Optimization
This may sound obvious and scary, but after GO-LIVE, the build and support never ends! This phase is commonly called “Optimization”. The key to a successful POST-LIVE optimization is implementing the best you can the first time around. The “Optimization Team” is usually compiled of members of the “Implementation Team”. We have found that these team members usually just fall into the role since they have the knowledge, background and experience to best help the hospitals move forward successfully.
The few months after GO-LIVE are the most crucial part of the beginning process of your POST-LIVE optimization and information gathering. During this point of the GO-LIVE, end users are usually given a direct line to report issues or concerns that can be essential to patient safety and workflow improvement or optimization.
Having been involved in many different types of hospital optimizations, we will share a few helpful tips and some advice as to how to go about starting and implementing POST-LIVE optimization.
What is Optimization?
The word optimization is defined as “an act, process, or methodology of making something (as a design, system, or decision) as fully perfect, functional, or effective as possible”. (http://www.merriam-webster.com/dictionary/optimization). In a hospital atmosphere, or any professional setting for that matter, optimization is not an easy or quick task. The optimization team must keep in mind that they cannot make the hospital software perfect; not necessarily because of the build or decision making process, but because the end users and departments are so diverse and unpredictable that it is impossible to please everyone. Also there are limitations to any software that not all users will understand. Always keep that in mind, it might help take a little pressure off your shoulders during this presumably stressful time. Optimization involves not only making improvements, but also software enhancements, and regional and/or national policies that must be implemented as our healthcare needs and trends change.
Task Organization
During the initial GO-LIVE, have a system in place to track all the issues and suggestions that are reported from the end users. When items are reported, they need to be assigned and given some kind of priority. One of these priority types should be “optimization”. These types would not be considered urgent but will be followed up on during the optimization phase. Once the LIVE urgent issues decrease, the POST LIVE optimization phase can begin. At this point, tasks can then be prioritized and assigned to the appropriate team members. Optimization can involve things like workflow improvements, build changes, or even new national regulations like Meaningful Use. Remember to always be flexible with your task items and add new tasks when necessary. During the always important analysis and decision making process of the optimization tasks, it is encouraged to follow what some facilities call, the 80/20 rule; 80% of end users do it one way, and 20% of end users do it the other way. Go with the majority.
Upper Management Buy In
Supervisors, Managers and Directors of departments do not have to answer to the optimization team, as they answer to upper management. The optimization team will be the ones implementing and changing the existing system functionality. Therefore, if there is any negative back lash from users or department management, then the optimization team can be left stuck up against a wall. Having an approval system with upper management or even the directors and managers (if resources are available) from the departments gives the optimization team a support system. We cannot emphasize how important and helpful this is, especially when dealing with managers, directors and physicians who are not happy with a change for their specific department.
Communication
Communication is vital to keep everyone in the hospital on the same page. When making decisions, the department that the decisions affect should always be involved in the approval and/or analysis of the change. Ideally the director or manager would be the best people to bounce ideas off of or get information from when implementing a change to the existing workflows, then get their approval. This way they feel involved in the decision and once implemented, then they can enforce the changes in the departments themselves. This process will also decrease issues reported by the end users.
Depending on the size of the facility and the amount of requested changes, these types of approval meetings should be once a week or once a month. Create a “system modification” meeting with an appropriate team to approve or reject changes to the existing functionality. Not only will these meetings help the team move forward, but may also stimulate conversation where other good ideas or information can arise.
Supervisors and Managers can play a key role in communication with end users. For obvious reasons, the optimization team cannot reach out to every end user, so there should be a plan put in place through some type of communication tree. (Some examples; Email, shift change meetings, create flyers and put in inboxes , place flyers in common areas where end users would see it, weekly management meetings, weekly or monthly physician meetings, or if you system has the capability post the messages within the system).
Education
POST-LIVE education is essential. If given the resources, it is helpful to have an education lead on the optimization team. This resource can focus on streamlining education and communication from the start. Education will then hopefully evolve into a smooth process that the end users become familiar and comfortable with.
The optimization team should never implement a change to the hospital end users without making them aware. Some end users are just looking for an excuse to call and complain, especially if they are not happy with the software to begin with. Education communication examples are the same as stated above in the communication section but also can be delivered through training classes or by ATE (at the elbow) support. No matter what approach is taken, some kind of information should always be delivered to each and every end user before they see the change. These few steps will help avoid being hounded by unhappy end users. In all honesty, it is really not fair to think end users can figure it out. Imagine your aunt or uncle who is working on 4 East as a nurse who did not grow up with computers; then imagine someone tells her/him to start adding patient Immunizations, but he/she has no idea where or how to do it. Yikes! It is just too stressful, especially when patients are involved and time is of the essence. Whether the change is big or small, education is the key to success. This will also help the end users gain a relationship with the ATE’s and the optimization team. This makes them more at ease and they will know who to refer to if there is an issue or concern in the future.
Optimization is a never ending phase when supporting a software system. Hospitals will always continue to change and evolve. Hopefully with some of the helpful tips above your system will continue to grow for the better during this POST-LIVE Optimization phase.
Good luck and happy optimizing. If you need more help with optimization, contact us and our staff can help!
