. 2014 Feb 12;5(1):92–117. doi: 10.4338/ACI-2013-08-RA-0066

Table 3a.

Comments for the 14 remaining themes: expert advice to CAHs and small, rural hospitals.

Themes in Table 3 (a-f) are in descending order according to the number of CAH peer experts who commented on each. The top box under each theme contains the peer comments. Other experts sometimes made similar comments; however, only unique comments made solely by others are included in the bottom box under each theme.

3. Communication
Communicate out from the EHR team to all staff much more than you think necessary. Be transparent and thorough; you’ll undercut yourself doling information by the spoonful. When the team has an important message to get out, have an event, such as a meal, and spend 10 minutes on the message. Throughout the process, the team should plan and promote a series of fun and informative happenings, especially during build and go-live. The EHR team should hold a project kickoff meeting with vendor staff and do something special that staff will enjoy based on their preferences (e.g. a potluck versus catered meal). At the beginning of the project create a mission statement and graphics for the project (e.g. C.A.R.E. for Clinical Excellence, Accelerated Growth, Regional Leadership and Employee Satisfaction). Put it on everything (e.g. the website, banners, t-shirts) to create consistency and continuity in messaging, and staff buy-in. It’s imperative to communicate with physicians throughout the process. EHR updates/issues should be a standing agenda item for medical staff and all other departmental meetings. Put out a newsletter every Friday, with details on what happened during the week, what’s on the horizon, what successes and failures occurred, and how the team will retackle whatever didn’t go as smoothly as hoped. Have a countdown clock on a computer screen in the cafeteria that shows days, hours, and minutes until go-live, and take photos of staff in front of it as it hits zero, zero, zero. The day before go-live give out pens that say “the last pen you’ll ever need.” Promote and have a celebration at go-live to relieve stress (e.g. set up a fake margarita bar and have the CEO and EHR team hand out snacks; provide green-for-go-live t-shirts with the mission statement to vendor staff and super-users to wear at go-live.) (N.B. Vendors emphasize electronic means. Peers suggest these but verified that they also employ the low-tech standbys they use for regular departmental/staff updates, e.g. binders and bulletin/white boards: Ingrained sources for updates that staff check regularly already are often more effective, especially to reach the many nurses who work only periodic shifts and don’t check the CAH email.)
Remind everyone constantly why you’re doing this and that it’s not about technology. Create a communication plan rather than expecting information to disseminate in an ad hoc fashion; work with the vendor, who will have samples. Accustom staff to using email ahead of install and go-live and checking it regularly at 8 a.m., noon, and 5 p.m. Do regular email blasts, newsletters, blogs, monthly “lunch and learns,” even a website with a progress-toward-go-live thermometer. Start 30 days before go-live and send out an email to all-staff every day, just alerts without much detail; content might include how many days until go-live, how the rollout will work, who will be involved, which departments will be affected when, how many extra hours will be needed, what will happen until paper records are gone. Continue sending out regular bulletins after go-live about what’s being learned and how to do things in the EHR.

3. Communication

Communicate out from the EHR team to all staff much more than you think necessary.
Be transparent and thorough; you’ll undercut yourself doling information by the spoonful.
When the team has an important message to get out, have an event, such as a meal, and spend 10 minutes on the message.
Throughout the process, the team should plan and promote a series of fun and informative happenings, especially during build and go-live.
The EHR team should hold a project kickoff meeting with vendor staff and do something special that staff will enjoy based on their preferences (e.g. a potluck versus catered meal).
At the beginning of the project create a mission statement and graphics for the project (e.g. C.A.R.E. for Clinical Excellence, Accelerated Growth, Regional Leadership and Employee Satisfaction). Put it on everything (e.g. the website, banners, t-shirts) to create consistency and continuity in messaging, and staff buy-in.
It’s imperative to communicate with physicians throughout the process. EHR updates/issues should be a standing agenda item for medical staff and all other departmental meetings.
Put out a newsletter every Friday, with details on what happened during the week, what’s on the horizon, what successes and failures occurred, and how the team will retackle whatever didn’t go as smoothly as hoped.
Have a countdown clock on a computer screen in the cafeteria that shows days, hours, and minutes until go-live, and take photos of staff in front of it as it hits zero, zero, zero.
The day before go-live give out pens that say “the last pen you’ll ever need.”
Promote and have a celebration at go-live to relieve stress (e.g. set up a fake margarita bar and have the CEO and EHR team hand out snacks; provide green-for-go-live t-shirts with the mission statement to vendor staff and super-users to wear at go-live.)
(N.B. Vendors emphasize electronic means. Peers suggest these but verified that they also employ the low-tech standbys they use for regular departmental/staff updates, e.g. binders and bulletin/white boards: Ingrained sources for updates that staff check regularly already are often more effective, especially to reach the many nurses who work only periodic shifts and don’t check the CAH email.)

Remind everyone constantly why you’re doing this and that it’s not about technology.
Create a communication plan rather than expecting information to disseminate in an ad hoc fashion; work with the vendor, who will have samples.
Accustom staff to using email ahead of install and go-live and checking it regularly at 8 a.m., noon, and 5 p.m.
Do regular email blasts, newsletters, blogs, monthly “lunch and learns,” even a website with a progress-toward-go-live thermometer.
Start 30 days before go-live and send out an email to all-staff every day, just alerts without much detail; content might include how many days until go-live, how the rollout will work, who will be involved, which departments will be affected when, how many extra hours will be needed, what will happen until paper records are gone.
Continue sending out regular bulletins after go-live about what’s being learned and how to do things in the EHR.