A critical success factor of any IT system implementation is to understand customer needs as thoroughly as possible. Even with the best planning and customer validation, healthcare IT projects tend to be iterative via negotiation points along the way to marry end user needs and software capabilities.
Within a hospital information system, clinical applications present unique challenges as people’s lives are at stake. Therefore, the only people qualified to own and drive a clinical application implementation are providers and clinicians. IT departments with strong depth and breadth in healthcare systems play key roles in identifying technical challenges as well as identifying potential patient safety issues. However, providers and clinicians must have the final say in decision-making. From the start, providers and clinicians should be involved in initial planning, as well as operational process review and improvement.
Initial Planning
To achieve the best outcome, IT project leadership, providers, and clinicians must own reviewing required functionality, workflow among modules, and integration with third party applications. Provider and clinician knowledge is key to identifying risks, assumptions, and specialty workflows to incorporate into system design, build, and training. By creating a partnership with physicians and clinicians from the beginning, an integrated team commits to seeing the project be a success and owning that success. This partnership helps ensure hospitals receive clinical and financial benefits from its investment.
Process Review and Improvement
Providers and clinicians play key roles in project governance. Project governance provides a sustained management framework to make critical decisions, stay aligned with operations, escalate and address issues, and keep a project visible and moving forward. This structure defines responsibilities for each governing body whether committee or individual.
Two key committees to establish within a project governance framework are medical and clinical executive committees. As aforementioned and at the highest level, these two committees should be involved in a system implementation from its onset. Each committee maintains oversight and has final say in decision-making when department leadership has challenges reaching consensus on topics such as workflow considerations, system design decisions, standardization, and order set build to name a few. The following points are a few provider and clinician vital activities:
- During project initiation, these committees should identify at least two key providers and two clinicians per impacted departments to work with IT and the project team to document current state processes. IT and the project team understand the old system and may be able to provide guidance through some of the current state “sticky wickets.” They provide insight as to why those challenge areas exist. Additional members of the project team should include Six Sigma resources to ensure collected data is adequate for process analysis.
- As implementation team members complete training, the project manager should schedule team leads to meet with providers and clinicians for knowledge sharing on new system functionality and potential impact on current processes.
- Reviewing current processes early in a clinical project provides an excellent opportunity to identify activities that require change to capitalize on new system functionality. Depending on the implementation timeline, teams may find opportunities to streamline current processes prior to implementing the system.
- For identified processes that will not change substantially in the new system, take advantage of this time to improve and streamline them. As part of streamlining processes, be sure to reflect industry best practices and ensure they align with organizational objectives such as increased patient safety, improved efficiencies, and higher customer satisfaction.
- As an implementation progresses, training materials developed must reflect not only system functionality, but also and more importantly, department processes and workflows. Quality training materials are essential to engage providers and clinicians in training and system adoption. To have providers and / or clinicians register complaints about training is very late in the implementation and may be difficult to turnaround.
Conclusion
Including providers and clinicians early on in clinical implementations is one of many critical success factors. While providers and clinicians do not build the system, receiving their feedback and consensus results in the best system possible for the organization. Ensuring training materials reflect departmental workflow processes identified during process review and improvement will improve provider and clinician engagement as well as adoption. Engaging early; reviewing and planning workflow processes; and affirming provider and clinician ownership drives home the point that, “this project is not an IT project; it is a clinical project owned by providers and clinicians.”
Lucy Honnold is a Senior Advisor at Impact Advisors.
