Learning for quality health services: A new thematic discussion on HIFA

The WHO Global Learning Laboratory (GLL) for Quality UHC and Healthcare Information For All (HIFA.org) are delighted to announce a new thematic discussion on HIFA: Learning for quality health services. The discussion starts on 28 June and will continue through to 20 August.

Quality of health services is critical to achieving universal health coverage (UHC): Between 5.7 and 8.4 million deaths are attributed to poor quality care each year in low- and middle-income countries, accounting for up to 15% of overall deaths in these countries. Improving access to health services must go hand in hand with improving the quality of these services. There is an urgent need to place quality at the centre of national-, district- and facility-level actions in order to progress towards UHC.

The discussion will explore in depth the following questions:

- What does quality of care mean to you, in your particular context? Why is it important to make the case for quality of care?

- From your experience, what might work best to enhance national commitment to quality of care? Have you seen any practical solutions that should be shared wider?

- From your experience, what are the biggest challenges for district health managers in tackling quality of care issues? Have you seen any practical solutions that should be shared wider?

- From your experience, what are the biggest challenges for improving quality of care at the facility level? Have you seen any practical solutions that should be shared wider?

Please forward this message to your contacts and networks and invite everyone to join us!

https://www.hifa.org/news/learning-quality-health-services-new-thematic-discussion-hifa

www.hifa.org/joinhifa

We have more than 60 HIFA members volunteering for this project. Also, we are introducing for the first time the concept of HIFA Catalysts, whose role is to stimulate comment and debate. We look forward to a rich discussion!

HIFA profile: Neil Pakenham-Walsh, HIFA Coordinator, neil AT hifa.org www.hifa.org

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Mapping some points to Hodges' model:

individual
|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

SAFETY cognitive access QUALITY of CARE quantity of CARE health literacy mental health	SAFETY faculty - facilities physical access QUANTITY of CARE quality of CARE distance rural : urban Between 5.7 and 8.4 million deaths are attributed to poor quality care each year ... accounting for up to 15% of overall deaths in these countries
PRACTICAL SOLUTIONS	low- and middle-income countries national commitment to quality of care Universal Health Coverage

New WHO Quality Toolkit

"On Monday 20 June WHO launched the Quality Toolkit - a new interactive, online resource for anyone at any level of the health system interested in improving the quality of health services.

The Quality Toolkit provides users with tools to facilitate specific actions to enhance the quality of health services. It is a companion resource to WHO Quality Health Services: a planning guide which provides an outline of key actions to be taken across the health system. The Toolkit then supports these actions with numerous tools. It also enhances understanding of the key interlinkages across the health system when implementing any tool.

The Toolkit incorporates key WHO-published tools and other materials related to quality of health services. It will be updated periodically to reflect new and emerging information relevant to improving quality of health services, including WHO technical products currently under development.

The Quality Toolkit is available at: https://qualityhealthservices.who.int/quality-toolkit

HIFA members are invited to navigate the Toolkit and consider how they might use the tools as part of their improvement efforts. WHO welcomes feedback on the Toolkit qualitytoolkit AT who.int "

Via - HIFA - https://www.hifa.org/

I - IDENTIFY tools and resources relevant to quality of care
M - MAP those tools against improvement needs or identify gaps
P - PLAN implementation of activities for improving quality of care
R - RECOGNIZE interlinkages between technical areas and the process of change
O - OPTIMIZE multi-level action
V - VISUALIZE journeys for improving quality of care
E - ENGAGE stakeholders across the health system

INDIVIDUAL

|

 INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

IDENTIFY (context) PLAN^ (mental health) RECOGNIZE* needs gaps	IDENTIFY (context) MAP / VISUALIZE PLAN^ (physical health) OPTIMIZE technical areas gaps needs
IDENTIFY (context) ENGAGE needs gaps	IDENTIFY (context) RECOGNIZE* needs gaps

Above rendering idealised and all embedded within spiritual and ethnocultural context.

*Recognition required politically to avoid individual frustration and facilitate (policy ...) coherence.

^Planning should (must) take into account need for parity of esteem between mental and physical health (with triage situations acknowledged).

Source: Jules Storr, Independent Consultant, S3 Global & working with WHO as part of the Quality Toolkit development team - via HIFA

RCN Congress 2025 iv - AI & quality improvement

Discussion: Artificial intelligence in nurse education &

Discussion: The role of nursing staff in quality improvement

We'll cover two agenda items in this post. First, resistance is futile in the apparent rise and ubiquity of artificial intelligence.

Discussion: Artificial intelligence in nurse education

Here is, another thing 'we need to get right'. Without checking, I'm sure I posted/tweeted about 'essay factories'. Now Generative AI has put the automated generation of academic essays on steroids. If a student is not motivated to learn, enthusiastic about their seemingly chosen course of study and the professional reward to be earned, then we are in trouble. Public and patient safety are at risk. AI, is however is here to stay - change and help us prosper(?). AI and GenAI are tools, just another step forward, an advance on finger tips, palms, stick, chalk, pencil, and pen. The brief for the discussion includes, with specific points emboldened:

'... Additionally, AI-driven simulations and virtual reality scenarios can provide hands-on experience in a controlled environment, enabling students to practice and refine their skills with greater confidence. 

Creating an engaging and supportive learning environment is key to helping nursing students embrace AI. HEIs can introduce AI concepts early in the curriculum and provide ongoing training and resources. Encouraging collaboration and open discussions about the benefits and challenges of AI can further enhance students' confidence in using these tools.

By taking these steps, nursing education can seamlessly integrate AI, ensuring future nurses are equipped to excel in an evolving health care landscape.

To effectively integrate AI into nursing education, RCN Wales, for example, advocates for higher education institutions (HEIs) to equip students with the skills to continually enhance their digital and biotechnological literacy, ensuring they meet their programme outcomes.

HEIs can incorporate regular assessments and feedback mechanisms to monitor a student’s progress and determine where AI tools add the most value.' . . .

Computer-aided learning has matured greatly since the 1980s and 1990s. AI and GenAI mark the seeming leap in progress over the past two years, with governments, professional bodies and society having to adjust and quickly. We need to watch how simulation, and virtual reality and other approaches to learning are applied, to assure the quality, safety and learning experience provided to students. There appears to be a risk in mental health nursing curricula being 'diminished'. Interpersonal skills are critical in psychiatric and psychological care. This might afford the advocates of technically-laden solutions to side-step the nuances of face-to-face human interaction. Amid the pursuit of what is mechanistic, let us value the humanistic also.

The biotechnical, is one a several literacies to keep sight of. AI, is of course bound up in bio-political concerns, that are still emerging. The 'health care landscape' is plural too: consider the patient's home, a ward, out-patient department, e-consultation, e-learning intervention, brief psychotherapy, occupational health, carceral care, and field hospital, veterans, migrant - refugee health and the homeless.

There's more, and references and a reading list are also provided on the above link.

Discussion: The role of nursing staff in quality improvement

'Quality improvement is about making a difference to patients by improving safety, effectiveness, and experience of care.

All nursing staff should have the abilities and support to become involved in addressing health care pressures, utilising their expertise in the profession as leaders, not only in care delivery, but also within the system. However, the work of nursing staff to deliver quality improvement is often limited to opportunities that are dependent on staffing, seniority and availability. 

Nurses’ willingness to attend training is often superseded by patient demand making attendance impossible. Other health care colleagues undertake work on research and service improvement alongside their role and as a requirement for their revalidation, this is not the case for nursing staff who don’t get these opportunities.

Consider the benefits of the nursing workforce undertaking quality improvement, conducting local research, reorganising working environments, translating or updating patient materials, trialling novel approaches to care or addressing health inequalities. These skills would not only improve the quality of care we provide but also prepare the nurse to influence and change systems throughout their career.

This is relevant UK-wide. Scotland's 2030 vision for nurses, states an intention to equip nurses with quality improvement tools and support, but only nurses in non-hands-on roles. NHS Wales offers quality improvement training through e-learning  via the ESR to health care professionals, in Wales. In Northern Ireland training is available, but only for Band 7 and above.'

What is the role of all nurses to get involved in quality improvement?'

There is a point with IT security that if it was 100% assured with all the prospective log-ins of an average user, would we ever get any 'real' work done? Does the same apply to research? I have heard this as an argument in practice; and a response to a drive for quality improvement too. Data takes time to collect, especially to answer new questions. Such arguments were also fielded when models of nursing were spoke of with eye-rolls and sighs of experience. Quality improvement is a fight, opportunities and resources can be found, especially if a culture of research is nurtured and sustained. What questions does a ward, unit, team have currently? What queries might new starters, newly qualified, students, and placement candidates provoke? If my reference to fighting seems strong; the fight is for time. The raw truth is in the NHS that quality improvement, research and supervision (in its various forms) are in competition, in the absence of coherent integration.

In bold above, the discussion includes:

'trialling novel approaches to care or addressing health inequalities'.

I wonder what that springs to mind? More seriously, we need be aware of what happens to 'quality'; in whatever educational form it is encountered and experienced. 

individual

|

INTERPERSONAL : SCIENCES

humanistic ------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

interpersonal skills informal / formal education QUALITY lifelong learning	biotechnical landscape quality improvement - clinical supervision?
inequity social preparedness for AI/GenAI	inequality management supervision?

BGS Report "Smarter data, better care: Empowering care homes to use data to transform quality of care"

 

"The British Geriatrics Society (BGS) hosted an event in London in September 2023 on ideas and practice around a minimum dataset for care homes. This report, which is based on presentations at the event and the debate that followed, makes 12 recommendations for the effective implementation and delivery of a national minimum dataset that we believe policy-makers and regulators should consider."

Below, I have related the report's 12 recommendations to Hodges' model:

 Individual
  |

     INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

my quality of life my quality of care care home residents research - how new Artificial Intelligence can be harnessed safely and ethically to extract optimum value^^ out of linked social care data

my quality of life my quality of care integration - a harmonised set of quality of life and quality of care indicators not just a process* (data gathering/entry) by care sector on behalf of others high-level of interoperability

resident's families (advocate) needs that cannot be met at home ^Government recognition of contribution of social care sector to society linking of information sources, preserving privacy but improving public's understanding of how such data can be used (benefits) combine learning from the DACHA study, evidence of the analytic power of data instruments like interRAI, and the lived experience of those working in our care sector

care home managers & frontline staff shared decision-making - commissioners, regulators and providers sector-wide conversation around the data that does and does not need to be known by different stakeholders Investment in a data-informed system for health care and social care - greater equity between the two^ sustained - longer term approach - reduce the data burden Government funding of dedicated in-home data coordinators - cost recognised from outset

4Ps in Hodges' model -

INTRA- INTERPERSONAL - purpose
SCIENCES - process
SOCIOLOGY - practice
POLITICAL - policy

^^Where does 'optimum value' lie in Hodges' model?
How are these reconciled?

Transforming the quality of care in care homes through better use of data.  https://www.bgs.org.uk/policy-and-media/transforming-the-quality-of-care-in-care-homes-through-better-use-of-data 

New WHO Quality Toolkit - 'Take ii"

Further to last months post, I've worried at times about the axes of Hodges' model and their status and function. Can I let the axis stand for itself?

INDIVIDUAL

|

|

|

GROUP

Do I expand (explode) the conceptual labels?

self - INDIVIDUAL - person

|

|

|

relationship - family - GROUP - community - population

There seems to be an asymmetry, when you traverse the axis - and its horizontal counterpart; from wherever you start. Perhaps, I worry too much as if the axis was regular then the generic property of the model overall would be diminished. Is this an axis at all?

The website for the Quality Toolkit at: https://qualityhealthservices.who.int/quality-toolkit

- explains the toolkit's scope that includes:

"This new online resource is a user-friendly toolkit to support action on improving the quality of health services at every level of the health system, from national and district to facility and community levels."

I have only scratched the surface here and hope to revisit again - in more detail. Please see below for reflections on the levels by which the toolkit can support action to improve the quality of health services. I have tried to suggest proximity and distance between the SOCIOLOGICAL and POLITICAL (policy). Perhaps, what is a 'clinic' has a name, that it is known by - a key part of the community. The community is closer to the people - to the would-be users of the facility. You can appreciate(?) here the challenge of getting the local community involved in their services. What is 'NATIONAL' should not be remote. Can people compare and contrast with what they are offered? 

 

On the website I note there are video presentations also. The prospect of regular updates for the toolkit is also welcome.

INDIVIDUAL

|

 INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

psychological access 'My' clinic Trust, I feel safe) (feeling safe) Tell others - my experience..	physical access clinic (appearance, facilities, safety) controlled environment (cleanliness, sterile.., or more social)
'the centre' COMMUNITY DISTRICT national	facility (policy translation / coherence?) community district NATIONAL

Original source: Jules Storr, Independent Consultant, S3 Global & working with WHO as part of the Quality Toolkit development team - via HIFA

Previously: New WHO Quality Toolkit

'Take II'? Quality means getting it right first time (even as you persist in what you are doing - your aspirations and quality improvement). Vitally, this means you, the team make a positive impression for the person, the individual, client .. carer, group. 

If they need to - they will recognise their own ability, knowledge, follow advice, they will come back, they leave not to return soon as they can now self-care and care for others in their home, community ...

 Please note: This post and that previous is not intended to denote endorsement of Hodges' model.

 

Quality (and Safety) Organisations come and go but ... care domains ...

"The NHS Improving Quality delivery team has developed and tested a new measure of "energy for change" which is helping to support innovation and improve service delivery." p.26.

"The energy index is evidence based - built up from a combination of academic and desk research - coupled with interviews with NHS staff." pp.26-27.

The 'energy domains' are:

individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

psychological intellectual	physical
social

spiritual

Land, M. (2014) Pedal to the metal to improve the NHS, HSJ, 7 March, 124: 6389. pp.26-27.

Another perspective is provided by The Kings Fund, from:

"Improving quality in the English NHS"

A brief history of policies on quality of care in England

...

• the establishment and later disbandment of the National Patient Safety Agency to collect and analyse data about adverse events
• the establishment and later disbandment of the NHS Modernisation Agency as a central support system for improvement
• the establishment and later disbandment of the NHS Institute for Innovation and Improvement as a (smaller) successor to the Modernisation Agency
• the establishment and later disbandment of NHS Improving Quality as a successor to the NHS Institute for Innovation and Improvement
• the establishment and later disbandment of strategic health authorities as regionalised resource centres for a range of tasks, including facilitating quality improvement pp.6-7.

Ham, Chris, Berwick, Don, Dixon, Jennifer, Improving quality in the English NHS: a strategy for action. London : The King's Fund, 2016, pp. 6-7.


The truly relevant - critical domains have remained a constant over the years, decades even.
 
Clearly, this is evidence-based -this is rocket science...?

How many times do we 'reinvent' this - evidence and desk research based...?

See also*: https://hodges-model.blogspot.com/2014/08/compare-and-contrast-potentia-energy.html

*Yes, I'm starting to repeat myself!

Nursing: magnetic Force 5

Back in 2009 I came across a post - Nurse magnets crucial for recruitment and retention about the 14 Forces of Magnetism:

In 1983, the American Academy of Nursing conducted a survey of 163 hospitals to learn why some hospitals attracted and retained well-qualified nurses who were devoted to quality patient care.

The 14 Forces are listed and described by the ANCC. The forces themselves include:

• Force 1 Quality of Nursing Leadership
• Force 2 Organizational Structure
• Force 3 Management Style
• Force 4 Personnel Policies and Programs
• Force 5 Professional Models of Care
• Force 6 Quality of Care
• Force 7 Quality Improvement
• Force 8 Consultation and Resources
• Force 9 Autonomy
• Force 10 Community and the Hospital
• Force 11 Nurses as Teachers
• Force 12 Image of Nursing
• Force 13 Interdisciplinary Relationships
• Force 14 Professional Development

The professional, organizational, and political (policy) emphasis of the 14 forces is obvious and becomes clear when each is weighed in terms of where it sits within the domains of h2cm.

Try it as an exercise. ...

Recruitment is ALL about magnetism.

If you are unsure, ask a magnet about the meaning of retention.

Demographics are already applying pressure upon these forces of magnetism. Not just when referred to explicitly in the USA within organizational media; but globally. Demographics is another magnet - it approaches with increasing force.

From here in the UK (and readers elsewhere) we have to exercise care when models are mentioned. While the theorists and philosopher's of nursing nail their definitions to the mast (h2cm?) there remains a models muddle, not just in the variety of models of care, but in the levels at which they operate. This is not a criticism, it's an observation - consider Force 5:

Force 5: Professional Models of Care
There are models of care that give nurses the responsibility and authority for the provision of direct patient care. Nurses are accountable for their own practice as well as the coordination of care. The models of care (i.e., primary nursing, case management, family-centered, district, and holistic) provide for the continuity of care across the continuum. The models take into consideration patients’ unique needs and provide skilled nurses and adequate resources to accomplish desired outcomes.

In the US in particular 'models of care' (moc) often refer to finance and accountability of costs (the market process), in the UK moc might refer to commissioning. In Force 5 the addition of 'Professional' (as the original author's no doubt recognized) is crucial. If you repeat the above exercise, plotting Force 5 on the Health Care Domains Model then you see how Force 5 works for nursing and remains to this day a great achievement as a yardstick for quality, assurance and retentive power.

In the almost 30 years since the research on the 14 Forces, I do wonder though if there is a need to imbue the following with magnetic properties:

• person-centred care;
• self-care;
• carers and public engagement;
• prevention;
• public (mental) health
• and informatics?

Yes, many of the above can be assumed to lie within the existing Forces 1-14. Health and social care are not static. Nursing has much to contend with from the level of the individual practitioner through to the group within an organization. The 14 Forces of Magnetism are well established in the USA and deservedly so, they clearly deliver.

In the political and economical heat of an economic recession, however; magnets may reach their particular^* Curie point. Then they cease to work.

The constant bangs and knocks of change, the incessant hammering of party politics and the 'market' on the door of "high quality nursing care" can also take its toll on magnetism.

Nursing needs to take care.

Related post on Healthcare IT News:

Top 10 trends for 2011 include IT, new care models

*OK it should be constant, but like our patients these magnets are not all the same - they have varying levels of vulnerability.

To follow some definitions from an olde book.

Holistic Bandwidth: All or Nothing

Quite a few years ago (Jones, 2004), I took the term bandwidth from the information and communication technology (ICT) world and applied it to health and social care. We seem to have been trying to achieve holistic and integrated care for decades. When care assessment, planning, intervention and evaluation is limited in scope this creates a narrowing of perspective, a bottleneck. Just as bandwidth problems used to affect the quality of on-line experience, so the bandwidth in health and social services ultimately affects the quality of care.

There's nothing wrong with perspective.

It's essential to making sense of the world. And after all, that railway line travels all the way to the vanishing point and it doesn't stop there. Road or railway - there's enough space reading between the lines to launch a whole film and literary genre.

I've said it before – but it really is ironic that many of the constraints in ICT have been overcome through broadband, memory costs/capacity and multi-core processors; while health services still struggle, still need to change:

From DISEASE - TREATMENT to PREVENTION - ENABLING ...

Single-track thinking is no longer sufficient, even if it is reassuring being able to see where you came from.

There’s an interesting non-trivial aside that follows from this bandwidth notion. The old conundrum of quality versus quantity.

Quality and quantity are the ties that bind, the Gordian knot. Cut this one at your peril!

Failure to focus on priorities, to take in that single, that utmost life-threatening perspective could result in disaster. Intensive care is the obvious example. Failure to attend to the physical priorities because of what seem new-age, airy-fairy ideas will quickly get you noticed.

There’s probably a paper out there on quality, quantity and appeals to holistic care. Returning to bandwidth I have wondered about how to measure this? Integrated care pathways and variance might be one approach, serious incident reports may be another revelatory approach? If it’s a care concept and moves ((uses energy) has currency) measure it!

There are a raft of measures for all sorts of things including, mood, behaviour, nursing care related, quality, risk and dependency. If you know of any that might measure holistic bandwidth, please let me know and add a comment here.

In the meantime I’ll ramble on - travelling h2cm's tracks…


Jones, P. (2004). Viewpoint: Can Informatics And Holistic Multidisciplinary Care Be Harmonised? British Journal of Healthcare Computing & Information Management, 21, 6, 17-18.

Gordian knot image c/o Bernice Steinbaum Gallery.

Social Care: in the round and square c/o King's Fund

Simon Bottery's Long Read -

What’s your problem, social care? The eight key areas for reform

- and listed below, have been mapped to Hodges' model. The full article and comments are well worth reading and may help readers discern the relationships between the key areas identified.

1. Means testing: it’s not like the NHS 
2. Catastrophic costs: selling homes to pay for care 
3. Unmet need: people going without the care and support they need 
4. Quality of care: 15-minute care visits and neglect 
5. Workforce pay and conditions: underpaid, overworked staff 
6. Market fragility: care home companies going out of business 
7. Disjointed care: delayed transfers of care and lack of integration with health 
8. The postcode lottery: unwarranted variation in access and performance

I have associated each with the respective knowledge (care) domain in which they are placed:

individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group - population

1. Parity of Esteem in Means Testing 2. (Catastrophic) Cost to me, anxiety, depression, stress 3. Unmet need (mental health, counselling ...) 4. Quality of Care (Mental Health, Well-Being..) 5. Workforce (values, person-centred, self-esteem, job-well-done, BE the Difference?) 6. Market fragility (attractiveness as career pathway, having a leader) 7. Disjointed care (number of carers, lived experience...) 8. Postcode (I thought this had been addressed?) (postcode? - a remote 'thing' outside through the window and (summer) garden]

1. Parity of Esteem in Means Testing 2. (Catastrophic) Cost to NHS - innovation, change, prevention, transformation 3. Unmet need (physical, access ...) 4. Quality of Care (Time, Logistics) 5. Workforce (tasks, scheduling, physically reasonable?) 6. Market fragility (scale, bed occupancy, local demographics...) 7. Disjointed care (geography, transfers, A&E admissions...) 8. Postcode ('literally') North, West, East, South, Regions, London, Urban, Rural ...

1. What is your Parity across 2. (Catastrophic) Cost to my family. 3. Unmet need (socialising, access, carer ..) 4. Quality of Care (Relationships, Belonging, Communication, Family Groups..) 5. Workforce (job satisfaction, status, social worth ..) 6. Market fragility (Public perception, marketing, negativity bias - local news, time for outreach, intergenerational engagement...) 7. Disjointed care (input of family, local provisions, self-funding - budgets...) 8. Postcode (pre-social care, pre-lottery?)

Means (let's Test that.) here too?  2. (Catastrophic) Cost to the State? 3. Unmet need (my choices, informal carer ...)  4. Quality of Care (Value for £, Measures, Inspection, safety..) 5. Workforce (pay and conditions, minimum wage?, Unions, contracts, training, BREXIT ..) 6. Market fragility (FUNDING settlements, estate, investment, staff turnover, Qualified staff, commercial history, profit, governance..) 7. Disjointed care (commissioning, ...) 8. Postcode (local policy, funding, protocols ..)

#RCN26 RCN Congress - Nurse Education

If you think hard-enough all the debates at RCN Congress connect to 'education', but two are laser-focussed:

Protecting nurse education

Resolution submitted by the Education Forum
That this meeting of RCN Congress asks RCN Council to lobby UK governments to protect nurse education from university sector economic pressures.

Quality of clinical placements

Matter for discussion submitted by the Students Committee
That this meeting of RCN Congress discusses ways in which the quality of clinical placements can be ensured and consistent across all 4 countries.

For more senior colleagues, you may momentarily think back - all rose-tinted - to the pre-undergraduate Schools of Nursing, but you also realise change was needed and inevitable. A new millennium was fast approaching.

Now, however it seems within the university ecosystem, nursing is a threatened subject and discipline. Nurse education is exposed and itself vulnerable. In the 21st century fitness-stakes - finance wins:

individual

|

INTERPERSONAL : SCIENCES

humanistic ------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

mental fitness	physical fitness
SOCIAL VALUE  & VALUES	FINANCIAL FITNESS

 

At RCN Congress, the status of nursing as a profession in the USA, was raised. Looking online, I found the following at the U.S. Department of Education: Myth vs. Fact: The Definition of Professional Degrees.

In January 2025 I posted about the situation at Cardiff University. At Congress the matter of the quality of clinical placements, became a resolution. The protection of nurse education provoked an impassioned and emotional debate. Student nurses seeing what is happening to nurse faculty. Nurse faculty seeing the years of experience 'walk' be-pushed out through the door. It seems there is no collective noun for a group, or collection of redundancies. Mass comes to mind, especially in this instance. A 'rash' seems appropriate. But, the condition is more serious and bears further investigation:

As a Google search demonstrates - https://share.google/SViFPWuJovKWhErEE

IT doesn't stop there ...

How many of us (nurses, and other 'professionals') are seeing job offers(?) such as:

Remote
Contract

$35/hr - $80/hr (this is lower than others ...)

About the job

Nursing Informatics Specialist (AI Training)

About The Role

Your clinical knowledge is more valuable than you think — beyond the bedside. We're looking for experienced nursing professionals to help train and evaluate AI systems built for healthcare. As a Nursing Informatics Specialist at Alignerr, you'll apply your frontline expertise to ensure AI understands real-world clinical workflows, EHR systems, and nursing documentation the way actual nurses do.

This is a unique opportunity to work at the intersection of nursing practice and cutting-edge AI — on your own schedule, from anywhere.

• Organization: ---------
• Type: Hourly Contract
• Location: Remote
• Commitment: 10–40 hours/week
  
  

What You'll Do

• Evaluate AI-generated clinical content for accuracy, safety, and alignment with real nursing workflows
• Review and annotate EHR documentation scenarios, flagging errors or gaps in clinical reasoning
• Translate nursing practice knowledge into structured feedback that improves AI model outputs
• Assess how well AI systems reflect clinical informatics best practices across areas like documentation, data integrity, and care coordination
• Provide expert insight on health IT tools, including EHR platforms such as Epic or Cerner
• Work independently and asynchronously on task-based assignments
  
  

Who You Are

• Registered Nurse (RN) or equivalent clinical background with hands-on experience in a healthcare setting
• Familiar with EHR systems and clinical documentation workflows
• Able to analyze clinical scenarios and communicate clear, structured feedback
• Detail-oriented with strong written communication skills
• Self-motivated and comfortable working independently in a remote environment
• No prior AI experience required — your clinical expertise is what matters
  
  

Nice to Have

• Experience in clinical informatics, health IT, or nursing informatics roles
• Familiarity with data annotation, quality review, or evaluation processes
• Background in quality improvement, patient safety, or clinical education
• Exposure to health data standards (e.g., HL7, FHIR, SNOMED)
  
  

Why Join Us

• Work on cutting-edge AI projects with leading research labs and AI teams
• Fully remote and flexible — set your own hours and work at your own pace
• Freelance perks: autonomy, variety, and global collaboration
• Apply your nursing expertise in a completely new and impactful way
• Contribute to AI that could meaningfully improve how healthcare technology serves patients and clinicians
• Potential for ongoing work and contract extension

You might think (no pun intended!): 

'Well this all about informatics. Don't worry - it will all work out fine!'

But, please notice, the clinical and nursing requirement:

"Registered Nurse (RN) or equivalent clinical background with hands-on experience in a healthcare setting."

Not exactly, Hodges' model is it? Even if specific to this role, what does it say:

• about :: the title of 'Registered Nurse'
• about :: Nurses and Nursing as a Profession
• and :: to search engines and agentic AI?

So be aware, and concerned (worried even!) for nursing and nurse education ... 
for the humanity of healthcare:

individual

|

INTERPERSONAL : SCIENCES

humanistic ------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

de-humanisation	BIG TECH
"Where has everyone gone?" Social values Social justice What about research, debate, evidence..?	Nursing Faculty Universities as Institutions that reflect Society Why is there an echo in here? It's been hollowed out.

P.S. I am not a technophobe. Previously: 'AI' : 'SOCIO-technical'