In today’s rapid EMR deployment environment, one critical success factor is a smooth go-live. In the rush to install a system quickly, don’t overlook the very critical go-live planning phase. There is much to consider in creating an EMR activation plan. Here is a general overview of the fundamentals required in any go-live planning activity to jumpstart your efforts.
The first step is to identify a go-live leader. Having led many system go-lives — including one of the largest “big bangs” in the country — I understand the complexities of these fast-paced, high-stress environments and suggest hiring a leader possessing the following competencies:
• Demonstrated ability to “herd cats” (specifically, this individual will depend on the contribution of other individuals who are facing many competing priorities) as well as persistence, keen attention to detail and continuous follow-up is key to keeping activity moving forward;• Enough operational background to understand end-user community challenges; and,• Sufficient technology experience to understand what is technically feasible for the cutover.
Once a leader is chosen, go-live team members are recruited. Many of the go-live plan’s components must be completed by experts responsible for a specific area. Completing the hundreds of logistical activities, on the other hand, will require an army, so to speak. Once a leader is appointed and a go-live team recruited, go-live planning begins in earnest.
The following activities should be included in any go-live plan:
Set up the command center: Start early! Procuring equipment and facility space can be a lengthy process. Reserving room on campus is ideal for inpatient go-lives. For ambulatory go-lives, find a space central to dispersed clinics.
Develop a super user program: Super users are critical to implementation success. They provide operational support for the project, support end-users in their departments/clinics, and serve as liaisons between end users and the project team. Some areas to consider when developing a super user program include:
• Define clear super user job descriptions and benefits to the organization necessary to secure the substantial financial and time commitment required for these critical resources;• Define super user staffing ratios and formulas to ensure adequate coverage for all departments/units across all shifts;• Select super users from those departments or clinics that will require support;• Develop a clear super user training path and timeline, supported by a go-live logistic plan; and• Develop a long-term strategy for maintaining a super user program post EMR implementation.
Identify hospital and clinic liaisons/key operational owners: These stakeholders are involved in go-live planning and are visible at cutover and the initial days of go-live.
Build a communication and marketing plan: Strong, strategic communications begins at project kick-off and continues through the project’s lifecycle. It serves to increase awareness and set internal and external (community, patients, payers) user expectations. Communication channels can include email updates, newsletters, regular team meetings/presentations, videos, countdown clocks, posters, a dedicated micro site, events, etc.
Address command center staffing: Scheduling staffing requires significant coordination. For hospitals, this is a 24/7 operation oftentimes supplemented with resources from the EMR vendor and contractors.
Define roles and responsibilities: All go-live team members should understand their responsibilities and how they fit within the team.
Develop the technical cutover plan: This plan should include conversion and cutover timings.
Address security: Without a doubt, system security access can be a potential risk issue in the beginning hours of go-live. Organizations should front load security support resources the first few days of go-live as this is when the majority of security issues will present. Testing sign-ons and passwords prior to activation ensures that the proper end user security set-ups are in place to mitigate issues.
Create an issue prioritization and resolution process: Creating a triage workflow and Issue Prioritization Definitions ensures that “critical” issues are first priority and addressed in the expected response time. The technical team can define a tool and strategy for tracking, categorizing, assigning responsibility, and working support tickets. Trouble Shooting Quick Guides, developed by the training team, can be very helpful for end users as well as “at-the-elbow” support personnel.
Technical change control process: Clearly define procedures and an approval process for reviewing and moving changes to production.
Host command center and at-the-elbow support training: An educational session and rally for all support staff prior to activation is critical. Provide documentation, tips, cutover plan, schedules, meeting times, issue tracking and resolution process, logistics, contact lists, etc.
Schedule status meetings: Communication throughout the go-live process is crucial. Plan for and schedule meetings for executive briefings, project leadership, change control, operational leadership and super user huddles.
Stage a go-live dress rehearsal: Workflow and technical dress rehearsals are invaluable in proactively identifying and correcting issues prior to go-live.
Update policies and procedures: Typically deemed a low priority, updated or newly written policies and procedures supporting the new system and addressing downtime can make a significant difference post go-live.
Have a contingency plan: Though planning goes a long way in avoiding major issues that require a contingency plan, there should always be a safety net plan in place.
Conduct final set-up and logistics: Create a comprehensive checklist of all necessary Command Center supplies, equipment (e.g., office and first-aid supplies, Kleenex, power cords, waste baskets, etc), and support services needs. All necessary support services arrangements should be made in advance (e.g., housekeeping, dietary, security, facilities, etc.).
Food: Go-live teams need nourishment and a lot of it! In addition to meal arrangements, provide sufficient drinks and snacks readily available to avoid lost time in travel leaving the Command Center.
Celebrate!: Last, but certainly not least, celebrate acknowledging the go-live team’s incredible effort and dedication in making the EMR deployment a success. Go-live teams work long, hard hours and deserve the recognition.
Sharon Reynolds, RN, serves as Senior Solutions Director of Implementation Services at CTG Health Solutions. Source
