Transcript Epic Presentation

(Epic)Project
Transformational Change: How To
Elicit And Sustain Adoption
Leadership Symposium
April 17, 2012
1
Overview
• A vital component to organizational success is the speed of
change required to react to market, regulatory and customer
demands. The ability to manage data and knowledge is a key
pressure for healthcare organizations and is a driver for
technology related endeavors.
• Technology changes such as the IQ4 Project involve not only
software and hardware, but differences in the way individuals
work and adopt the systems.
• In this session, we will explore a “proven methodology”
approach to facilitating acceptance of significant change in the
work environment and enhance individual involvement and
buy-in with transformational initiatives.
4/5/2011
2
Transformation Journey
• Call To Action
– Participant Engagement
• Eric Lothe, IQ4 Executive Project Sponsor for IH-DM
• Road to Adoption
– Execution And Incorporation Of Change
• Mary Ann Osborn, IQ4 Clinical Adoption Executive
• Stabilization and Sustainability
– Achievement Of The “New Normal”
• Kathy Brandow, IQ4 Manager of Informatics
4/5/2011
3
(Epic)Project
Call To Action
Participant Engagement
Eric Lothe, IQ4 Site Executive Project Sponsor
4
Significance Of The “Call To Action”
- Our brains are hard-wired to resist “change.” As a
vital organ, the brain seeks activities such as habits
and routines and resists decision making which
creates uncertainty and uses more energy and
resources.
- Effective Leaders seize events such as IQ4 to create
new more effective organizational habits and lead
the way from the “known to the unknown”
- A way to break the cycle of habits and facilitate
change, is to provide the “reason” or the “individual
value or benefit” of the change.
7/16/2015
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Creation Of The Call To Action
• Define The “Reason or Why” IQ4 is Important
• Communicate the “Benefit and Value” To Stakeholders:
– Leadership Meetings
– Employee Town Hall Meetings
– Project Kick-off Meetings
• Continue to communicate the “Value” frequently
– Project Web-site -IQ4 HQ
– Site Newsletters
– Physician Meetings
• Provide reminders
– IQ4 Logo on Pens, Notebooks, Lanyards
– Facility Signs
7/16/2015
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Employee Communications
Communication
Complete?
Do’s and Don’ts SE video shown in training and posted to IQ4 HQ
Yes
Management Toolkit with Talking Points for Staff (emailed to managers, printed
copy sent to department, and posted on IQ4 HQ)
Yes
Employee Buttons, Patient Talking Point Cards, Info Posters
Yes
Monthly Newsletter and Weekly Email Updates
2/6-3/2
Video message from CEO distributed on 3/2
2/20
“Party in a Bag” Distributed to Managers
2/24
Post Go-Live Online Updates (2x daily at 1 pm / 5 pm)
3/3-3/17
Post Go-Live Emails (2x daily at 1 and 5 pm)
3/3-3/17
Leading The Call To Action
• Conduct regular Steering Meetings to identify
talking points and incorporate key messages within
the Leadership Team
• Ensure policies are in place to support the work
• Address issues immediately to communicate
importance of the initiative
• Identify Project Goals and publish the status for
achievement of Project Key Performance
Indicators. Hold Leaders accountable to “role
model” and lead goal accomplishment.
4/5/2011
8
Revenue Metrics
Measure
Goal
Current: Week
21
Days in AR
Top Performer - 10%
of Epic clients (42.48)
Avg (53.34)
48.70
Avg Daily Revenue
At pre-live levels by
end of month 2; over
baseline level by
month 6 ($603,945)
$ 590,206
Avg Weekly Cash
Posted
85% of baseline at 10
weeks; greater than
baseline at 8 months
($1,644,236)
$ 1,749,573
Avg Billing Lag (Days
from Discharge to Bill)
Top Performer -10%
of Epic clients
(12.82)
11.22 (Epic data only)
Goal Attainment
Clinical Metrics
Measure
Goal
Current: Feb
2012
Med Rec Compliance
90% of discharge
Med Rec completed
by the discharging
physician
95% (Inpatient)
Adverse Drug Events
25% decrease in
medication errors by
December 2013
0.463 errors per
1,000 doses
Compliance with
CMS Core Measures
95% compliance with
12 reported Core
Measures
NA (Q4 2011)
Will be available 4/12
Patient Satisfaction
63% “always” yr 1;
68% “always” yrs 2 &
3 on Communication
About Medications;
and 87% “always” on
Discharge
Information
57% Communication
About Medications;
82% Discharge
Information
(Q4 2011)
Goal
Attainment
User Adoption Metrics
Measure
Goal
Current: Feb
2012
CPOE Adoption
Goal: 80% of
orders entered by
Providers at 3
months; 90% at 6
months
93% (out of
52,829 orders)
Documentation
Adoption
80% of patient
care doc
completed real
time at 3 months ;
90% at 6 months
81% real time
documentation
Medication
Administration
Adoption
90% barcode
compliance at 3
months; 95%
compliance at 6
months.
96% Patient
Scanned
93% Medication
Scanned
Goal
Attainment
Go-Live Attributes of Success
Take Excellent Care of Patients
Goals
 Patient satisfaction
 Timely communication with our patients
 No adverse events related to the new EHR
Metrics Review:
• Feedback from Power Rangers
• Feedback from Patient Relations
• Press Ganey / HCHAPS
• PIMINIX (adverse events)
Owner(s)
Deb Moyer
Dr. Purtle
Physician Adoption & Satisfaction
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Goals
Generous at the elbow support
Frequent touch points with physicians / groups
who are struggling
Identify “hot spots” and increase support and
rounding for those areas
Understand how we will support the “nonfrequent” physicians so they still practice here
Metrics Review
• Identify and track issues
• Hot Spots being addressed
Owner(s)
Dr. Purtle
Dr. Guest
No Significant Loss of Revenue




Goal
Monitor OR volumes and productivity – quickly
returning to post-live levels
Monitor ED throughput and LWBS
Monitor ancillary service volumes
Stay current with charge entry
Owner(s)
Joe Corfits
Metrics Review
• Monitor ancillary dept. volumes and revenues (compare to pre-go-live)
• Monitor level of late charges by dept. (compare to pre-go-live)
• Monitor # of days before bill drop (compare to pre-go-live)
• Monitor level of efficiency and productivity relative to rev. cycle issues
(measure the levels/completion rate of work ques by dept. post go-live).
• Monitor change in case mix index (compare overall cmi and product line cmi to
levels prior to go-live)
Maintain Positive Attitudes &
Calmness
Goal
 Management ownership of activity and attitude
during go live
Metrics Review
• Feedback from Power Rangers
• Feedback from Super Users during shift change
Owner(s)
Eric Lothe
Steve Stephenson
Timely and Satisfactory Issue
Resolution
Goal
 Critical tickets are escalated appropriately
 Tickets are quickly moved to resolution
 Leaders are informed of the top issues at any
given time, any given day
Metrics Review
• Number of open/closed tickets
• Number of critical tickets
• Top issues from consolidated issues list
Owner(s)
Proctor Lureman Roxie
Menke
Myra Aubuchon Deb Muro
Amy Olson
Jody Michael
(Epic)Project
Road to Adoption
Execution And Incorporation Of Change
Mary Ann Osborn, IQ4 Clinical Adoption Executive
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Road To Adoption
• Proven Methodologies Were Foundational To The
Successful Execution Of Change:
– A Defined Project Structure helped to organize the
work
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7/16/2015
Decision Making and Escalation Process
Project Leadership Team to monitor status
Project Management Best Practices
Project Status Reporting
Certified Project Resources
Design Teams made up of Subject Matter Experts across the
organization helped validate, design and test the system
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Project Organizational Structure
Road To Adoption
• Adoption Or Individual Incorporation of
Change Was Supported By:
– Site ownership of the project
– Site resource involvement to retain knowledge
and experience (Design Teams, Credentialed
Trainers, Super Users)
– Workflow Review, Dress Rehearsals and Practice
using Adaptive Design Principles
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Workflow Review Process
• Practice Future State workflows and compare
to current State Workflows using Adaptive
Design methodologies
• End to end departmental Workflows reviewed
and approved by Managers and staff
• High impact Cross-functional Workflow
Review Sessions attended by MultiDisciplinary Site Team
• Dress Rehearsals conducted prior to Go-Live
Road To Adoption
• Adoption Or Individual Incorporation of
Change Was Supported By:
– A multi-faceted Communication Plan
– Go-Live Readiness Assessments
– Training
• Employees expected to attend training and pass
proficiency exam
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IQ4 Training Methodology
The goal for training is to:
–
–
–
–
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Maximize each person’s time.
Instill confidence in the Epic system.
Increase end user adoption of the new technology.
Promote “efficiencies”.
Empower users with the proper skills for a successful golive.
– Obtain Epic’s “Good Install” status which provides
incentives to follow best practices and “do the “right
thing”
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IHS Learning Strategy
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Road To Adoption
• Adoption Or Individual Incorporation of
Change Was Supported By:
– Go-live Support
• Experienced resources (Physicians, Nurses, Epic, Project
Team, Credentialed Trainers, Super Users) available
during the go-live period (Weeks 1 and 2) to provide
immediate assistance and role model use of the system
and workflows. Support Centers available to assist
users during the 1st 4 weeks after go-live.
• Executive Rounding with deployment of SWAT Teams
• Daily Leadership Meetings
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(Epic)Project
Stabilization And Sustainability
Achievement Of The “New Normal”
Kathy Brandow, IQ4 Manager of Informatics
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Stabilization
• The brain seeks a return to “normal” activities
in which habits can again stabilize. However,
this will not occur immediately until the “New
Normal” is identified and accepted.
Individuals may experience specific stages of
the grief process for 1-4 months during the
stabilization period.
• A defined strategy assists with the transition
to Stabilization and Sustainability
The Strategy For Sustainability
• The Goal Of Sustainability Is To Create A
Successful Ongoing Support Model:
– Organization of Site and Project Support Team
– Continued monitoring of Key Metrics and Goals
– Master Issues List maintained to communicate
progress towards resolution
– Identification of improvement ideas managed by
Affinity/User Groups
– Execution of ongoing Training Plan
– Post Live Visits
Transformational Change
• These Principles are applicable to any
Transformational Change project and may
provide assistance with managing the change
and adoption outcomes.
Questions?
7/16/2015
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