• Order Technology Drill Down DVD
• Facilitator Manual
• TD2 Presentation Slides from HIMSS

The Robert Wood Johnson Foundation (RWJF) awarded a grant to the American Academy of Nursing in December of 2005 for a project called "Technology Targets: A Synthesized Approach for Identifying and Fostering Technological Solutions to Workflow Inefficiencies on Medical/Surgical Units."

A major component of Technology Targets is a process called Technology Drill Down (TD2), which represents an opportunity to develop an improved process for identifying technological solutions to medical/surgical unit workflow inefficiencies. Twenty-five hospitals and health care systems participated as a TD2 site between March of 2006 and May of 2007. All of the sites found the process to be beneficial in identifying workflow issues and areas most ripe for technological fixes as well as process improvements. The study is currently in the data analysis phase and a presentation of findings will be shared at the 2007 AAN Annual Conference in November.

The Technology Drill Down process focuses on medical/surgical unit workflow from a systems-wide or global perspective rather than a unit perspective. It engages not only RNs, assistive personnel, and unit clerks but also department members from across the entire health care team (including, for example, pharmacy, materials management, social work, and respiratory therapy) whose work processes interface and are interrelated: they all impact patient care and delivery. This interdisciplinary perspective provides a unique opportunity for looking at and analyzing these processes to see where and how they can be improved to create more efficient health care environments. Moreover, the process allows for the involvement of key decision makers such as chief nursing officers and chief information officers as well as environmental experts, clinical engineers, human factor's engineers, and architects before time and financial investments in technologies are made that so that they can be informed by the day-to-day realities faced by frontline staff.

The American Academy of Nursing has now made the Technology Drill Down process available for all hospitals to facilitate through a TD2 DVD and Facilitator's Manual.

This process is facilitated by an internal representative of your organization with assistance and materials available on this DVD which includes the facilitator's guide. Once your hospital's leaders have identified a medical/surgical unit that could benefit from the TD2 process, approximately 20 to 30 unit and interdepartmental representatives convene for a day and a half for the primary purpose of mapping out gaps between current workflow and an idealized workflow as well as potential technological applications that could close the gaps.

Group participants begin by identifying major work categories and then analyzing their current work environment and process within each work category. Then participants envision their ideal day or how the work would flow under ideal circumstances, identifying gaps between the current and the ideal environment. As they talk, the facilitator will map or diagram the discussion, which will appear on the screen that all participants can see. This response keeps the group engaged and focused on the task at hand. Processes that need to be changed to reach an ideal state are identified and available technologies that could fill the gaps are discussed. Moreover, participants identify specific requirements for new technologies and discuss how these technologies could reduce waste, add value to nurses' time and create efficiencies in overall workflow and work processes.

TD2 precisely defines and measures the technological gaps between practice and need and, in generic terms, describes technological products that could close the gaps.

To order the Technology Drill Down DVD, please click here.