# Presentation: 810345

## 502H VA Nursing Outcomes Database (VANOD) – Show Me The Data! 

- Julie Presley, BA
- Diane Bedecarré, RN-BC, MS

**Notes:**
Welcome
My name is Diane Bedecarre. I am the Nursing Informatics Site Liaison for the VANOD Program. With me is my colleague Julie Presley who is our Management & Program Analyst. Julie works for both the VANOD Program and the VSSC. 
This morning’s session is a combination lecture and hands on. However, we have the computer room available later today from 12:40 – 1:15 and again from 6:30 to 8:00 this evening for practice. The VANOD team will be available to help you complete some structured exercises or we can work with you one on one during that time if you so desire. We know you are all at different levels with ProClarity, hopefully you will all learn something new today. Having some dedicated time to peruse and play with the database will help you see what data we have right now and give you an opportunity to look at your facility reports. 
We have Room Assistants to help you if you get stuck, please raise your hand and one of them will come over and assist you. We want to make this as interactive as possible.  We’ve reserved time at the end for questions and answers. Please use the index card to write your questions down during the presentation and the room assistants will bring them up front. We will address them at the end of the session.
Don’t worry about taking notes, the scripts and verbiage will be available on the VeHu and VANOD websites. Toward the end of the class, we will point you to some additional training resources. 
Relax, have fun, know that you can’t break anything so don’t be afraid to make a mistake.  Don’t hesitate to ask questions, that is why we are here, for you to learn more about our product.
So let’s get started...
Now’s a good time to put your cell phones on mute.

## Slide 2

- Office of Nursing Services

**Notes:**
We‘d like to introduce you to the other members of our VANOD Team who are here today helping out:
Bonnie Collins our Program Manager
Alicia Levin who is the Implementation Coordinator
And Mimi Haberfelde our Education Coordinator
So how many nurses are there in the VA? You might be surprised to know there are 63,000 RN’s, LPN’s and Unlicensed Assistive Personnel working in the VA. 
The VA is the largest employer of nurses in the United States, perhaps the world. 

## Information Overload

- JCAHO

- KLF Menu
- 321 Reports

- FCDM
- 60 cubes

- DSS

- SHEP

- EPRP

- Performance
- Measures

- CFO

- VANOD

- NDNQI

- All Employee
- Survey

- Performance
- Monitors

- CAMS

- IHI

- NQF

- Courtesy of VSSC

- Office of Nursing Services

**Notes:**
Ever feel like this? You have data and reports coming and going from multiple sources. These demands can be overwhelming.

Maybe you would rather feel like this.......

## Slide 4

- Office of Nursing Services

**Notes:**
We hope that what we show you today will consolidate some of your data needs.

## Objectives

- Describe the VANOD data and source files
- Identify ProClarity tools used for VANOD Reports
- Perform simple report customizations
- Utilize VANOD data to answer key questions
- Explain data validation process & tools to use
- Locate additional training resources

- Office of Nursing Services

**Notes:**
Our objective today is that  you will be able to:
Describe the VANOD data currently in the database and the source files
Identify the 3 ProClarity tools used for VANOD reports 
Perform simple report customizations in the Dashboard and Briefing Books
Utilize VANOD data to answer key questions
Explain the data validation process and describe the tools available to use
And lastly to locate additional training and support resources on the VSSC and VANOD websites

## What is VANOD?

- Office of Nursing Services

**Notes:**
What is VANOD?
VANOD stands for the VA Nursing Outcomes Database.  We are building a database of nursing sensitive indicators, collecting information related to nursing processes and patient outcomes.  

In the VA, nursing is the largest healthcare workforce and has the most direct patient contact, yet we lack standardized, consistent performance data in relation to patient outcomes.  The purpose of VANOD is to provide data that is useful to nursing administrative and clinical staff for managing resources and as a way of monitoring nursing practice and patient outcomes. 

You can see our logo here, looks somewhat like the St. Louis arch. It reads VANOD, Bridging Nursing Quality, Practice and Research.

## Mission and Vision

**Mission**: to create a national database of clinically relevant, **nursing-sensitive quality indicators to identify trends and** areas for improvement in order to:
- Improve the quality and safety of healthcare for veterans
- Support strategic decision-making through benchmarking
- Support data driven decisions for clinical practice and staffing methodology
- Evaluate relationships between nursing-sensitive indicators and patient and staff outcomes
**Vision:** to be recognized as a valued, essential producer of reliable and usable information for both clinical and administrative decision making

- Office of Nursing Services

**Notes:**
Mission: to create a national database of clinically relevant, quality indicators to identify trends and areas for improvement in order to: 
Improve the quality and safety of healthcare for veterans 
Support strategic decision-making for clinical practice and staffing methodologies 
Evaluate relationships between nurse-sensitive indicators and patient and staff outcomes 

We hope to be recognized as a valued, essential producers of reliable and useful information.

## What Data is Available Now?

- Three VANOD Subject Areas:
- Administrative Indicators
- Data Source – PAID & HR files
- Universe – Everyone in the _nursing_ Cost Center 8241 and everyone who has a _nursing_ Budget Object Code
- RN Satisfaction Survey Results
- Data Source – 1st Annual National RN Survey 10/06
- Universe – Staff who self-report as an RN
- Pressure Ulcer Prevalence
- 2 Pressure Ulcer Prevalence Surveys 4/06 & 10/06

- Office of Nursing Services

**Notes:**
Let’s talk about what data is available now.
Currently, there are 3 subject areas for VANOD reports and they are the Administrative Indicators, the RN Satisfaction Survey results and the Pressure Ulcer Prevalence data. 
Let’s discuss where this data comes from: Administrative data is pulled from nationally used VistA files, namely from PAID financial databases and Human Resources files. This data is automatically extracted after each pay period. 

Who is included in the administrative data? VANOD captures data on everyone that is assigned to the nursing cost center of 8241 and/or who have a nursing Budget Object Code of 1061-1069, excluding Nurse Anesthetists. This means we capture administrative data on nurses both in and out of the nursing Cost Center.

The RN Satisfaction data comes from the VANOD All RN Survey that was administered for the first time last October. This survey will be repeated every fall. This is a completely separate survey from the All Employee Survey administered in spring. By the way, Nurse Anesthetists were included in the RN Satisfaction survey, so you will see results for CRNAs in that data.

The Pressure Ulcer data comes from two previous prevalence studies that sites voluntarily participated in FY 06. We hope to have Pressure Ulcer Incidence data very soon as a result of the new Skin Risk Templates that will be distributed later this year. 

## Current Administrative Indicators

| FINANCIAL |
| --- |
| FTEE |
| OT Hours + CTE Hours |
| Overtime Amount |
| Hours segmented by Proximity to Patient:
1) Staff in Direct Care
2) Hospital Support Staff
3) Nursing Administration, etc. |
| Costs (Gross Pay + Benefits) |

| DEMOGRAPHIC |
| --- |
| Age |
| Duty Basis |
| Educational Level |
| Gender |
| Retirement Eligibility |
| Skill Mix |
| Years of Service |

- Office of Nursing Services

**Notes:**
The first indicator we are going to look at today are the Administrative indicators.
The Administrative data are divided into two groups:  Financial and Demographic.
Financial Data: which includes FTEE; Hours Allocation & Types of pay
Demographic Data: includes age, gender, duty basis, educational levels, retirement eligibility and years of service

The data is granular to the time and leave unit and pay period level.

## How Can I Access the Data?

- VSSC website  http://vssc.med.va.gov
- Three ProClarity Report Products:
- Web Standard ProClarity
- 	*For Casual Users*
- ProClarity Excel Dashboard
- 	*For Executive Viewers*
- Desktop Professional
- 	*For Report Generators*

- Office of Nursing Services

**Notes:**
The VANOD data is available to the entire VA community via reports housed on the VSSC intranet website. 

VANOD uses three ProClarity products – 
Web Standard which is geared more toward casual users, 
the Dashboard which provides an executive view 
and Desktop Professional which is the best tool to use for those who create reports for wide distribution. 
We will look at each of these products today.

## Recap

- VANOD is a database of nurse sensitive indicators
- All staff assigned to Cost Center 8241 and/or have a nursing Budget Object Code are included in VANOD
- Data is automatically extracted from common VistA files & from the annual RN Satisfaction Survey
- Three subject areas
- Three ProClarity tools used

- Office of Nursing Services

**Notes:**
Before we move into the database, let’s recap. 
VANOD is a database of nurse sensitive indicators. 
All staff that are assigned to nursing cost center of 8241 and who have a nursing Budget Object Code are included in VANOD. 
Data is automatically extracted from common VistA files and from the annual RN Satisfaction Survey. 
There are currently three subject areas for reports which live on the VSSC website: Administrative Indicators, RN Satisfaction & Pressure Ulcers.
There are 3 tools we use in ProClarity to generate reports

Since we were unable to have the internet available here today, we are going to orient you to the VSSC website via the next few PowerPoint slides. For the hands on portion, you will be using the real applications.  

## VSSC Homepage

**Click on VANOD – VA Nursing Outcomes Database**

**VSSC Homepage**

- Office of Nursing Services

**Notes:**
Here we are on the VSSC Homepage. This is the website that houses the VANOD ProClarity Reports. There are links to this website directly from the VANOD website as well.
This page is divided into 9 boxes for various subject areas. 
The VANOD database link is in the lower left hand corner box under Special Projects. You would click on the VANOD link to go to our Products page.

## VANOD Products Page

- Briefing Books

- Cube

- Dashboard

- VANOD
- Subjects

**VANOD Products Page**

- Office of Nursing Services

**Notes:**
This brings up the VANOD products page. Let’s talk about this page.
Under the blue title bar that reads: Special Projects VANOD, you see an area for Important Announcements. Under the announcement section you read Learn More About with 3 links to Frequently Asked Questions, Resource Documents and Tutorials. These contain very helpful resources for learning more about VANOD ProClarity reports.

Under the resource links you can see 3 radio buttons for the 3 VANOD subject areas: Pressure Ulcer Prevalence, RN Satisfaction and VANOD Administrative Indicators.
The next section below the radio buttons shows icons for the 3 ProClarity product types or tools we use. From left to right, you can see the icons representing Briefing Books, Cubes, and Dashboard. You can filter what displays on your screen by either the subjects above or by product type.
The last section on this page displays several rows with the product icon, the hyperlink to the reports, and a Definitions icon which takes you to the Data Definitions document. Lastly there is a link to free ProClarity software downloads which we will discuss later.
In the live system, if you hover your mouse over the report links you will get a brief description of the report, and information about any additional software requirements and cube server addresses. 

## Tour of VANOD Dashboard

- Executive View Admin data
- Excel (familiar environment)
- Customizing to facility is very easy & quick
- Does require software download - FREE
- Desktop Professional 6.1 *and*
- Business Reporter *and *Hot Fix 6.1

- Office of Nursing Services

**Notes:**
The first ProClarity report tool we are going to look at is called the Dashboard. 
The Dashboard provides you with a comprehensive workbook of administrative data. 
It provides the nurse exec a one stop shop for admin data and it can be saved on a common directory for others in your organization to access.
It is an Excel product so it will look familiar to you.
The advantage to using this tool is that it is very easy to customize to your facility. 
You will need to install the free software that is available on the VSSC website in order to make this work. 

Let’s go there now. Normally, you would access the Dashboard from the VSSC website, however today you are going to click on the Internet Explorer icon on your desktop. The one that reads VSSC VANOD. This brings us to the ProClarity Analytics Server page. Click on Nursing. Now click on the 1st link that says FY07 VANOD Administrative Dashboard. 

## Dashboard Recap

- Look for the wrench icon on VSSC website
- Consolidated repository of administrative data
- Easy to customize to your facility
- Excel type product
- Available to users with software installed
- Automatic data updates
- Save to network directory for others to access

- Office of Nursing Services

**Notes:**
To Recap:
The Dashboard provides a consolidated repository for administrative data.
Easy to customize to your facility
It is an Excel like product which is familiar to many users.
Available to VA users who have the free ProClarity software installed.
Data updates automatically
You are able to save it on a network directory for others in your facility to access.

## Tour of Web StandardBriefing Books

- Available on the VSSC website:
- http://vssc.med.va.gov
- Briefing Books display pre-defined report views of All VA data
- No additional software required
- No special access required
- Useful for casual viewers
- Limited sharing, printing & slide-making capabilities

- Office of Nursing Services

**Notes:**
On our next product tour you will be using the Web Standard version of ProClarity to access the Briefing Books. 
Briefing Books display pre-defined default reports showing All- VA level data.
No additional software or special access is required to view these reports.
They are great for casual report viewers who simply want to customize them to see their own facility data.
You might recall, the product symbol for Briefing Books is the blue stack of books icon. Normally, you would click on the Administrative Indicators Briefing Books from the VSSC website. For today’s session, we are going to click on the VSSC VANOD Internet Explorer icon again on your desktop to open the ProClarity Analytics server page again. Now click on Nursing and then click on the 2nd link for the VANOD Administrative Indicators Briefing Book. You might need to maximize your screen. Now remember, this is not the way you will access these reports when you get home, this is just the way we set it up for the VeHU training environment.

## Briefing Book Recap

- Look for briefing book icon on the VSSC
- Available to all VA intranet users
- No additional software or security required
- Default reports can be easily customized
- Saved to My Views – personal folders
- Reports update automatically when new data comes in

- Office of Nursing Services

**Notes:**
Let’s recap. The VANOD Administrative Indicator Briefing Book reports are available to all VA intranet users. There is no additional software needed to view these reports and no special security access required. 

Default reports are organized into folders such as Demographics and Financial. 
These reports display All VA data but can be easily customized to your facility and saved to your My Views folder to be accessed again.
Reports will update automatically as new data comes in. 

## Take a Break!

- Office of Nursing Services

**Notes:**
We’re going to take a brief break here so you can get up and stretch. Try not to leave the room, but if you have to use the restroom, now’s a good time. We will try to restart in 10 min. 

## RN Satisfaction Survey

- Purpose:
- Measure the satisfaction of VA registered nurses by obtaining annual feedback
- Identify opportunities for improvement in order to improve nurse retention and recruitment
- Support the Magnet Journey
- Results:
- ProClarity Cube/Briefing Book (VSSC Website)
- Comprehensive Analysis by COLMR (VANOD Website)

- Office of Nursing Services

**Notes:**
Now we are gong to discuss another subject – RN Satisfaction and demonstrate on another product, the cube. As you probably know, in October 2006 VANOD conducted our first annual RN Satisfaction Survey. The purpose of this survey is to:
   Measure the satisfaction of VA registered nurses by obtaining annual feedback
To Identify opportunities for improvement in order to improve nurse retention and recruitment
And To Support the Magnet Journey

Interactive ProClarity reports can be found on the VSSC Website and a comprehensive Analysis, conducted by the folks at COLMR (Center for Organization, Leadership & Management Research can be found on the VANOD Website.

So let’s discuss some of the aspects of the survey, then we’ll dive into the data and look at some site results.

## RN Satisfaction Survey ToolPractice Environment Scale

- 43 items total
- 36 core questions
- 31 standard questions per Lake
- 5 additional questions related to IT support of nursing practice, added by VA
- 1 Overall job satisfaction question
- Taken from VA All Employee Survey
- 6 Demographic questions

- Office of Nursing Services

**Notes:**
The questionnaire VANOD used in this survey was a modified version of Eileen Lake’s Practice Environment Scale (PES).  
There were 43 items total in the survey:
Of the 36 Core Questions 31 were standard questions from the Lake survey and 5 questions were added by the VA to capture information regarding IT support of Nursing practice within the VA

There was one overall Job Satisfaction Question that was taken directly from the All Employee Survey 
as well as 6 demographic questions

## Six Subscales

**Six Summary Scales addressed by the survey include:**** **
- Nurse _Participation_ in Hospital Affairs (9 questions)
- Nursing Foundations for _Quality of Care_ (10 questions)
- _Nurse Manager_ Ability, Leadership, and Support of Nurses (5 questions)
- _Staffing_ and Resource Adequacy (4 questions)
- Collegial Nurse-Physician _(RN/MD) Relations_ (3 questions)
- Information technology (_IT_) that _support_s nursing care (5 questions)
**Response options: Four-point agree/disagree**
- Strongly agree (numeric value = 4)
- Agree (3)
- Disagree (2)
- Strongly disagree (1)

- Office of Nursing Services

**Notes:**
Scale scores were created from the 36 Questions in the survey. Scale scores are based on the combined answers from several questions on the same topic.  This is done because:
Scales more reliable than individual items
You can see patterns easier with 6 subscales  vs. 36 individual questions

The 6 Summary Scales are:
	Nurse Participation in Hospital Affairs (9 questions)
	Nursing Foundations for Quality of Care (10 questions)	
	Nurse Manager Ability, Leadership, and Support of Nurses (5 questions)
	Staffing and Resource Adequacy (4 questions)
	Collegial Nurse-Physician (RN/MD) Relations (3 questions)
	Information technology (IT) that supports nursing care (5 questions)
When we get to the data, we will show you where you can see the individual questions for each of the subscales.

As indicated in this slide, we used the following numeric values when computing summary scale scores and when performing all other statistical analyses.

4 Strongly Agree
3 Agree
2 Disagree
1 Strongly Disagree

## FY07 RN SatisfactionTalking Points

- Nationally validated workforce survey instrument
- 41% Response Rate
- good valid sample and data
**Direct Care RNs** are least satisfied
- statistically significant difference between each of the three groups
- Satisfaction **DROPS** after one year in the VA, then picks up again if they’ve been in longer than 10 yrs

- Office of Nursing Services

**Notes:**
Here are some observations based on analysis of National VHA data for the RN Satisfaction Survey.  We can look at your data to see if this holds true.
For the entire VA, there was a 41% response rate 
Direct care RNs are the least satisfied of the 3 groups
Satisfaction drops after 1 year in the VA then picks up again if they have been in longer than 10 yrs.

## RN Satisfaction Demo

- What was the response rate at my facility?
- Of all the RNs that participated in the survey at my facility, how many identified themselves as Direct Care?
- What were the average subscale scores at my facility? How do these scores compare to national scores?
- Which of my staff are most satisfied, least satisfied?
- Where can I find unit level data?
- Can I see the individual question responses?

- Office of Nursing Services

**Notes:**
Earlier this year we sent out some structured exercises to the Nurse Execs. Several people have told us they felt the exercises were not easy to complete, that ProClarity is not intuitive, however they enjoyed the process and have requested that we send out additional exercises. For today’s exercise, let’s look at the data and answer the following questions: 
We just heard the national response rate was 41%, but what was the response rate at my facility?
What percentage of my direct care RN’s completed the survey?
What were the average subscale scores at my facility? How do these scores compare to national scores?
Which of my staff are most satisfied, least satisfied?
Where can I find unit level data?
Can I see the individual question responses?

We are going to open the third ProClarity tool, Desktop professional and look at your data. On your desktop you have an Desktop icon that looks like a blue book with a chevron. Click to open the Desktop icon for the RN Satisfaction survey now. 

## Conclusions (1)

- Survey was a success
- 41% response rate overall
- Respondents were generally representative of all VA RNs at the national level
- Wide variation in response rates observed among facilities
- Great opportunity for improvement at some sites
- Overall, RNs were:
- Most satisfied with IT support of nursing care
- Least satisfied with (a) participation in hospital affairs and (b) staffing and resource adequacy

- Office of Nursing Services

**Notes:**
In conclusion, all in all the survey was a success
41% response rate overall
Respondents were generally representative of all VA RNs at the national level
Wide variation in response rates observed among facilities
Great opportunity for improvement at some sites
Overall, RNs were:
Most satisfied with IT support of nursing care
Least satisfied with (a) participation in hospital affairs and (b) staffing and resource adequacy

## Conclusions (2) 

- Demographic characteristics did have a modest impact on RN’s job satisfaction
- The most substantial impact was observed regarding tenure with VA
- Satisfaction **DROPS** after one year in the VA, then picks up again if they’ve been in longer than 10 yrs

- Office of Nursing Services

**Notes:**
The COLMR analysis reveals that demographic characteristics did have a modest impact on RN’s job satisfaction. 

The most substantial impact was observed regarding tenure with VA
Direct care RNs are the least satisfied of the 3 groups
Satisfaction drops after 1 year in the VA then picks up again if they have been in longer than 10 yrs.
Overall satisfaction was lowest in the 6-10 years in VA group. Maybe the mid career group is where we should focus our interventions to mitigate turnover.

## Next Steps	

- Facility nurse executives should review local results
- Review findings regarding statistically significant differences – COLMR Analysis (VANOD Website)
- See Appendix B
- ProClarity data cube available on VA intranet
**VSSC Website:  http://vssc.med.va.gov**
- Identify areas of excellence & opportunities for improvement
- Next survey: October 2007

- Office of Nursing Services

**Notes:**
Review local results in ProClarity along with the wonderfully informative COLMR Comprehensive Analysis PowerPoint found on the VANOD Website.  Appendix B  of that PowerPoint provides an extensive table that reports the scores for each facility and VISN on each of the scales and on the overall RN job satisfaction question.  

Identify areas of excellence & opportunities for improvement

Prepare for next survey – Oct 2007

Let’s wrap up our discussion of RN Satisfaction data and talk about data validation and additional training resources.

## You Can Validate Your Data

- ProClarity Validation Reports
- Able to drill down to Time & Leave Unit level
- No staff identifiers, total numbers only
- VANOD Data Validation Reports
- Local VistA reports distributed by VANOD
- Active Nurse Staff Report
- VANOD Nurse Staff Education Report
- Class III software
- Lists nurses by name, codes & T&L Units

- Office of Nursing Services

**Notes:**
Data is only good if it is valid. VANOD provides tools to validate Administrative data. The first step is to use the ProClarity Validation reports in the Briefing Books or in the Dashboard on the VSSC whereby you can drill down to your facility, and your T&L units to get aggregate numbers of staff

Secondly, to get local data, we have provided sites with two VistA routines that print local reports on nursing staff by their relevant codes. These local reports (the Active Nurse Staff Report & VANOD Education Report ) are considered Class III software in that they are not nationally supported by the Office of Information. We did test them before they were distributed, and the pilot sites did not report any significant problems.

Sites can run these reports to verify if staff are assigned to the correct cost centers and have the appropriate Occupation Code, Budget Object Codes and Assignment Codes. Reference materials on how to validate the data resides on the VANOD website. 

Let’s take a look at the data validation tools now.

## VANOD Active Nurse Staff Report

**NAME        OCC SERIES/TITLE        T&L   LOCATION      ASSIGN       CC     BOC**
- NURSE,ONE     061050               325                88       8241   61
- NURSE,TWO     062102               073   NHCU-G       00       8241   66
- NURSE,THREE   061055               450                75       8107   64
- NURSE,FOUR    061055               285   OR           88       8202   61
- NURSE,FIVE    061055               335   TCU          88       8241   61
- NURSE SIX     061050               285   OR           88       8202   61
- NURSE,SEVEN   061050               335   TCU          88       8241   61
- NURSE,EIGHT   061055               325   ICU          88       8241   61
- NURSE,NINE    062102               074   NHCU-1       00       8241   66
- NURSE,TEN     062002               352   2A/2B        00       8241   65
- Press Enter to continue or ^ to exit:

- Office of Nursing Services

**Notes:**
This is an example of the Active Nurse Staff Report that lists nurses by name, Occupation Code, T&L, Primary Assignment Location from the Nursing Package, Assignment Code, Cost Center & Budget Object Codes.
In fact, sites that utilize these reports mention they have used them for other things besides VANOD. For example one site used the list to assign Outlook email to all their RNs, another site said it helped to identify where nurses worked so they could target their RN Satisfaction Survey advertising campaign. Several sites contacted us and said this report helps them with their DSS labor mapping. 
HR Is primarily the keeper of this data, but it is up to the sites to work with their HR department to make sure this data accurately reflects your current nursing workforce. 

## VANOD Education Validation Report

- 					                          	                         **NAME****	****      SSN  T&L  OCC ****	**** BOC    EDUCATION**
**	****	****	**** ****SERIES **
- NURSE,ONE    0001  325  0610    61   BACHELORS DEGREE IN NURSING
- NURSE,TWO    0002  073  0621    66   HIGH SCHOOL + ADDITIONAL TRAIN
- NURSE,THREE  0003  450  0610    64   BACHELORS DEGREE IN NURSING
- NURSE,FOUR   0004  285  0610    61   1 SEMESTER OF GRADUATE STUDY
- NURSE,FIVE   0005  335  0610    61   MASTER'S DEGREE IN NURSING
- NURSE,SIX    0006  285  0610    61   BACHELORS DEGREE IN NURSING
- NURSE,SEVEN  0007  335  0610    61   BACHELORS DEGREE IN NURSING
- NURSE,EIGHT  0008  325  0610    61   BACHELORS DEGREE, OTHER
- NURSE,NINE   0009  074  0621    66   LESS THAN 1 YEAR OF COLLEGE
- NURSE,TEN    0010  352  0620    65   NURSING DIPLOMA
- Press Enter to continue or ^ to exit:

- Office of Nursing Services

**Notes:**
Let’s look at another local VistA report. Here is a sample of the local education validation report that we have available. This report can be used to validate the levels of education that are displayed in the ProClarity reports. 
Identifiers have been washed from this report, but you can see that this report lists nursing staff by name, SSN, T&L, Occupation Code, BOC & level of education. Once you get this report, it can be easily exported to Excel where you can sort by T&L and compare it to your ProClarity data.
You will want to make sure that these educational codes are correct and current. 
What we have heard from sites is that often times this data is not kept current as people attain additional degrees. A facility level process will need to be developed to ensure that nursing and HR work in tandem to correct these files and maintain them on an on-going basis.
For instance, in this report, we have circled Nurse 3 who is coded with a Nurse Practitioner BOC, yet she is listed as having only a Bachelors Degree in nursing. This would merit further checking. Doesn’t sound right.
Once your data is updated, the next report run will reflect the new data. It does not go back retrospectively.

## ProClarity: Education Validation

- So I can see an accounting of RNs by T&L and their educational levels for my facility.

- Office of Nursing Services

**Notes:**
Here is the Education Validation report from the briefing books on the VANOD website. 
Along the top of the grid you see the blue column headers for levels of education.
The numbers running down along the left hand side are the T&Ls for one facility.
Two slicers along the top allow you to select a recent pay period and type of nursing employee – RN, LPN, Nursing Assistant
You see that there are no individual staff names, the data displays in aggregate numbers only.

This data is pulled from the PAID system, not the nursing package.

## Validation Process (local VistA Reports)

**IRMS**
- Request IRMS Liaison to install routines on VistA
- IRMS to assign menu options to those who will run reports
**Nursing **
- Identify individuals to run reports
- Validate accuracy of data in local reports
- Prioritize efforts
- Direct Care, Unknowns, and Non-Nursing Staff
- Ensure current hires/transfers are correctly coded
**HR/Finance/Nursing/DSS**
- Negotiate with HR to update relevant codes

- Office of Nursing Services

**Notes:**
Here are the steps we’ve identified for data validation.
IRM must install the routines and assign menu options to those who will run the reports

Nursing might want to assign designated staff to periodically run this report, export it to Excel, sort by T&Ls and coordinate the data validation process within your facility. Oftentimes that falls on the VANOD Site Coordinators shoulders, but we have heard from some sites, they also utilize Administrative Officers, Nurse Recruiters, or Nursing AdPacs.

HR Is primarily the keeper of this data, but it is up to the sites to work with their HR/Finance department to make sure this data accurately reflects your current nursing workforce. It helps to have good relationships with your HR department to get this done. Some sites have designated HR Liaisons who they work with directly. 

## Data Validation Recap

- Nursing should be protectors of their data
- Data validation is a process, involves multiple departments
- Local and web-based reporting tools are designed to help you
- Prioritize your efforts – start with Direct Care staff in inpatient units

- Office of Nursing Services

**Notes:**
To recap, nursing needs to be protectors of their data.  Nursing needs to continually monitor this data to ensure it’s validity for both local and national reports.
Data validation is a process and involves multiple departments
Local and web-based reporting tools are designed to help
Start with direct care staff, they are the most critical for future HPPD calculations.

## Training Resources

- Frequently Asked Questions (FAQ’s)
- On-line self-paced training – VSSC website
- Webinars – sign up on VSSC website
- Structured exercises –VANOD website

- Office of Nursing Services

**Notes:**
We certainly don’t expect you to be able to go back to your facility and be an instant ProClarity expert. We do however want you to know about several training resources on the VANOD and VSSC websites.
 First of all the ProClarity Frequently Asked Questions is a good place to start, and that document is located on both the VSSC & VANOD websites.
Also on the VSSC website are links to self-paced  training programs and webinars taught be both VSSC and VANOD staff. 

And there are additional resources on the VANOD website like structured exercises that users have told us they found helpful. 

## Training Resources - VSSC

- Office of Nursing Services

**Notes:**
On the VSSC home page is the link to the Training Calendar. 

## VSSC Calendar of Classes

- Office of Nursing Services

**Notes:**
Here is the training calendar on the VSSC website. You can register for classes from this site. 

## ProClarity ResourcesVANOD Website

- Office of Nursing Services

**Notes:**
The VANOD website is another treasure trove of information around using ProClarity. Under the ProClarity Resources link you will find PowerPoints from previous classes, structured exercises, and reference documents. As always, the VANOD team is available for assistance, you can contact us via email.

## Best Practices From Your Peers 

- VISN 23 - SharePoint website
- Miami – Local dashboard
- Durham - Facility network directory
- Baltimore – utilized RN Satisfaction data to improve work environment
- Gainesville – great validation processes
- Phoenix – partnered with HR
- North Texas (Dallas) – local T&L reports

- Office of Nursing Services

**Notes:**
Sites have shared their success stories with us on how they share their reports and expert ProClarity resources.

VISN 23 is a best practice example for creating a VISN level website using SharePoints to house their reports for each facility. Jana Kozisek has not only customized the VANOD default reports for each facility in the VISN, but they have also created additional reports as requested by users.   These reports are on a common portal that nursing manages. 

Miami did a cool thing in that they created a local dashboard with VANOD and local clinical data.
Locally, you can customize the VANOD reports using the Dashboard and the Cube tools, save these reports to a common directory for others in your organization to access.  Durham has done a nice job of that. Their Site Coordinator is now in the process of educating their nurse managers on using ProClarity tools.
Baltimore for instance has done a nice job of using the data to make changes to improve the work environment.
Both Gainesville and Phoenix have both done a great job of establishing data validation processes within their organization that work for them. They have shared their strategies on Site Coordinator calls.
Lastly, North Texas has recently shared with us some T&L level reports that we found so useful that we are going to make copies of those for the briefing books default charts.

We applaud our sites for taking the time and effort to validate their data,  to learn ProClarity, to develop custom reports and to disseminate the information within their organization.

## Course Recap

- Described the VANOD data and source files
- Performed simple report customizations
- Demonstrated how to use VANOD data to answer key questions
- Explained data validation process & tools to use
- Located additional training resources
- Showcased Best Practices around the nation

- Office of Nursing Services

**Notes:**
We are just about done with our formal presentation. As a recap, what we have done is:
Described the data and their source files available in the VANOD database
Performed simple report customizations in the Dashboard Briefing Books
Identified the 3 ProClarity tools we use for reports 
Utilized VANOD data to answer some key questions 
Explained the importance of data validation and described the tools available to facilitate that process
Locate additional training and support resources and lastly
Showcased best practices around the nation

We hope you leave here with a better understanding of our database. It is our database – all of nursing. Stay tuned and watch us grow. 

## “Data becomes information based on its relation to other data and the observer’s interest and expectation.”

- David D.  Wood

- Office of Nursing Services

**Notes:**
This is a quote from a previous VeHU presentation that was passed along to us from Toni King from Lexington. 
“Data becomes information based on its relation to other data and the observer’s interest and expectation.”

## Questions?

- Julie Presley, VSSC
- Diane Bedecarré, VANOD
- Bonny Collins, VANOD
- Alicia Levin, VANOD
- Mimi Haberfelde, VANOD

- Office of Nursing Services

## Question #1

*What percent of Nurse Practitioners (NPs) working in the VA responded to the RN Satisfaction Survey?*

- Office of Nursing Services

**Notes:**
Trick question, answer in comments section

## Answer #1

*Q: What percent of Nurse Practitioners (NPs) working in the VA responded to the survey?*
-  RN Satisfaction Briefing Book
- Demographics folder in RN Satisfaction
- Report #3 Respondent Characteristics: Nurse Type

- Office of Nursing Services

**Notes:**
29.6% of participation –info in comments section below

## Question #2

*Where can I view my facility scores for the *_*individual*_* questions in the RN Satisfaction Briefing Books?*

- Office of Nursing Services

## Answer #2

*Q: Where can I view my facility scores for the *_*individual*_* questions in the RN Satisfaction Briefing Books?*
- RN Satisfaction Briefing Book
- Report #6 FY07 Scale/Questions (drill to facility and nurse type)
- Slicers for Facility, Type of Nurse & Work Setting

- Office of Nursing Services

## Question #3

*What percent of survey respondents from your facility had 6-10 years of tenure*
*in the VA? *

- Office of Nursing Services

## Answer #3

*Q: What percent of survey respondents from your facility had 6-10 years of tenure in the VA?*
- RN Satisfaction Briefing Book
- Demographics folder
- Report #5 Respondent Characteristics: Time in Va
- Facility slicer

- Office of Nursing Services

## Question #4

*How many VISNS are below the national average scale scores for staffing? *

- Office of Nursing Services

## Answer #4

*Q: How many VISNS are *_*below*_* the national average scale scores for staffing?*
- RN Satisfaction Briefing Book
- FY07 VISN Scales folder
- FY07 & VISN averages staffing

- Office of Nursing Services

## Question #5

*For FY07, how is Overtime distributed among nursing roles at your facility?*

- Office of Nursing Services

## Answer #5

*Q: For FY07 how is Overtime distributed among nursing roles at your facility?*
- Admin Briefing Book
- Financial folder
- Type of Pay
- OT Trend report
- Expand nursing roles in the grid

- Office of Nursing Services

## Question #6

*Compare Overtime and Sick Leave hours for RNs in your facility.*

- Office of Nursing Services

## Answer #6

*Q: Compare Overtime and Sick Leave hours for RNs in your facility.*
- Admin Briefing Book
- Financial folder
- Hours Allocation
- Report #4 Hrs Allocation OT & SL Comparison
- Select Facility & RN from slicers

- Office of Nursing Services

## Question #7

*Which T&L unit in your facility had the highest Overtime expenditures for RNs in the last pay period? *

- Office of Nursing Services

## Answer #7

*Q: Which T&L unit in your facility had the highest *_*overtime*_* expenditures in the last pay period?*
- Admin Briefing Book
- T&L level report
- #5 Pay Overtime by T&L Unit
- Facility slicer

- Office of Nursing Services

## Question #8

*Are any of the RN’s in your facility listed as having only a high school education?*

- Office of Nursing Services

## Answer #8

*Q: Are any of the RN’s in your facility listed as having only a high school education?*
- Admin Briefing Book
- Demographic folder
- #2 Education level
- Select facility
- Select 0610 HR Occ Code

- Office of Nursing Services

## Question #9

*What is the oldest and youngest age group of nurses in your facility?*

- Office of Nursing Services

## Answer #9

*Q: What is the oldest and youngest age group of nurses in your facility?*
- Admin Briefing Book
- Demographics folder
- Age Group
- Facility
- HR Occupations – select 0610 from the Set-up panel
- Apply

- Office of Nursing Services

## Question #10

*How many of your Direct Care RNs are eligible to retire at your facility?*
*Administrative RNs?*

- Office of Nursing Services

## Answer #10

*Q: How many of your Direct Care RNs are eligible to retire at your facility?*
*         **Administrative RNs?*
- Admin Briefing Book
- Demographics folder
- #5 Nursing Employees Retirement Eligibility
- Budget Object Code slicer RN 1061
- Nursing Role slicer

- Office of Nursing Services

## Question #11

*Use Create Your Own View to trend the OT_CTE for Fiscal Quarters in FY07 for the facilities in your VISN*

- Office of Nursing Services

## Answer #11

*Q: Use Create Your Own View to trend the OT_CTE for FQs in FY07 for the facilities in your VISN*
- Admin Briefing Book
- Create Your Own View
- Select items in Measure---OT_CTE
- Drill on Time
- Drill on FY07
- Drill down on Facility
- Drill down on VISN
- Add a chart - View button, select _line chart_

- Office of Nursing Services

## Question #12

*How many staff at your facility have over 30 years of service?*

- Office of Nursing Services

## Answer #12

*Q: How many staff at your facility have over 30 years of service?*
- Admin Briefing Book
- Demographic folder
- #9 Years of Service
- Select facility

- Office of Nursing Services

## Question #13

*How do I save custom reports for viewing later?*

- Office of Nursing Services

## Answer #13

*Q: How do I save custom reports for viewing later?*
*From Toolbar in Desktop*
* **Book*
*Add to Briefing Book*
*File – Save Book As....*
*Rename Book*
*Save on local network directory*

- Office of Nursing Services