%) mean (sd) min max Unit 7 /Variable n (%) mean (sd) min maxGender Gender

Male 39 (49.37%) - - - Male 38 (50.0%) - - -

Female 40(50.63%) - - - Female 38 (50.0%) - - -

Ethnicity Ethnicity

Hispanic 22 (27.85%) - - - Hispanic 17 (22.37%) - - -

Non Hispanic 54 (68.35%) - - - Non Hispanic 58 (76.32%) - - -

Not Reported 2 (2.53%) - - - Not Reported - - - -

Unknown 1 (1.27%) - - - Unknown 1 (1.32%) - - -

Avg Diff in Pain .91 (2.4) -5 8 Avg Diff in Pain .78 (2.2) -6 10

Avg LOS (in Days) 5.14 (11.5) 0 103 Avg LOS (in Days) 6.61 (10.7) 0 83

Unit 6 /Variable n (%) mean (sd) min max Unit 8 /Variable n (%) mean (sd) min maxGender Gender

Male 27 (44.26%) - - - Male 32 (57.14%) - - -

Female 34 (55.74%) - - - Female 24 (42.86%) - - -

Ethnicity Ethnicity

Hispanic 16 (26.85%) - - - Hispanic 13 (23.21%) - - -

Non Hispanic 42 (68.85%) - - - Non Hispanic 42 (75.0%) - - -

Not Reported 3 (4.92%) - - - Not Reported 1 (1.79%) - - -

Unknown - - - - Unknown - - - -

Avg Diff in Pain 1.24 (3.0) -5 10 Avg Diff in Pain -.52 (1.7) -7 4

Avg LOS (in Days) 3.79 (3.9) 0 19 Avg LOS (in Days) 4.45 (5.2) 1 37

TiPSI: Unit-Level Differences

TiPSI: Temporal Anomalies

TiPSI: Year of Trending Unit-Level Data

CUPID is a question

generator as well as an

answer generator.

CCNR TiPSI Demo: A Summary

Documents

Colorado Collaborative for Nursing Research (CCNR) · PDF file... Ann Henderson, PhD, RN-BC, Education Nurse Specialist, Clinical Education ... Pediatric Nursing, SVP, CNO ... PhD,