The EHR team must continue to meet after go-live and when MU is met. Know that optimization and ongoing work slows but never completely ends. Designate a partial FTE position to focus on addressing system issues, other than Director of Nursing; this is especially important if there is not an onsite IT person. |
Separate out go-live from optimization, which will continue, and put this into your long-range plan; it will take years to build out the system to where you want it to be. The back and forth between people and devices, constant upgrades, patches, changing standards for data/ formats/usability, changes in formulary and order sets, as well as tweaks by your IT person, mean that your system will constantly change. It’s fluid. Vendors: Be more explicit and transparent about the fact that optimization is ongoing. Make sure you’re actually capturing the data necessary; see what you’re entering and figure out what other data elements you need to add. Pay attention to evaluation of the clinical efficacy of the system and its impact on the organization; look back at your key performance measures, your clinical indicators to figure out what outcomes are linked to the EHR; put these on a report card. |
| 14. Project Management |
Build a real case for your strategy and make sure your hospital can handle all the change and disruption, especially if you’re implementing everything all at once. Culture “eats strategy everyday for lunch,” so managing culture change will be a major part of managing this project. The project leader must stay on top of timelines and hold the vendor to them; the CEO must be direct and even tough to do/assist with this. |
Designate a project leader, whether it’s the CEO or other team member. Do a gap analysis to understand where you are before starting and what your detailed plan is to move forward. Develop a project timeline, assess it periodically, stick to it. Move quickly through implementation and pursue a “big bang” rollout rather than a progressive rollout; however, don’t rush too much. Rely on starter order sets from the vendor if possible. Keep track of who is coming to meetings; be flexible in scheduling: If you have to have early or evening meetings for everyone to participate, do so. Have really good project management, including having your team at elbows on the floor for the first few weeks, then track problems and deal with them one at a time. |
| 15. System Install/Go-live |
The EHR team and department heads should meet daily during install and go-live, both a.m. and p.m. during go-live week, tapering off to once per day, then once per week. As part of go-live, take all of your paper forms and find where they are in the system. |
Make it clear early to all staff (and physicians) that vacations cannot be scheduled during key install days and go-live. Administration should do nice things for the staff during install and go-live( e.g. cookies, cupcakes, popcorn) to say thank you. Create a central, living document for concerns and problems – what, when, that it’s been tested again to verify the problem – so that all important issues get rolled into it, and you’re not reinventing the wheel or making duplicate reports to the vendor. |
