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Terminologies and Quality in Healthcare « Language: Taken for Granted at our Peril ». David C. Benton Chief Executive Officer International Council of Nurses Northern Nurses Association Conference 23 November 2010. International Council of Nurses.

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Terminologies and Quality in Healthcare « Language: Taken for Granted at our Peril »

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Terminologies and Quality in Healthcare« Language: Taken for Granted at our Peril »

David C. Benton

Chief Executive Officer

International Council of Nurses

Northern Nurses Association Conference

23 November 2010

International Council of Nurses

  • A federation of 135 national nurses associations

  • Represents >13 million nurses

  • Goals

    • bring nursing together worldwide

    • advance the nursing profession

    • influence health policy globally


  • Technology: Change is Constant

  • Problem or Solution

  • International Terminology Standards

  • Terminology for Nursing: ICNP

  • Quality Indicators for Nursing

  • ICNP 2020

Demographics and technology

Demographics and technology


  • Not a trend, not going away


  • Will continue to impact society and nursing

  • Take charge of technology to advance the nursing profession, improve our practice and the outcomes of our patients

Part of the solution or part of the problem


“The ability of two or more systems, or components, to exchange information and to use the information that has been exchanged.” (IEEE, 1990)

Interoperability is central to continuity of care and communication among and across health professionals and health settings.

System integration & data sharing with EHRs requires standards


Governments & Health Care Ministries




Patients at Home, Work, & In Community

Care Delivery Settings

Health Care Providers

Factors motivating the need for technology and terminology standards

  • HIS and EHR implementation

  • Recognized value of

    • Continuity of care

    • Quality indicators and outcomes

    • Evidence-based standards

  • Globalization of healthcare

ICN: Worldwide participationin standard terminologies to promote quality healthcare

Today’s healthcare terminologies

Integrated across settings




ICNP: Terminology developed using advanced technologies

Explicit definitions (formal definitions) and textual descriptions

Greater detail (or granularity)

Conforms with other standards and criteria:

ISO standards (e.g. ISO 18104:2003)

HL7 registered

Integrated into NLM UMLS

ICNP in the EHR

  • Discrete, structured, standardized, electronic, retrievable data

  • Integrated with other health care data

  • Data captured at the point of care

  • Reused for many purposes

ICNP provides data about nursing practice

  • Supports the documentation of care by nurses to facilitate re-use of the data for:

    • Planning

    • Decision support

    • Managing

    • Financial forecasting

    • Quality Improvement

      • Outcomes analysis

    • Policy development

ICNP data for nursing-sensitive quality indicators

  • National Indicators (examples):

    • Canadian Health Outcomes for Better Information and Care (C-HOBIC)

    • US National Database of Nursing Quality Indicators (NDNQI)

    • Portuguese Nursing Minimum Data Set

  • Evolving ICN Global Indicators

  • ICNP Partnerships

    Worldwide Network of National Nurse Associations

    Nursing Specialty Organizations

    Health Ministries and Governments

    Health Information System Software Vendors

    ICNP Research & Development Centres

    Researchers & Translators

    Terminology and Standards Developers

    ICNP International Partnerships with WHO and IHTSDO


    • ICNPbecame a member of the WHO Family of International Classifications


    • ICN entered into a formal partnership with IHTSDO to harmonize with SNOMED-CT

    ICNP Version 2 (2009)

    • Over 2800 concepts

    • Electronic format, download from Internet

    • ICNP Tool Set to assist in implementation and migration to new versions:

      • Browser

      • Mapping (ICNP C-Space)

      • Translation

    • Formal maintenance program with version release plan

    ICNP® Programme


    in Malta, 2011



    ICNP 2020

    • Add value through

      • Tracking the interventions most used in different practice settings and client groups to inform curriculum design and CPD investment.

      • Providing global benchmarking data to track outcomes for quality.

      • Identifying key indicators and sentinel deviations to trigger corrective actions.

    Continue to work together within the global healthcare community to promote quality nursing care.

    Thank You

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