Date post: | 25-Dec-2015 |
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Why problems occur
Implementation poorly planned
Poor communication within the team
information, shared planning, listening to feedback
Lack of ongoing flexibility within process
Not considering ALL stakeholders
Lack of training
wrong time, wrong emphasis
People undermine the process
The Role of the Practice Team
Recognise and accept that change is required
Identify barriers to the change - and ways of overcoming
Plan how the change is to be implemented:
internal and external focus (responsibilities, impacts, risks)
Monitor and evaluate how successfully change is
progressing
communication, feedback, early warning signals
Deal with the consequences of change:
additional training, review of systems, awareness of risks
Maintain business as usual
The planning process
Define the scope:
What do you want to achieve? Get to know the new software
especially where it’s different (views/actions/workflows) Identify the key stakeholders
practice team, patients, pharmacies, attached staff etc Identify and plan a timeline for change (GANTT charts)
Review systems of workingdo they need to change?
Develop a ‘Communication Plan’ pre/during/post and internal/external
Identify team and individual training needs Identify potential risks
Training Needs Analysis (TNA)
Risk The system supplier may not identify your real needs: Lack of understanding around the practice current systems of
working Inability to complete a gap-analysis between old and new Lack of knowledge of individual strengths and weaknesses in
relation to IT within the team
Potential Pitfalls Increased incidence of clinical and administrative errors
after implementation, for example:1. Items in the ‘wrong’ place on the page (e.g. appt books)2. Data not matched in new system (e.g. immunisations)3. Incorrect data entered into patient records
Training Needs Analysis (TNA)
Solution Ensure you compete your own TNA
Examine the new system in relation to your current processes (visit practices)
Where are the gaps? Where do things look really different? Who are your problem team members? Where will the language have to change? Which practice processes need to be adapted to fit the new system? What workarounds did you create in the old system – manual
matching? Try to avoid ‘workarounds’ as these can make life difficult later on Supplement training by your supplier with individually tailored add-
ons
Patient Management/Communication
Risks Patient demands outweigh resources during
implementation Patients do not understand that services may be
disrupted
Potential Pitfalls Increased incidence of patient complaints Complaints not being dealt with as empathetically as
normal
Patient Management/Communication
Solution Create a project plan in relation to managing service
delivery including patient communication around the implementation period
Consider reduced service provision during migration and implementation weeks
Identify the key services you must provide, for example: Emergency surgeries only / Acute prescriptions Ask patients to request repeats before the date of change where
possible Postpone coding where possible Ensure patients have positively-framed information well in advance,
during and after (thanks) Remember that some patients will need questions
answered/reassurance
Post migration week: data extraction and re-entry
Risks Data re-entry following migration week
Potential Pitfalls Information is updated incorrectly into the patient
record Consultations are transcribed incorrectly into the
records
Solution Agree a plan in advance and identify mismatches
early
Utilise a recommended data extraction tool Or set up paper templates for record-keeping (labels?) Encourage doctors and nurses to ‘cut and paste’ their own
consultations
Migration week: data extraction and re-entry
General points
Ensure old system data is archived securely and is retrievable
Disc Image + attached functions (e.g. appointment book)
VISION – ‘treatment groups’ (e.g. GP service provision/school nurses)