Move from Traditional Change Management to Agile Methodology · PDF file change management to...

Click here to load reader

  • date post

    28-Sep-2020
  • Category

    Documents

  • view

    1
  • download

    0

Embed Size (px)

Transcript of Move from Traditional Change Management to Agile Methodology · PDF file change management to...

  • 1

    Move from Traditional Change Management to Agile Methodology

    Session #139, February 13, 2019

    Sherri Hess, MS-IS, BSN, RN-BC, FHIMSS Chief Nursing Informatics Officer, Banner Health

    Jean Palazzetti, MSN, MBA, RN, Sr Dir Nursing Informatics, Banner Health

  • 2

    Sherri Hess, MS-IS, BSN, RN-BC, FHIMSS

    Jean Palazzetti, MSN, MBA, RN, HCM

    Has no real or apparent conflicts of interest to report.

    Conflict of Interest

  • 3

    • Pre-Agile Landscape at Banner Health

    • Why agile

    • Agile principles

    • How to implement agile

    • Benefits of agile

    • Data to support

    • Retrospective

    Agenda

  • 4

    • Explain the importance of moving from traditional change management to Agile methodology

    • Explain how to implement a governance model to support an agile, rapid methodology

    • Describe the importance of a data driven approach, using analytics to lead design

    • Identify three principles in Agile methodology

    • Describe three benefits of Agile methodology

    Learning Objectives

  • 5

    Banner Health System

  • 6

    Dare To Dream

  • 7

    Polling Question

    How long from request for an enhancement to implementation?

    Responses

    1. 0-3 months

    2. 3-6 months

    3. 6-9 months

    4. 9-12 months

    How many requests are in your backlog?

    Responses

    Under 100

    100-300

    300-600

    Way too many to count

    Are your end users satisfied with your enhancement process?

    Responses

    Delighted by the process

    Saddened, needs improved

  • 8

    • Significant growth

    • New venues of care delivery

    • Essential Clinical Data Set

    • Clinician satisfaction

    • Patient Obsessed culture - Sofia

    • Minimal data used to drive changes/enhancements

    Landscape For Change

  • 9

    • Enhancement process long

    • Unclear on decision making process

    • Metrics unclear

    • Large meetings – poor decision making

    • Education was “one size fits all”

    Why Agile?

  • 10

    Waterfall Change Management

    – Converted large academic system

    – Enhancement request was complex

    – Large backlog of requests

    – Adoption low

    – Communication was challenging

    – Rarely went back to measure success

    Pre Agile

  • 11

    Which Landed Us Here

  • 12

    18,000 Nurses

    Done

    Done

  • 13

    Agile Principles

    • Satisfy customer-early and continuous delivery

    • Welcome change

    • Individuals and interactions over processes and tools

    • Working software over comprehensive documentation

    • Customer collaboration over contract negotiation

    • Respond to change over following plan

  • 14

    • Training

    • Assemble the teams

    • Start-DO SOMETHING

    • Scrum meetings

    • Grooming sessions

    • Retrospectives

    How To Implement

  • 15

    Benefits Of Agile

    • Whole team & stakeholders (SMEs) at the table real time

    • Simplicity

    • Reflection & Fine Tuning

    • Team size

    • Work broken down into manageable units

    • Focus on quality

    • Frequent delivery

  • 16

    Capabilities Completed

    Average:

    • 23 Capabilities per Iteration

    Total Counts:

    • 362 Complete

    • 17 Ready

    • 86 In Progress

    • 299 Backlog

    1 2 2 2 3 2 3 2

    7 9

    5 4 8

    1 2

    1

    1 1 1 2

    2

    1

    6

    1

    2

    11 5

    10 8 5 5

    12

    6

    8

    9

    10 15

    24

    1

    1

    4

    3 2 2

    2

    3 3

    3

    1 1

    2

    6

    1

    2

    6 1

    6

    5

    1

    6

    6

    3 1

    1

    2

    3 1

    4

    3

    2

    5

    8 4

    10

    9

    7

    7

    7 8

    7

    3

    0

    5

    10

    15

    20

    25

    30

    35

    40

    45

    Iteration 01

    Iteration 02

    Iteration 03

    Iteration 04

    Iteration 05

    Iteration 06

    Iteration 07

    Iteration 08

    Iteration 09

    Iteration 10

    Iteration 11

    Iteration 12

    Iteration 13

    Iteration 14

    Iteration 15

    Iteration 16

    Ambulatory Consumer/Portal Cross Venue Operations

    Hospital Based Medicine Lab Meds Process

    Procedural Specialty Medicine

    Break/Fix

    Only

  • 17

    Orders to Scheduling

    Decreased the turn around time from procedure order to actual scheduling time by 36.4%

    Equated to 2 days and 4 hour reduction

  • 18

    • Baseline

    – 25.40% of the orders were scheduled within the first 24 hour of the order being placed

    – 10.31% of orders were scheduled between 24-48 hours

    – 35.71% of orders were scheduled within the first 48 hours

    • Comparison

    – 43.12% of the orders were scheduled within the first 24 hours of the order being placed

    – 11.22% of orders were scheduled between 24-48 hours

    – 54.34% of orders were scheduled within the first 48 hours

    Increased the amount of orders scheduled within 48 hours by 52.2%

    52.2%

    Baseline: February 2018

    Go Live: September 5, 2018

    Comparison: October 2018

    Excludes: Orders with a turn around time greater than 28 days

  • 19

    Prevented 534,532 mCDS alerts for all users 6.4+ million projected prevented mCDS alerts over 12 months for all users

    Data Source: Millennium

    Baseline: 3/1/18 – 3/31/18

    Comparison: 8/8/18 – 9/8/18

    534,532 prevented mCDS

    alerts over 1

    month for all users

    6.4+ million projected prevented

    mCDS alerts over 12

    months for all users

  • 20

    ED Physician Efficiency Metrics

    Adjusted Time in EMR per patient reduced from 19 min 42 seconds to 11 min 59 secs. Total of nearly 8 minutes!

  • 21

    • Interdisciplinary team

    • Triad approach

    • Feedback Loop

    • Dedicate resources

    – Support

    – Education

    – IT

    – Informatics

    Aligning Support To The Work

  • 22

    Banner Comprehensive Approach

    Agile Governance

    ECD Clinically

    Driven

    Data

    Utilization

    Efficiency

    Analysis

    ECD/Model

    Subjective

    Survey

  • 23

    • What went well

    – Hit the ground running

    – Teams engaged and Leaders supportive

    – Stakeholders on board

    – Large amount of work done in a short amount of time

    – Clinicians eager for optimization

    Post Agile Retrospective

  • 24

    • Lessons Learned

    – Not all pieces have to be done in one iteration

    – Review usage and efficiency analytics before and after

    – Take time to address poor adoption

    – Put all projects in one place

    – Don’t bombard one group with too many changes

    – May be too agile

    Retrospective, cont’d

  • 26

    • Are you ready to adopt agile and two-week sprints?

    • Responses

    • Bring it on!

    • No way!

    Polling Question

  • 27

    Sherri Hess MS-IS, BSN, RN-BC, FHIMSS

    Chief Nursing Informatics Officer

    602-747-7288 | Sherri.Hess@bannerhealth.com

    Jean Palazzetti, MSN, MBA, RN, HCM

    Sr Director Nursing Informatics

    602-747-7538 | Jean.Palazzetti@bannerhealth.com

    Questions

    mailto:Sherri.Hess@bannerhealth.com mailto:Jean.Palazzetti@bannerhealth.com