hugo Clinician Engagement Session January 2013 Deb Karcz

hugo Clinician Engagement Session January 2013 Deb Karcz Healthcare Undergoing Optimization

Together hugo will transform our world “ Life is like a ten speed bicycle. Most of us have gears we never use Charles M Schulz Healthcare Undergoing Optimization

Agenda • • PAC/CAC decisions Device Simulation & Evaluation Design Review Update Change Management Open House demonstration Open discussion/Concerns Wrap up – Coming Events Healthcare Undergoing Optimization

Participating Hospitals Healthcare Undergoing Optimization

HUGO Overview Operationalize Quality Assurance Launch Optimize the Provider Experience Go-Live Client Executive Session Project Kickoff Prep. Session GATEWAY System Review Design Review System Validation Project Startup Trainer Go-Live Prep Maint. Training Integration Testing GATEWAY Y Testing Go-Live Readiness Move to Production Post. Go-Live Assess. GATEWAY Stabilization End-User Training Discrete Events Workflow Localization GATEWAY Design 5

Clinical Informatics (CI) Matrix Clinician Track Lead: Deb Karcz CI : Laurie Young covers VH IP, Critical Care, Mother Baby, CI: Lori Sashegyi Orr covers: UH, SJHC, Parkwood IP, Mental Health, & Peri-Op Ambulatory Track Lead: Janine Riffel CI: Jan Linner Regional Leads and teams Site Clinical Informatics Specialist London Allied Health : Joanne Andrews, Kayley Perfetto Provider Track Lead & Order Sets: Andrew Nemirovsky CI: Tina Holden covers ED and providers

Clinician and Physician Advisory Committees The Clinician Advisory Committee (CAC) and Physician Advisory Committee (PAC) provide strategic leadership in the transformation of the clinical service delivery model. • Provide advice to the HUGO Steering Committee • Function as an accountable decision making body • Promote the design of the system and content Healthcare Undergoing Optimization

Example of Decision document Who Will Document on the e. MAR? Questions: Which non-physician professionals will document on the e. MAR Possibilities: All regulated health professionals (RHP) will document on the e. MAR Nursing only will document on the e. MAR Considerations: The e. MAR should be recognized as the patient’s e. MAR, not a particular discipline Better practice recommends that all hospital health professionals with administration of medications within their scope of practice should document medications they administer on the e. MAR Recommendations: Nursing and other specific RHPs only will document on the e. MAR. Decision: Identified Regulated Health Professionals (RHP’s) and identified non-Regulated Health Professionals (non-RHP’s) will document on the e. MAR. As well, identified RHP students and identified non-RHP students will document on the e. MAR. Healthcare Undergoing Optimization

Draft decisions for CAC/PAC review • What is on the e. MAR? • What is not on e. MAR? Healthcare Undergoing Optimization

CAC decisions for PAC review • Documentation on the e. MAR Ø Who will document on e. MAR • What clinical documentation will be included in this phase of HUGO Ø Criteria for this decision ØRecommendations for documentation Healthcare Undergoing Optimization

RFP End User Evaluation Who? • RFP committee, HUGO SMEs, LHSC & SJHC providers & clinicians, STEGH site reps What? • Scoring of short-listed vendors within each RFP category (WOW carts, wall mounts, scanners) • Participants may evaluate all categories or specific ones only Purpose: • Satisfy the requirements of the RFP process ***Must complete this segment before Workflow Simulation Healthcare Undergoing Optimization

Workflow Simulation Who? • HUGO SMEs, HUGO team, CI staff, providers & clinicians from all sites What? • Clinical scenarios representative of ED, ICU, Inpatient, Ambulatory procedural clinic, Ambulatory clinic room • CPOE, CLMA, e. Med. Rec scenarios • Attendees can choose their scenarios based on their roles and area of practice Purpose: • • • Exposure to different types of devices and equipment being considered Elicit feedback on usefulness and practicality in various location Understand concerns and provide opportunity for questions

Future Devices Events • STEGH Device Fair – Mid-Apr. to Mid-May (TBD) after RFP decisions – Multiple device types displayed – Key participants – STEGH providers & clinicians • Device Drop-in Days – – Dates TBD Multiple device types displayed One-day “road show” device fair at multiple sites Key participants – providers & clinicians Healthcare Undergoing Optimization

Design Review Update • We will be using a PAL (Patient Access List) • Communication Types reviewed: verbal, phone, medical directive, non MD, written. There may be others. • Nurse Review will be completed as an acknowledgement of an order. • Problems and Diagnosis is part of scope. How and by whom it will be completed to be determined. • Nurses will be able to give meds prior to pharmacy verification Healthcare Undergoing Optimization

Design Review Update • Medication given early or late will have a warning • Medication reconciliation will still occur at transition points • Failure to scan process draft in progress • Form process draft in progress • Route form error process draft in process • Non unit dose, multi dose vial process to be determined Healthcare Undergoing Optimization

Change Management It’s not so much that we’re afraid of change or so in love with the old ways, but it’s that place in between that we fear…It’s like being between trapezes. It’s Linus when his blanket is in the dryer. There’s nothing to hold onto. - Marilyn Ferguson, American Futurist Healthcare Undergoing Optimization

Emotional Cycle of Change Rewarding completion (satisfaction) Uninformed optimism (hope) Morale Extra work implementing new standards Getting results: less time firefighting Informed optimism (confidence) Hopeful realism (hope) Informed pessimism (Valley of Despair) Time Healthcare Undergoing Optimization 18

Getting Buy-In • Often difficult because people believe they are comfortable with their current way of behaving • We “get stuck” and resist change – even when we know it is for a good reason!! • So, how do we deal with the “resistors”? Healthcare Undergoing Optimization

Managing Transition Means Providing… • Control - How can you get people involved in the process to “have a say in the future” • Understanding - Do they understand what is happening and why? Are they clear on what is changing and what is not? • Support - Do they have emotional and practical support for what you are going through? • Purpose - Do they have a sense of personal purpose to give meaning to their actions? Healthcare Undergoing Optimization

Communicating the Change The 4 P’s • Purpose: Why are we doing this? Does everyone clearly understand the overall outcome this change is trying to accomplish? • Picture: Where are we going? Can everyone “see the vision”? Is there an emotional connection to the vision that truly engages people? • Plan: What are the key events and when will they occur? • Part: Does each department, functional group and team collectively understand what they have to do in order to make this change succeed? Healthcare Undergoing Optimization

Open House Demonstration Healthcare Undergoing Optimization

Upcoming Events • Device Fair : Feb 8, 15 • Workflow Localization workshop: March 7, 8 th • System Validation workshop: April Healthcare Undergoing Optimization

Open Discussion/Concerns Healthcare Undergoing Optimization

HUGO Website Healthcare Undergoing Optimization

For more information HUGO Clinician Track Lead : Deb Karcz HUGO Ambulatory Track Lead: Janine Riffel HUGO Provider Track Lead: Andrew Nemirovsky HUGO website: link from intranet homepage E-mail HUGO: hugo@lhsc. on. ca Thanks for your participation! Healthcare Undergoing Optimization