Create a comprehensive training plan with your vendor and know specifics (e.g. How much webinar versus on-site end-user training? When? To what extent is it a train-the-trainer model – i.e. What and how much training of users do they expect your staff to do? Who trains physicians? Sometimes nurses don’t want to be the first or sole trainers for them.) Ask how many vendor staff will be onsite for user training, at staff “elbows” for go-live, and for how long, e.g., Two staff might not be enough for a multiple-module go-live. Consider hiring more training/onsite go-live support than the vendor’s basic service. Provide lots of access for staff to the test system, including icons on every PC and in dedicated spaces so users can train and test and practice simultaneously. Create competency checklists; have super users sit down with each user prior to go-live to check skills and remedy any areas if there are standout user-knowledge gaps. Make super-users available across all shifts from go-live through at least 60 days. Having the CEO and senior administration onsite 24/7 during go-live is beneficial for moral and practical support; they can direct vendor staff and super-users wherever assistance is needed, coordinate EHR team meetings, and provide all-staff updates. For new staff spend a couple of days strictly training on the EHR, followed by time on the floor, then a return to the computer so that processes and fine details make sense. |
Get lots of training. Don’t cut corners on bringing physicians in and training them. Many hospitals have used the strategy of training nurse super-users on what the doctors will use, and then they become the best way to train the doctors. Train nurse super-users, mid-levels, and nurses from physicians’ offices on CPOE. You’ll need an ongoing training and education plan after go-live; hospitals fall down on this, so know the level you’ll need. Know what level of ongoing training and support you’ll have. |
| 9. Workflow/Productivity |
Closely examine how your nurses document, and then put in time upfront to make sure the documentation module works well (e.g. navigation is smooth and the workflow is efficient for your patient types). Delve into how much your financial processes change now that your clinical processes are computerized. Set expectations about EHR use; user speed increases, but some find that their EHR processes require more time than desired (e.g. medication reconciliation) even after some optimization. |
Think about a workflow redesign process. Make decisions about work processes and knowledge management first; designing the software modules comes last. Define cases for each of your typical patient types and make sure staff, including physicians, walk these all the way through the system during go-live to ensure that all patient care steps are incorporated into the workflow and the basic data necessary for care is displaying; know how a patient gets from A to B and so on through the system. You’ll revamp after go-live, but you don’t want to have to back up too much afterwards. Workflow will change; studying it beforehand is the start to what you’ll need to know. |
