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Guest Blog: Healthcare IT and Operational Ownership

March 23, 2015
by Christine Personius
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Christine Personius

For many years, we have heard that healthcare IT projects should be operationally owned and led by organizational leaders and clinicians. It is an ongoing struggle with many healthcare IT projects.

In general, when a large healthcare IT project such as an electronic medical record (EMR) implementation is initiated, it is determined to be operationally owned and is widely communicated to the organization during its early phases. The reality, though, is that many projects are still IT owned and led. I believe the intent is there for these projects to be operationally-driven, but that model appears to be outside the comfort zone for both operations and IT.

How can IT help shift ownership and participation to their operational partners? During the project planning phase, developing an operational ownership strategy which fosters and allows operations to take more of a leadership role in a healthcare IT project is essential to success. The overall goal of the operational ownership strategy should include governance that promotes and includes strong operational project leadership, a standard and timely decision making process, change management and communication plans, as well as a detailed “operational readiness” plan to foster and allow operational ownership throughout the life of the project and beyond. The “readiness” plan should include educational material for operations on the project processes and upcoming milestones, key areas where their participation and ownership is vital to the success of the project, and a toolkit they can use to manage the project in collaboration with IT.

A proposed approach for developing an operational ownership strategy should include the following:

  • Bring aboard strong operational leadership whom are willing to set the overall direction for the project and make difficult decisions that need to be made to encourage system usage and standardization. Some difficult decisions include computerized physician order entry (CPOE) usage requirements, training requirements, and workflow standardization across departments.
  • Develop a governance model that includes operational leadership at all levels and set expectations about priority and participation. Provide opportunities for operational leaders to be included in project planning and design to ensure they understand the importance of their role in making the project a priority.
  • Define a standard decision making process where key decisions are identified, assigned to the appropriate governance level, and assigned due dates to encourage timely decision making. Each decision and their status should be kept in a centralized decision log where the outcome of the decision can be documented as well as who participated in the decision making process.
  • Use a communications format that can help expedite decision making when the options have been fully researched and understood prior to the decision making session. Having a process for communicating decisions to the operational stakeholders must be identified as well as a process for updating any related policies or procedures.
  • Ensure that a communication and change management plan are initiated at the beginning of the project. Providing information early and often to all stakeholders is important to allowing operations to take ownership. Communication of the project priorities and direction by operational leadership to all senior and mid-level leaders creates awareness and sets direction so that all leaders understand the priorities. This sets the foundation for operational leaders to begin to take ownership.
  • The next step includes providing frequent communication regarding decisions, project status, upcoming changes, and their role, so they can better understand the project and communicate to all operational stakeholders all the way down to the department level. Knowledge is power and it quells the fears of the unknown.
  • Prepare a readiness toolkit for operational leaders to begin to understand the changes they will need to address that affect providers, staff, and daily operations with the implementation of the new system. The toolkit should include education on upcoming changes in workflow, changes in policy and practice, as well as tasks and considerations that each operational area will need to prepare for (e.g. training, cutover, go-live, etc.). This includes identifying operational experts and super users, participating in system design, identifying and reporting on measures of success, preparing for end-user training, and go-live related activities.

Strong collaboration and constant communication between IT and the operational leadership of hospitals, clinics, and ancillary areas is important to a successful implementation. Utilizing the tools and practices outlined above will put you in a good position for success.

 Christine Personius as a Senior Advisor at Impact Advisors

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