In today’s world, it’s easy to be tempted by the latest trends rather than focusing on the everyday, fundamental processes that need our attention.
Take that posh new restaurant that just opened around the corner, for example. Even though I might prefer to spend my money on a fine-dining experience there instead of paying the electric bill, let’s face it, I really need to keep my refrigerator running. So, to make sure I don't forget to pay the electric bill or any other "must-have" expenses every month, I've set up a fundamental process – autopay.
Similarly, by setting up a standard process for project intake and governance at your healthcare organization, you can eliminate predictable challenges and limit efforts that reinvent the wheel.
I know what you may be thinking – this is easier said than done, especially when it comes to decision-making. It’s true. We’ve all been there: in a project meeting discussing who can make a decision. The input in the room swirls around who shouldn’t make the decision; that “Suzy” left the organization and no one else knows the history or reason for a decision; and that “Dr. Smith,” our champion, has seven other conflicting projects this month and can’t attend the meetings.
(That story doesn’t improve no matter how many times I tell it, and to sum up the conclusion – spoiler alert – we need to meet again as we couldn’t reach an answer.)
However, after working with many health systems and listening to the desires and challenges within stakeholder groups, I know one thing for sure: You don’t have time to waste on predictable challenges and the inefficiencies they create. It might take a little extra planning and decision-making on the front-end, but you’ll be happy you invested the time and money to resolve these matters when you did. Especially with the fast-paced, changing regulations and multiple priorities facing healthcare today.
By focusing on rebuilding or repairing the processes that keep us from moving swiftly, we’ll begin to streamline efficiencies and achieve the best care delivery for our patients. Though we’ve come a long way since the beginning of EHRs, there's still ground to cover to make the IT/operational partnership innate within the healthcare ecosystem. If we make a few improvements to the areas I've suggested below, I believe we'll be much closer to reaching this goal.
Healthcare governance vs. IT governance
Why not make them one in the same? I’m a clinician and know this isn’t always a great use of everyone’s time, but I can think of very few topics these days that don’t impact both groups. The key here is the right people attending the right meetings and knowing when to speak up and when not to. Review your current structures, redefine the groups and their purpose, and keep meetings organized with tight regulation of agendas. This is possible, I promise.
No one wants to be the bearer of bad news, but sometimes we have to be. What did your leadership team agree upon as the strategic initiatives for this year? Does this request help meet them? Have the requestor present his or her case to the project approval committee. Who is the gatekeeper for change requests and new projects at your organization? If that name (or names – but no more than five of them) didn’t roll off your tongue, you’ll want to identify that individual as soon as possible.
Do this after you determine how critical an item is – why waste the effort on something that might end up in the five-year plan? This is a data point for timing to be sure, but if it’s mission critical, find a way. Develop ways to estimate effort and resources without needing to meet to scope things exactly. Let’s face it, there will never be a perfect time for a project, and you will seldom be able to free up all the resources you need at once comfortably. Educated estimates are OK for planning. Being agile and ensuring quality work during the execution should win the day.
Everyone wants it now, and somehow the words ‘patient safety’ or ‘regulatory’ weasel their way into 90% of decision documents. Set guardrails and expectations around requests and execution. Build confidence that things will happen, but also educate people on the "why" when they are bumped or deprioritized. Communication is key, and an automated email is not always the way. Implement the “fastest five minutes” in meetings to give IT updates and hit the top highlights that are relevant to the group. This keeps the lines of communication open between operations and IT and gives people an opportunity to hear (rather than read) the things that matter to them.
Wanting what is cool vs. getting what you need
Every day, new products and hot topics pop up causing us to lose focus on the problems we already know we need to fix. The things we face every day might have a solution waiting in the wings that teams haven’t had the chance to focus on given other top priorities. Repeated issues don’t always have the allure to get the resources or dollars allocated since they are tough to unravel and often sore spots within an organization. Despite that, these are often expensive inefficiencies that are wearing away the constitution of your devoted staff. Fix these first.
Do you have the right positions in IT and operations to support ongoing change? Integrated roles often exist during implementation but have vanished along the journey. There are a lot of creative ways to add or revise roles, but you need to start somewhere. Depending on the culture and structure within your organization, reviewing and updating roles and responsibilities that might be antiquated or reallocating staff time can be a good first step. Could you integrate your clinical educators into informatics work and IT training to make education of processes and policy changes more integrated? Do you incorporate the EHR into your clinical competency education? Do you have clinical champions with a percentage of their time dedicated to IT initiatives within their specialty? If you’re fortunate enough to add FTEs to your team, be selective in the hiring, onboarding, and education of the new positions – you want to make a splash.
OK, no subtlety here. You knew I was hinting at this all along, but really, we can help you to conquer the implementation of a robust project intake and governance structure, map out ways to add or revise roles within your organization to make the biggest impact, or mentor your teams to stand this up themselves with a little helping hand. We'd love to listen to your needs to determine the best strategy for your organization.
Leanna Hester is a Director of Optimization Solutions at Nordic leading development and execution of Strategic Solutions. She works with clients to make their people, processes, and technology more efficient and supportive of the organizational goals. Leanna brings 14 years of healthcare experience and is passionate about drawing from her IT expertise and nursing background to help healthcare systems use the EHR to deliver quality patient care.