It seems like everywhere you go, hospitals are building and/or expanding. Facilities continue to invest in technology to boost efficiency, eliminate duplication, and prevent errors, as well as to replace aging or obsolete infrastructure.
In January 2012, culminating more than seven years of planning and three years of construction, Rush University Medical Center successfully moved approximately 200 patients into a 14-story state-of-the-art patient tower located in Chicago’s West Side Illinois Medical District. “The Tower,” as the new construction is known, is the crowning achievement of a 10-year campus redevelopment project that combines new construction, renovations of select campus locations and investments in leading edge construction and technology. It is the largest capital project in Rush’s 174-year history.
The new 830,000-square-foot hospital tower encompasses 304 private adult and critical care beds on the top five floors. Included is the Robert R. McCormick Foundation Center for Advanced Emergency Response, which provides an advanced level of readiness for large-scale health emergencies from biological or chemically exposed patients—one of the first of its kind in the US. Three consecutive floors at the base of the hospital make up the Rush interventional platform, where diagnostic testing, surgical and interventional services and recovery are located within a short distance of each other, enhancing collaboration between medical specialists and adding service convenience for staff and patient families. It has 42 procedure rooms and enlarged operating suites to accommodate new technology and the latest in diagnostics and imaging. Rush’s new tower is be Chicago’s first full-service, “green” hospital and is designed to conserve resources, reduce waste and use sustainable building materials. Rush is seeking Leadership in Energy and Environmental Design (LEED) gold certification for the tower, demonstrating environmentally responsibility in building efficiency.
Jaime B. Parent
Moving large volumes of patients is a daunting task…equally daunting is the task of ensuring that all technologies associated with direct and indirect patient care are installed, tested, and fully functional for the move. No fewer than 35 projects were chartered for the move, all designed to run on over 4 million feet of cable, 5,000 end user devices and a wide spectrum of state of the art diagnostic and monitoring equipment. Over 22,000 network jacks and 1,200 wireless access points support all telephonic and system network activity. And it all has to work, on day one.
So how does one stage and execute such a move? A sound strategy across a variety of different levels in the operation is the most effective approach.
1. Develop a solid relationship and collaboration approach.
2. Use an information system quality management plan.
3. Watch the delta between construction and infrastructure.
4. Hire effective project managers.
5. Manage scope creep.
6. Test, test, test.
7. Keep documentation current.
8. Hit your milestones.
9. Hold people accountable.
10. Have an effective governance strategy.
Develop a solid relationship and collaboration approach. Optimal patient care is embedded in the establishment and maintenance of efficient clinical and administrative workflows. Any disruption of such workflows (aka downtime) can be disastrous for a patent care area. Nothing disrupts workflow more easily and in a more complicated matter than the introduction of new technology. Unless a collaborative relationship between the business owner and technology project manager is achieved, project implementation may be viewed as “an IT project.” Minimized disruptions and ease of transition can be greatly facilitated by a well-informed and trained customer who has taken the necessary ownership and buy-in for the technology they will soon be using every day.
Use an information system quality management plan. In addition to the significant project plans that need to be developed, a well-established quality plan is essential. An IT quality plan assists the project managers and line of business owners with the project execution and pulls them in synch with a common bond…quality. A well-run quality plan also helps to align disparate work centers and bridges the communication gap between complex and different IT and clinical nomenclature.
Watch the delta between construction and infrastructure. Technology is totally reliant upon the success of building construction. It is not uncommon for building contractors to build all IT closet infrastructure as well as install building components that support applications. In addition, the labeling of components is often done by non IT personnel who may be expert at following blueprints, but who might not know the complexity of network jack labeling and punch downs. A skilled project manager needs to align and communicate very closely with construction personnel to maximize the scope understanding and ensure sufficient documentation. Proper labeling avoids significant rework.
Hire effective project managers. Project management is an art form, and nothing puts such form on display as a multifunctional project portfolio. It is sometimes possible to make a tech lead a project manager; it almost never works the other way around. Even so, your team will be overwhelmed with all of the life cycle aspects of project implementation. To ask them to act as project managers does them a great disservice as well as creates a hindrance to your customers. Having fully trained and certified project managers will help you meet your milestones and keep your projects on track.
Manage scope creep. Shortly after project kick off, celebration gives way to scope creep. Oftentimes, the excitement of new technology and the lack of budget considerations and other hidden costs lead customers to believe that technology is easy to implement and simply can’t possibly be that expensive! Managing scope creep will help you deliver the project on time and on budget.
Test, test, test. Some things look great on paper or in the lab. Integrating them in a critical care work center can be a different story. Conduct extensive unit testing, regression testing, integrated testing and complete end to end testing, especially with third party vendors. Maintain good records and conduct multiple cycles. Documenting and fixing project defects will save time and effort at go-live.
Keep documentation current. Good documentation will help minimize errors and enable all project deliverables to be on time and on budget. Using version control with an integrated document management system contributes to effective communication and better overall process management.
Hit your milestones. The easiest way for a project to get into trouble is to blow past milestones, considering them insignificant…or falling for an even more dangerous trap, “well get to them later.” No, you won’t, because other project milestones will be in the way. Keep the milestones and promises you set forth when you put your plans together. They were put there for a reason; hit your milestones when they are due.
Hold people accountable. The best route to success is to have everyone involved with solid governance and clear lines of authority and responsibility. Make sure this a top to bottom team effort with effective communication and collaboration at all levels.
Have an effective governance strategy. An effective governance strategy will help to create a framework for the authority and accountability needed to keep projects moving and to make them successful—this is especially important in matrix environments. A well-established and thought-out strategy facilitates effective communication and configuration management, and provides for a forum when tough decisions need to be made.
These ten principles helped us keep the lines of communication and dialogue open and created the cohesiveness and teamwork essential for such a complex operation. Simply stated, the technology is important, but the management of workflow; end-to-end testing, governance and strategy; and communication and collaboration were the foundation for our synergistic project execution and success.
Jaime B. Parent, FHIMSS, CPHIMS, PMP, is associate CIO and vice president, IT Operations at Rush University Medical Center.