advantage of best practices across the
THR network. But the team made the
project more approachable to user input
by breaking it into modules such as
nursing, clinical documentation, pharmacy and order entry. Within each
module, the team recruited clinicians—
including nurses and lab professionals—
in designing the system workflow.
“We broke it down and even looked at
different specialties, such as the process for
medication in the intensive-care unit,”
says Ms. Johnston. “It was a huge plus.”
The design phase involved clinicians
from every network hospital as the team
strove to build a communication network that would help ensure stakeholder
“Some of the meetings could have
more than 200 people,” says Ms. Johnston.
The project team knew it wouldn’t get
people to use the system unless they
were properly trained. Now it just had
to find a way to convince the executives
to put sponsor weight and budget
behind the effort.
So the team set to work building
charts and graphs that “quantified the
staff hours required for training and
helped people understand the impact it
would have on the hospital,” says Ms.
Yet even with the executive sponsors
on board, the training team still faced a
mammoth task. It now had to actually
build the training modules that would
attract a user base that wouldn’t be
exactly rushing to make the switch. Most
of the doctors on the THR network were
independent physicians, meaning that
they could take their business elsewhere
if they didn’t care for the system.
“For lots of doctors, it takes more
time to type in an order as opposed to
telling a nurse to give the patient a shot
of something,” says Ms. Lahoud. “Few
community-based hospital systems have
been able to get significant usage of these
systems by doctors voluntarily. We
The push to go paperless at
Texas Health Resources (THR)
reveals some lessons learned:
Practice what you preach. THR
used an online collaborative tool to “avoid
creating a bunch of paperwork,” says Sallie
Moore, PMP, THR. The team also decided
that not every student needed every piece
of training material. Having a full set in the
classroom and making the information available online did the trick.
Remove the paper crutch. The
THR team started migrating important,
paper-based information such as lab reports
online—forcing the doctors to follow.
Consider what will disappear. “We
didn’t realize that the paper world provides a
set of visual cues that you don’t tend to consider,” says Patricia Johnston, THR. “For
example, placing an order involves putting a
paper in a basket, where somebody will see
it and move on it. With the paperless system,
we had to find ways of letting people know
when tasks were in the queue.”
Prepare to discover broken
processes. Electronic systems are less
forgiving of incomplete or inaccurate data.
For example, if the person carrying out the
admissions process fails to put the right
doctor’s name on a patient’s file, the doctor
won’t find the patient when he or she logs
on. But Ms. Johnston cautions against
blaming the system.
believe we did because we were able to
train them effectively.”
To get them into the training,
though, the team had to dangle some
awfully big carrots.
“If they participated, doctors got
opportunities to get some of their continuing medical education trips paid
for,” says Ms. Lahoud. “There were
some pretty significant prizes.”
The team also discovered some
workers lacked computer basics.