Critical Success Factors of Project Management Planning

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1 Critical Success Factors of Project Management Planning Kathy Schroeder, RN, PMP, Senior Director, Tenet Healthcare and Liz Coffey, PMP, Service Line Executive, Global Services DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

2 Conflict of Interest Kathy Schroeder, RN, PMP and Liz Coffey, PMP Have no real or apparent conflicts of interest to report HIMSS

3 Learning Identify the critical success factors for go-live Apply the success factors Review specific assessment processes used to help ensure success factors are achieved The go-live readiness assessment Pre-live conversion assessment 3

4 Tenet 49 hospitals in 10 states More than 100 outpatient centers 57,000 employees $8.854 billion net operating revenues (CY'11) 515,693 admissions (CY'11) 4 million outpatient visits (CY'11) 4

5 Chronology of Clinical System Strategy and Our 2013 Beyond Pre-2005 Current state assessment Legacy replacement Advanced clinicals initiatives Expand scope of advanced clinicals 5

6 As Our Clinical System Culture Evolved, Our Project Complexity Grew This is where the idea for the new EHR starts getting a little complicated. 6

7 The Search for The Search for Success Finding out how to replicate success and avoid pitfalls when implementing an electronic health record HIT MYSTERY STORIES 7

8 Searching for Success Evaluated/researched past implementations Delineated common traits Developed a scorecard to evaluate the criteria and how much each contributed to success 8

9 9 CPIC=Clinical Process Improvement Committee

10 Searching for Success Conceptualized key criteria for a successful implementation Reviewed project information to assess achievement Included 2 categories of measurement: - Did the criteria exist within the project plan and in the correct time sequence? - Was there a documented project deliverable (evidence) for each criteria? Documented findings for each hospital on project review template 10

11 What We Found: Every hospital had a project plan and project deliverables Although substance and quality varied, every hospital had a project schedule with tasks and some level of project deliverables included Technical tasks were clearly defined Project Managers had consistent tracking of vendor-specific tasks and timelines (e.g., testing) Internal status reporting was good There was consistent evidence of project status reporting 11

12 Opportunities for Improvement and Recommendations Lack of full project plan integration 12

13 Opportunities for Improvement and Recommendations Project plans included both generic and vendor-specific plans; multiple entries and dates for the same tasks Optimization tasks and timelines were inconsistent 13

14 Opportunities for Improvement and Recommendations Sign-off process and sign-off documents were not included for each deliverable, such as project charter, scope statement, and test plan and execution Limited evidence of build audits and existing build status 14

15 Opportunities for Improvement and Recommendations Evidence of limited issues reporting Definitions and terminology were inconsistent in project documents 15

16 Opportunities for Improvement and Recommendations Limited evidence of Transition-to-Support information, training plan, go-live support plan, etc. Recommendation: establish consistent criteria and document specific dates in project plan For example, what has to be included in the transition-to-support information or the go-live support plan? 16

17 And the Points to 17

18 18 16

19 The Right Leadership Executive Governance Clinical Process Improvement Committee (CPIC) Physician Partnering Communications Examples Governance formed early in project with regular meetings Added a dedicated Clinical Informaticist to the team Added a Physician Champion to the team Results Timely decisions and change management Leadership commitment fostered clinician buy-in Hospital got the message this was something done with them and not to them 19

20 The Right Build Vendor system and clinical standard alignment Accurate and complete build Data accuracy Charge master Examples Results Added a dedicated current state assessment organization to the team Performed build audits to ensure complete and accurate content Accurate build for testing and training Less frustration Match between training and production 20

21 The Right Environment Testing, training, and mock run system environments User equipment Interfaces Work and training space Examples Results Hardware/technology assessments, including: Workstations on Wheels (WOWs) Isolation Rooms Plans for delivery and storage Equipment testing executed IT integral part of the project team 21

22 The Right Future State Meaningful Use (MU) Plan Examples Conducted an MU road show early with subsequent visits involving leaders/team to be aware of why and how Prompted hospital leaders decisions, such as identifying MU sponsor, MU coordinator for reporting, training, and communications Results Established liaison to home office focusing on timely communications as changes ensued MU coordinator could communicate and address the information 22

23 The Right Testing & Preparation Comprehensive testing Appropriate and timely training Immersion/Mock Run Methodology Examples Followed a comprehensive unit, application and integrated testing methodology, including impacted non-clinical systems such as admitting, billing, and HIM Used a variety of training methodologies depending on the volume, user population, and infrastructure Conducted mock go-live with super user roles, command center, 24-7 shifts Results Allowed practice in the application with the future state clearly painted Answered: How is my day going to look on Day 1 of activation? How will I interact with my patients and new system? 23

24 The Right Resources Super user planning Comprehensive go-live plan Examples Super user commitment contract" was created, detailing expectations, timeline, milestones, and overall commitment Leadership supported super users having no patient care responsibilities during the course of project and at activation Results Team and leaders were prepared for what the project entailed including backfill for key positions Trained, practiced, and knowledgeable "organic staff" were available to address issues Confidence gained early for and in super users 24

25 25 And the

26 Preparing for Success Go-live Readiness Assessment Focuses on input from the local project team Defines and reports status on progress of meeting the 16 success factors Prepares for the detailed/operational assessment which is conducted at a later time Pre-Live Conversion Assessment (the on-site clinical readiness assessment) Focuses on detailed (clinical and operational) areas Conducted onsite Audience may include project sponsor, PM, CI, hospital leadership team, super users, managers, directors, training lead, staff, nurses, end users 26

27 Preparing for Success Reviewing specific criteria early in the project allowed time to react and reduce areas of risk Understanding that local project teams often had different views than providers, SMEs, managers, and end users - used approach to align gaps Focusing on the 16 critical success factors increased adoption and satisfaction at go-live 27

28 Kathy Schroeder, RN, PMP, Senior Director, Tenet Healthcare Liz Coffey, PMP, Service Line Executive, Global Services, Encore Health Resources 28

29 The 16 Factors Appendix 29

30 Critical Success Factors Definitions Success Factor Description Evidence Clinical Process Improvement Committee (CPIC) Process Established Vendor System and Project Standard Alignment The effective integration of process and build activities. During the CPIC meeting, the current/future state analysis status reviews reflect gaps, the process, and/or P&P changes according to the project timeline Ensure that the vendor standard and Project standards are in sync. In the initial gap analysis, gaps are identified and a plan is formulated to address. Key stakeholders are engaged Gap analysis report closure, updated P&Ps Charge Data Master, Pt. Types, Service Types are validated. Signoffs for critical activities, such as project charter and scope, testing documents, super user planning documents, training, etc. are completed in the designated project phase and timeline 30

31 Critical Success Factors Definitions Success Factor Description Evidence Accurate and Complete Build Super User Planning Ensure that build is completed to standard, audit vendor system reports against catalog. Build completion checkpoints are reflected in the build status updates. Unit, application, and integrated testing rounds occur according to the project timeline. Super users are identified and documented on validated project schedules. Nurse Managers have validated patient care staffing schedules to ensure that super users are not included in patient care Unit and application testing result failures=0, scripts completed and reviewed, issues report and resolution, vendor system report reviewed Evidence of super user assignments on planning documents, staffing schedules published 31

32 32 Success Factor Comprehensive Testing Environment and Plan Critical Success Factors Definitions Description Ensure comprehensive test scripts for application and integrated testing: Reflect current & future state workflows Include patient type scenarios with extensive functionality for each Ensure that a complete testing environment is available (or workaround defined) with an adequate equipment testing plan Coordinate and conduct load test Obtain evidence of information flow from bedside monitors/mdis into the test environment through the ibus and MDIs Ensure results validation with HIM Maintain and update testing environments Manage and communicate planned change control process and freeze dates Evidence Evidence of review and test script sign off. Testing issues reported, reviewed, and resolved before next round of integrated testing. Vendor system, hospital information system, electronic pharmacy cabinets, and materials management/charge capture information included in test scripts, planning, and execution. End user device set up, printer routing, wireless coverage and bandwidth included

33 Critical Success Factors Definitions Success Factor Training Plan Description Establish appropriate training environment and tracking process. When in training, ensure that end users are not assigned patient care responsibilities. Ensure that training plan is defined against scope, job roles, and staffing Evidence Training planning and logistics are in place. Evaluated competencies and attendance for super users and end users. Updated basic computer skills assessment. Identified super user trainers conduct teach backs prior to conducting end user training, WBT, vendor training domain, and security/roles reviewed and validated Immersion/ Mock Dress Rehearsal Ensure knowledge transfer through immersion plan Formal training immersion plan, practice sessions, training system patients are regularly refreshed and clear plan to test competency in place. Walkthroughs in department, tips and tricks posted, mock run/dress rehearsal planned and executed 33

34 Critical Success Factors Definitions Success Factor Description Evidence Comprehensive Go Live Plan Charge Master Plan and prepare for go live criteria. Ensure that go live conversion assessment is documented. Ensure that dashboard reviews, issues tracking, and reporting are in place. Complete hospital schedule, project schedule, and command center planning. Ensure live cut over plan Ensure that all Charge Master updates are current and validated Positive go live readiness assessment results, cut over plan/schedule, and go live staffing plan Full CDM validation 34

35 Critical Success Factors Definitions Success Factor Description Evidence Communications Communications with nursing, physicians, hospital leadership and hospital staff regarding go live activities and preparatory events (testing, mock, training, immersion, cut over, go live events, and go live support) Physician Partnering Ensure that physicians know how their daily routines will change. Identify and communicate changes/impacts to reports. Understand where physicians will look up information and if that will change. Document and educate on what is changing Formal communication plan in plan and communication tools prepared. such as letter from CEO to hospital staff, posters, table tents, and diagrams Conduct presentations to medical executive committees and quarterly medical staff meetings 35

36 Critical Success Factors Definitions Success Factor Description Evidence Interface Plan Ensure Data Accuracy Meaningful Use Plan Ensure syncing up of interfaced or stand alone systems relying on vendor data Validate data accuracy and formatting in systems receiving data from vendor (or vice versa) Validate workflows and data collection required to support Meaningful Use Hospital Information System CDM, ED and RT orders, and Pharmacy Electronic Cabinets (formulary) Integrated testing results validation by non project vendor areas receiving or sending data, such as HIM, RT, ED, and the hospital information system Document a plan that details what data elements are needed, where they will be collected from and how they will be collected 36

37 Critical Success Factors Definitions Success Factor Description Evidence Equipment Plan Smooth Support Transition Hardware assessments are based on clinical needs to support online clinical documentation and results reporting resulting in a hardware device checklist Ensure smooth transition to production support Ensure that adequate devices and device placement to support the clinical workflows are validated through walkthroughs and sign off. Hardware checklist is validated with department directors Transition plan, optimization team plan with established dates and times 37

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