Questions & Answers: Words from the Street: Delivering on a Provincial Mandate at the Local Level
IN = Interviewer JC = Jenny Cockram KFW = Keary Fulton-Wallace
JC: The WTIS was a focused project with very tight timelines that could not be missed. As one of the Beta hospitals, we had a very strong sense of teamwork because we were playing a big role in providing input for future phases. There was also a sense of excitement because we had the support to bring technology to physician offices that might have been disinclined to move in that direction without this initiative.
KFW: Compared to other projects I've been involved in, the WTIS was much more intense and had the added pressure of being implemented within very short timelines.
IN: What challenges did you face in managing the WTIS project at the hospital level?
JC: There were several significant challenges to overcome. The first was in ensuring timely and practical communication to all parties and departments involved. This included surgeons' offices - some that didn't necessarily use email or voicemail; individuals in various departments who faced potential workflow changes; responding to clinical questions while answers were still being developed; and keeping senior management up-to-date on progress. We also had to overcome the perception that this was a non-critical care project, which meant providing and regularly repeating benefit statements from the perspectives of the hospital, surgeon offices and patients.
Also, as implementing Internet connectivity was a hospital responsibility, we faced some challenges in gaining access to physician offices and resourcing for this in terms of people and equipment.
KFW: Our initial challenges were very similar to the above. With very limited resources, we faced tight timelines for deliverables. Ensuring enough information technology support within our hospital was particularly challenging. Working directly with surgeons and their offices was also a challenge, including persuading them to support and participate in the initiative. As the project team was also learning along the way, there were challenges at times in getting consistent and timely responses to clinical questions.
surveyed for Lessons Learned at the conclusion of Phase III in
March 2007, Hospital PMs reported on their experiences in deploying
IN: What aspects of the WTIS deployment approach were most helpful to your hospital achieving success?
JC: The WTIS project team allowed for flexibility in understanding and supporting hospitals in dealing with local needs. A large part of this was accomplished with an effective support model. Having single points of contact and providing clear points of communication meant that hospitals knew where to turn for information. It also allowed the WTIS project team to understand unique hospital challenges. Because hospitals were grouped together based on similarities, there were opportunities to learn from one another and work together.
Tools to support deployment and communication, such as newsletters, indicator reports to monitor weekly progress and project plans, were also well received. These were a complement to a support model that allowed hospital project teams to stay focused and to a certain extent set their own deadlines within the key project timelines.
KFW: The WTIS project team supported us by providing lots of helpful material (although at times it was a bit overwhelming) and by making subject matter experts available to hospitals throughout the project.
IN: What should healthcare IM/IT projects consider in order to improve deployment experiences in the future?
JC: Do not assume all hospitals have the same level of support from senior management teams. Helping hospital teams maintain executive support is critical. Project teams should also ensure they have ways of gathering input from those doing more of the day-to-day work, ensuring a better understanding of workflow requirements and internal workings of hospitals. Also, projects should provide a robust system for sharing and storing information centrally; email can become unruly.
KFW: Project teams should consider involving a range of hospital staff in the first round of data gathering rather than relying solely on physician input, as physicians do not always understand the details of internal office processes. I would also suggest that projects provide more opportunities for hospitals to share "best practice" methodology with each other to avoid re-inventing the wheel.
|The two Hospital PMs
interviewed for this commentary offered the following advice for
PMs involved in future healthcare IM/IT projects at the regional or
About the Author
Jenny Cockram is an independent consultant specializing in e-Health solutions, bringing technology and people together. She was the overall Project Manager to Grand River Hospital during the Beta Phase of the WTIS project and became an advisor for the WTIS project for subsequent deployment and expansion.
Keary Fulton-Wallace is the Performance Management and Wait Time Coordinator for the Huron Perth Healthcare Alliance. She has been active in the Performance Management and Utilization community since 1990. She currently sits on the Wait Time Data Quality Working Group for Cancer Care Ontario.
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