Omaha System Overview

Description:

• Consists of three relational, reliable, and valid components designed to be used together:
  
  • Problem Classification Scheme (client assessment)
  • Intervention Scheme (service delivery)
  • Problem Rating Scale for Outcomes (client change/evaluation)
    
• Is a research-based, comprehensive, standardized taxonomy. It is designed to enhance practice, documentation, and information management. It is intended for use with individuals, families, and communities who represent all ages, geographic locations, medical diagnoses, socio-economic ranges, spiritual beliefs, ethnicity, and cultural values.
• Its terms are arranged from general to specific, and are intended to be easily understood by health care professionals and the general public. It provides a structure to document client needs and strengths, describe multidisciplinary practitioner interventions, and measure client outcomes in a simple and user-friendly, yet comprehensive, manner.
• It enables collection, aggregation, and analysis of clinical data. It supports quality improvement, critical thinking, and communication. It fosters research involving best practices/evidence-based practice. It links clinical data to demographic, financial, administrative, and staffing data. It is a middle range theory that supports other established health care theories. Examples include Donabedian’s structure, process, and outcome approach and the Neuman Systems Model.
• It is a framework for integrating and sharing clinical data that has existed in the public domain since 1975. It meets Medicare/Medicaid, Joint Commission, and CHAP guidelines and regulations. It has been recognized by American Nurses Association since 1992, and is listed in the Healthcare Information Technology Standards Panel (HITSP) Use Cases. It facilitates interoperability among users and computer software vendors, and has the potential for use in personal health records. Additional examples of integration are listed in Links.

Users:

• Initial users included staff members employed in home care, public health, and school health practice settings, as well as some educators in the United States.
• Current users are nurses, therapists, social workers/counselors, physicians, registered dieticians, recreational therapists, chaplains, community health workers, chiropractors, and other health care providers. Users also include nursing educators, researchers, and students enrolled in associate degree to doctoral programs, and other health-related students.
• Approximately 8,000 practitioners use point-of-care Omaha System software to document the services they provide at their 300 locations. Approximately 2,000 more practitioners use paper-and-pen records. Users and their sites include home care, public health, and school health practice settings, nurse-managed center staff, hospital-based and managed care case managers, educators and students, occupational health nurses, parish nurses, acute care and rehabilitation hospital/long-term care staff, researchers, members of various disciplines, and computer software vendors. Some Omaha System sites are international.
• Users are described in diverse publications as well as on other sections of this Web site including Case Studies, Links, and Conferences.

History:

• Work on the Omaha System began in the 1970s when Visiting Nurse Association (VNA) of Omaha (Nebraska) staff began revising their home health and public health client records and adopting a problem-oriented approach. The goal was to provide a useful guide for practice, a method for documentation, and a framework for information management. From the beginning, DeLanne Simmons, VNA of Omaha Chief Executive Officer, envisioned a computerized management information system that incorporated an integrated, valid and reliable clinical information system organized around clients who received services, not the multidisciplinary practitioners who provided services.
• Between 1975 and 1986, three research projects were funded by the Division of Nursing, US DHHS to develop and refine the Omaha System. Further research designed to establish reliability, validity, and usability was conducted between 1989 and 1993, and funded by a National Institute of Nursing Research, NIH RO-1 grant. Practitioners employed at the VNA of Omaha and 7 diverse test sites located throughout the USA participated in the four empirical, inductive studies. Practitioners submitted data based on actual client services they were providing, not on retrospective record review. In addition to the rigorous developmental research, more than 50 unique and diverse additional studies have been conducted to generate findings of practical, economic, scholarly, and professional value.
• During the early years, information was disseminated through workshops and speeches. The first Omaha System article was published in 1981, the first books in 1992, and the current book in 2005. The Omaha System is not held under copyright, but needs to be used as published and accompanied by a reliable source such as the 2005 book or this Web site.

For more details about the Omaha System, refer to the 2005 book and other publications.