Know your own culture, and although this means work, make sure everyone on staff knows why you are doing this, and agrees that it’s for a good reason, not just because it’s a regulation because change for a good reason, a purpose, works much better than change for change’s sake. If you set out the goal, for example, of going paperless, from the Board on down, you’ve got to set your expectations and be explicit that they apply to everyone; it’s got to be non-negotiable. |
Know what your value proposition is in implementing an EHR. Don’t think of this as an IT project; it’s an operations automation project, and from the strategic level to the clinic level, it’s about patient-centered outcomes. Articulate why you are doing this project, what you want to get out of it, and what your measurable goals are: Meeting MU? Increasing quality? Changing workflow? Know whether you’re doing a clinical transformation project or an implementation project; if it’s the later, you’ll mainly fit your processes to the software, not vice versa. Know what “done” looks for your project charter. Know what your expectations for the project are: Answer to all your prayers or a task to move you along the continuum toward improved patient care? Because it’s the vendor’s job to sell you the product, and the hospital doesn’t always have people who can critically evaluate tools, so some have unrealistic expectations; It’s too easy then to make it “Oz the Great and Terrible” and want to jettison the system. |
| 17. Leadership |
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Make certain you’ve got top-down leadership and sponsorship; what the CEO and CFO know about the process is important. The CEO must be engaged, particularly for CAHs. You need departmental level buy-in from all department heads, including from Health Information and materials management departments, not just top administration. Clinical and operational leadership must engage fully in this process. If not, it’s a recipe for disaster. Although most CAHs have never undergone any major undertaking like this, the ones with strong leadership and lots of communication succeed, whereas the more fragmented ones have a harder time. This project is an organizational change project, and it will rise and fall on how all, not just the CEO, understand, set, and guide expectations. Vendors must enter the environment in a respectful way and be “absorbed” by existing leadership: The voice of the project is the leaders of the organization. |
| 18. Governance |
| No CAH peer experts made comments for this theme. |
Governance structure is necessary to roll decisions downward and advocate for this change. This is a fundamental piece that drives decisions: Implementations that have not been successful are ones where key decisions were made loosely. A good team will do all the preliminary work, but one person must make final decisions. Know who is going to own this solution when the vendor gone; there needs to be a physician to drive the physician system, a clinical person to drive the clinical portion. |
