hugo e Huddle 9 December 2013 Kristin Stillert
hugo e. Huddle 9 December 2013 Kristin Stillert, MBA, B. Sc HUGO Program Manager Healthcare Undergoing Optimization
Agenda • Alexandra Hospital, Ingersoll go live • Training • Order Sets • Conversion Readiness Review • Questions Healthcare Undergoing Optimization
AHI Conversion "As a physician the way I practice medicine isn't going to change, however I now have access to approaches to care that are standard across the region. And this is great news for patient care. “ -- Dr. Joel Wohlgemut, AHI Chief of Staff Healthcare Undergoing Optimization
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AHI Conversion: Go Live Day 1 • 5 a. m. downtime to switch the physician and staff positions to HUGO. • 7 a. m. HUGO launched and shortly after the first patient came into the emergency department. • AHI super users, along with the HUGO and Cerner teams located both in Ingersoll and in London, were ready in the early morning hours to support the downtime and go live. Healthcare Undergoing Optimization
Benefits Statistics: First 24 Hours Number of issues logged since go live: 87 – Issues resolved 77 – Issues outstanding 10 Total Medication Administration events: 200 - 96 % of the patient armbands scanned successfully - 91 % of the medications scanned successfully Number of medication alerts: 43 - 33 alerts for above prescribed dose - 19 alerts for early or late medication administration - 9 alerts for no order in system 2 patient mismatch Healthcare Undergoing Optimization
Benefits Statistics: Week One Number of issues logged in first week: 159 – 35 issues outstanding Total number of Medication Administration events: 2023 - 96 % of the patient armbands scanned successfully (positive patient scan) - 89 % of the medications scanned successfully (positive medication scan). Number of medication alerts: 551 (27%) - 35 % early/late reason - 29 % above prescribed dose (higher dose dispensed by Pharmacy, nurse modified appropriately) - 12 % med Interval Alert - 12 % no order in system 7 patient mismatch (0. 7% of total alerts) Healthcare Undergoing Optimization
Lessons Learned • Go Live support “at elbow” very important • Initially will be slower • Regular check ins throughout day with on site team, super users, command centre • Conversion Prep documents properly prepared onsite teams • If training not completed, access not granted – AHI formally notified individuals Healthcare Undergoing Optimization
AHI Achieves HIMSS Level 5 • With the adoption of HUGO, AHI is one of two Ontario hospitals which have achieved HIMSS Level 5. • There are three hospitals in the province which have reached level 6 and no hospitals at level 7 at this time. • AHI’s previous score before HUGO go live was 3. 256. • Most of Ontario’s 211 hospitals are in the Level 2 -3 range. • HIMSS (Healthcare Information and Management System Society) is a global organization focused on better health through IT. OHA uses HIMSS to measure the adoption of the electronic health record on a scale of 0 - 7. Healthcare Undergoing Optimization
Go Live Support: HUGO & Cerner Teams Healthcare Undergoing Optimization
Learn More on HUGO Website Benefits Dashboard on HUGO Website Healthcare Undergoing Optimization
Training Healthcare Undergoing Optimization
Training Objective • Train 100% of users before conversion date • Provide a “play” or training environment for practice leading up to conversion • Provide various strategies to provide a safe and supportive learning environment • End users must be trained to get login Healthcare Undergoing Optimization
HUGO Training Timeline • 8 weeks prior: – Trainer training (3 days) and – Super user training (1 -2 days) • 6 weeks prior: – End user staff/provider training (1 -4 hours) Healthcare Undergoing Optimization
HUGO Training update Hospital Alexandra Hospital Complete Listowel Wingham Hospitals Alliance End user training in progress St. Thomas Elgin General Hospital Tillsonburg District Memorial Hospital End user training in progress Middlesex Hospital Alliance Trainer training starting Dec 10 Woodstock Hospital Trainer training starting Dec 10 St. Joseph’s Health Care London Trainer training scheduled for Jan 6 LHSC University Hospital Trainer training scheduled for Feb 3 start LHSC Victoria Hospital Trainer training scheduled for Feb 3 start Healthcare Undergoing Optimization
Super user roles Roles before go live • We will need trainers to help train and circulate in the training room • Can work as either trainer or circulator depending on comfort level Role after go live support • Continue to support end user questions in your area when working • Remain up-to-date with any changes that occur in the system Healthcare Undergoing Optimization
Super user commitment Trainer training • 7 to 8 weeks prior: 3 days of training • Trainers need to be able to work for 10 weeks from 8 weeks before go live till 2 weeks after, with no additional clinical assignment Super user training • 2 days cross training nursing and provider Go live support • 11 days after go live • Float between units supporting all end users • With no additional clinical assignment during this time Healthcare Undergoing Optimization
Super User recruitment Attributes • Expertise in their Cerner application – Power. Chart/Pharm. Net/Surgi. Net/First. Net/Rad. Net • The go-to person in your area for computer questions • Comfortable coaching people on how to navigate the system • Able to help support on the night shift Healthcare Undergoing Optimization
Leadership Commitment • Support for staff interested in being super users and/or trainers – Facilitation of time away from regular position • Monitoring of WBT and education compliance by staff members – WBTs will be available via learning management system (LMS), where available, or by web link for sites with no LMS Healthcare Undergoing Optimization
Go Live Day • There will be super users roaming around the hospital to help • Training materials will be available on the Clinical Informatics website which is quick linked on the Power. Chart toolbar. • There will be a HUGO hotline to call if you are having trouble • Command centre at each site and one technical command centre Healthcare Undergoing Optimization
London skills and computer training Self assessment survey is posted to i. Learn and Learning. Edge Sign up for Learn Computer Basics Links on HUGO website Healthcare Undergoing Optimization
Order Sets Healthcare Undergoing Optimization
Order Sets: a four step process While we began HUGO order set development using a seven-step process, it has evolved into a more streamlined four-step process. Healthcare Undergoing Optimization
Order Sets: summary chart We have recently added a summary chart to complement the detailed Order Set Tracking Chart. The summary chart provides the total number of order sets and indicates how many have been completed for each step. Each of the 4 step represents the cumulative total. Of note, Step 4 includes order sets that do not require P&T/DTC approval Healthcare Undergoing Optimization
Order Set: summary chart Healthcare Undergoing Optimization
Order Sets: for more information Healthcare Undergoing Optimization
Conversion Readiness Healthcare Undergoing Optimization
HUGO Conversion Schedule Go Live Date Nov. 12, 2013 Jan. 22, 2014 Feb. 19, 2014 March 2014 - TBD April 13, 2014 Hospital Alexandra Hospital COMPLETED Listowel Wingham Hospitals Alliance St. Thomas Elgin General Hospital Tillsonburg District Memorial Hospital Middlesex Hospital Alliance Woodstock Hospital St. Joseph’s Health Care London LHSC University Hospital April 27, 2014 LHSC Victoria Hospital Healthcare Undergoing Optimization
Conversion Readiness • Detailed documents will be utilized to prepare for the clinical conversion • Project management cut over steps (Cerner) • Clinical cut-over steps (back entry of data) • Conversion readiness check list (tasks for Cerner, HUGO team, hospital) • Communication prep check list • Change Preparedness check list • As we get closer to conversion, the HUGO team will work to provide specific details on the requirements Healthcare Undergoing Optimization
Conversion Readiness • In advance of clinical conversions, a leaders meeting is held at each organization which include: • • • High level demo What to expect leading up to and during go-live Leadership activities required to support a successful go-live Change and transition planning Opportunity to bring forward questions/concerns • Leader meetings held approximately 30 days before golive • Following leader meetings there will be regularly scheduled conversion review meetings with a defined audience Healthcare Undergoing Optimization
Questions? ? ? Healthcare Undergoing Optimization
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