Implementing Health Outcomes for Better Information and Care (HOBIC): Lessons from an Early Adopter Site

Measuring patient outcomes to assess quality and to support evidence-based decision-making has gained momentum over the last two decades. In Ontario, the Health Outcomes for Better Information and Care (HOBIC) initiative has become a part of the province's Information Management Strategy as a way to demonstrate the impact of nursing care on health outcomes. In fall 2006, HOBIC implementation began in early adopter sites with the goal of sharing lessons learned with other healthcare providers and organizations. This action learning study was undertaken in one of the early adopter sites to gain a greater understanding of the factors that support, or fail to support, the integration of HOBIC into professional practice. Participants reported a lack of confidence using HOBIC that they attributed to scarce resources for ongoing education and support. Together, we developed a simulation workshop aimed at enhancing communication skills to achieve more meaningful nurse-patient interaction during the HOBIC assessment. This paper focuses Canadian nurse leaders' attention on the reality that implementing HOBIC is far from straightforward. The real challenge in HOBIC implementation is not mastery of the technology per se, but support for nurses and their ability to adapt daily practice in order to maximize its functionality.