PM Network - April 2009

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 buy-in.

“Some of the meetings could have more than 200 people,” says Ms. Johnston.

TRAINING TIME

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. Lahoud.

It worked.

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

PAPER CHASE

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.”