Hospital staff and executives often sit through meetings where important tasks are discussed, but when it comes time to delegate the work or follow-up afterward, things get lost in the shuffle, particularly in an emergency department.

However, during an EHR implementation, those leading the implementation cannot afford to get lost. They need to be focused, stay driven and keep up with the timeline for the go-live date.

But how do leaders keep a department full of busy clinicians on schedule and on task? By doing two things—finding champions, and facilitating clear, constant communication.

Identify champions
It’s absolutely essential to identify champions in specific areas across multiple departments and teams, who will help paint the big picture for everyone else. If the task is left without delegation, an organization never really makes the substantial progress it needs to stay on track with the build.

Every group has a variety of different talents, and every organization has talented individuals whose gifts must be applied to an implementation. A good champion will be able to work well with others to have a positive impact on an implementation.

Organizations not only need a successful leader in the physician build, but they will also need a separate lead for the nurse, radiology and lab builds. All the components of the build must come together so they work in unison. An organization can have the greatest physician build, but if nurses are suffering because their build isn’t done right, then the system doesn’t work—everything has to be cohesive.

A champion must be willing to answer to their peers. If things aren’t working, the staff must have someone to go to, to ask, “Why isn’t this working?” People will put up with temporary workarounds if necessary, because they understand the challenges of implementing software, but they still want to be heard.

A common mistake when selecting a champion is choosing someone from an administrative role because of the belief that the type of work is similar. However, administrators usually already have their hands full, so to add these implementation responsibilities to their plates can be overwhelming. Usually, an organization is better off taking someone out of clinical time and allowing them to make this project “their baby,” with the expectation that they need to make this work for everyone.

People who are natural leaders will usually step up to the plate to become champions without much prodding. But this role is not for everyone. Providers really need someone who understands workflows and has an acumen for matching up what the system’s capabilities are and what is happening on a day-to-day basis. And that person must have a vision to help everyone work together on the common goal.

Communicate constantly
Once a champion is identified, the organization will need to help them facilitate constant communication between groups. Satisfying teams with the process—both both before and after go-live—comes comes down to pre-implementation planning.

For example, implementing within the ED is a completely different ballgame from other projects. With the controlled chaos that is an ED, it’s important to get the new workflow in front of clinicians visually, as soon as possible. In our implementation, Northwestern Medical Center decided to upload the system icon onto each workspace and desktop—this was a noninvasive way to start preparing clinicians for the upcoming change.

When it came down to the actual implementation, Northwestern Medical’s communication strategy was to have consistent meetings while staying in touch and moving tasks forward via emails, screenshots and conversations with champions. In the ED especially, scheduling time for everyone to meet on a regular basis is difficult, but this is a crucial step that is crucial to secure clinicians’ buy-in.

Through the meetings at Northwestern Medical, it became evident that it was important to prioritize the build and pay attention to the basics. In large group meetings, conversations can drill down into minutia very quickly, and many minor details about which people argue don’t make that much of a difference to eventual workflow.

As long as a group doesn’t stray too far away from its goals, an implementation will be successful. Don’t try to tackle a huge number of new initiatives that are not needed right away. There’s enough going on in a new implementation, just in terms of helping providers to learn and use the software.

Stay focused on the big things, like moving patients from Point A to B, providing appropriate treatment and orders, and grouping orders, discharge and dispositions.

A close partnership with an EHR vendor can be very beneficial—it needs to be a 50/50 relationship; if a vendor doesn’t have someone to respond to concerns or questions as they arise, it can negatively impact the build.

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Louis Dandurand, MD

Louis Dandurand, MD

Louis Dandurand, MD, is an emergency department physician and ED software informaticist at Northwestern Medical Center in St. Albans, Vt.