Lessons Learned: The completion of a new installation

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It is said that life imitates art. I have found that for me recently life has paralleled my studies. I have recently completed a project that I followed from inception to completion. It has been an interesting journey.

I began this journey in October of 2006. I was new to healthcare informatics and project management having just taken a new position a month earlier. I was asked by the CNO who I report to directly, to coordinate the demos of three companies who were to show us their vital sign solutions for a system that would integrate with our Meditech EMR. This was a bit of a challenge at first as I had not done anything like this in my nursing career; however my family owned several retail stores so I was familiar with salesmen and felt confident in my ability to deal with them.

After having arranged the demonstrations and gone through the process of narrowing it down to 2 vendors we had many discussions between IS and nursing about which vendor we would choose.  The CIO moved ahead and approved purchase from a vendor who would also supply us carts on wheels. After receiving the carts it was found that the vital signs equipment they had shown us in the demo was not what was on the carts. The equipment did not work and there was not a previous interface with Meditech as they had told us.

First lesson, communication is of utmost importance in selecting a vendor and implementing a new system. The CIO had made this decision without the approval of the CNO and had not talked with me about this also. Therefore the system did not meet the needs of the clinical staff though the IS staff felt it was the best choice. This was the second lesson which has been discussed in these chapters of Health Care Informatics, An Interdisciplinary Approach, the need for the healthcare informatics professional to understand the needs of the clinicians.

After more discussion and deliberation another vendor was chosen and we began the task of assessing and deciding how much equipment to buy, getting board approval and going through with the purchasing process.  At this time the CNO officially appointed me as the project manager.

I began setting up the acceptance of the products and working with the implementation team to coordinate not only training of the end users but working with the IS staff on the integration with Meditech. This provides the 3rd lesson which is also discussed in this module of my educational program. Never underestimate how many different entities are involved in a project. Not only were IS and the nursing staff effected but so were the bioengineering, purchasing, physicians, of course patients as well as safety and quality assurance departments.

One of the issues that are discussed in this module is the need to meet standards set by many agencies that the hospital answers to from JCAHO and OSHA to IEEE and AHRQ. It was interesting to see how this project required attention to many of these standards.

We came across many “bumps in the road” on this project. There was a previously unplanned upgrade to Meditech which delayed implementation. There then was a problem with Meditech not accepting messages from the PDA’s used to download vitals into the Meditech module which required a “special build” from Meditech. There were wireless assessments, training to both the IS and the bioengineering staff for support and maintenance of the system. There were builds needed both in Meditech and in the software on the PDA’s for the integration and then there was the issue of a lost shipment of PDA’s.
 At times I doubted the project would ever come to fruition. However, with much communication, organization and attention to detail we were able to complete implementation of the project with the final go live on March 4th. We are live on 5 inpatient units and are now looking to expand this to the outpatient arena. The staff loves the new processes and feels it has improved safety with positive patient ID and real time documentation of the vital signs. The team worked together, IS, bioengineering, and nursing as well as the other involved entities as well as the implementation team from our vendor, making the actual go live was a very smooth and positive process for all involved.

The final lessons learned, timing is everything, expect the unexpected, communication is essential and there are no small projects!

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