A Go-Live Journey – from Theory to Reality

Silvia Fazekas, Engagement & Adoption Lead South Eastern Sydney Local Health District

• Go-live preparation and roll-out of an eMM system across two co-located facilities

• Benefits and challenges of varied go-live approaches

• Preparing for the unexpected – benefits of user engagement

Outline

• eMM implementation experience • St Vincent’s Hospital Sydney • SESLHD Randwick Campus (excl SCH) • The Sutherland Hospital

• Prince of Wales Hospital

• Mental Health Service

• Royal Hospital for Women

• ICU, Neonates, Fluids out of scope

• 9 month roll-out – Pilot in Oct 2015 and roll-out until April, MH in May, RHW in June

Co-located Facilities

• Parallel engagement strategies

• Early engagement with senior stakeholders AND ward based clinical staff

• Written and visual communications

• Targeting the message to the correct audience

• One size does not fit all but might need slight tweaks

• Dissociation of changes from eMM

Strategies for success

Oops…

• Important to recognise differences of work areas

• Clinicians have similar needs, but different policies and procedures, environments, patients, culture

• Physician vs Surgeon

• Nurse vs Midwife

Knowing the Audience

•Phased go-live • Slower, staged roll-out approach • Targeted and focussed • Time to concentrate on specific users and

workflows

•Big Bang go-live •Rapid roll-out approach •All areas at once

Go-live approaches

Benefits of go-live approaches

Phased: Big-Bang:

At the elbow support at go-live Much faster roll-out

Time to build user confidence All areas live at once

Able to identify potential issues and manage these before progressing too far

No risk of associated with a protracted hybrid paper/electronic system

Able to catch and correct error prone short cuts Streamlined patient transfer processes

Able to identify patterns or trends related to poor design or practice and correct ahead of next area

Everyone doing the same thing from Day 1

Fewer people to re-train if needing to change functionality or workflows

Able to refine roll-out and support strategies before next area

Just in time training model

Challenges of go-live approaches

Phased: Big-Bang:

Lengthier roll-out Need to have all of your duck in a row for go-live

Hybrid paper/electronic processes in place and risk of related errors

Need to have all devices ready and configured

Staff need to be mindful of eMM to non-eMM (and vs.) transfer processes

Need to have ALL staff trained and remembering training

Need all doctors and various services trained at the first go-live

Need a very robust super user and support strategy

Changes to system or workflow during or post-go-live need to be communicated to all users

•A mix of the two approaches • Phased – ward by ward • Elements of Big-Bang – allow wards to decide based on

size and IT/eMR confidence levels about soft or big-bang approach.

Preference?

• Formal and informal relationships • Ward leadership team meetings

• In-services and dress rehearsals

• Embedding changes ahead of the system implementation

• ‘Focus Learners’ and Super Users

• Flexibility in training sessions and timing for some groups

• Pre-go-live support and post!

User engagement

• Buy-in and ownership

• Tricky processes unearthed

• Unwritten workflows identified

• Poor/bad habits discovered and managed

Benefits of user engagement

Thank you - Questions?

Silvia Fazekas – eMEDs Engagement & Adoption Lead South Eastern Sydney Local Health District silvia.fazekas@health.nsw.gov.au