Readers Write: Time Out for Pre‐Implementation Training

Time Out for Pre-Implementation Training 
By Tiffany Crenshaw 

I’d like everyone to join me in giving a hand to the nurses at Marin General Hospital for bringing a bright spotlight to the specific issue of healthcare IT implementations and patient safety, and  the broader issue of the enormous pressure hospitals are under today.

As recently reported in HIStalk, a group of nurses from Marin General voiced their concerns at a recent board meeting with the hospital’s new CPOE system, citing threats to patient safety as a result of inadequate training and other unspecified problems with the software. Unlike those EMR detractors we’ve read about in the last few months, this group doesn’t want to kick the new technology to the curb. They simply want a “time out” for additional training so they can use it in the most effective way possible to provide the safest care possible. 

This particular hospital’s struggle with new technology highlights the many pressures providers  across the country are facing when it comes to implementing new healthcare IT systems. Many hospitals are enticed by Meaningful Use incentives. Some sign on the vendor’s dotted line, not realizing implementation timelines suggested by vendors are at times too aggressive and don’t typically allow for proper end-user training. But since hospital XYZ down the street is doing it and Meaningful Use deadlines are looming, new systems are being installed rapidly across the US. I’ve heard more than one hospital executive say meaningful utilization is becoming an afterthought. 

In my 15 years in this industry, I’ve learned – and I’ve seen my clients learn – that implementing EMRs isn’t a project that affects just one department for a few months. It’s an initiative that touches every facet of a hospital – from IT to operations, from clinical to financial. It can’t be stated enough how big of an initiative the transition to an EMR is. Its size necessitates careful, methodical planning – not only for implementation, but for training; go-live support; and post-implementation optimization, support, and continued education.  

Perhaps it is because of this “project” mindset that healthcare associations have become vocal in their cries to delay the transition to ICD‐10 and the deadline for Stage 2. Providers are realizing these initiatives and the funds they’ve spent on them will be compromised without a proper strategy in place for training, implementation, post go‐live, and continued education around upgrades.

Is there a disconnect when end users such as the nurses at Marin General are filing “assignment despite objection” forms while upper management attributes nurses’ uneasiness as “just to be expected” during times of change, or are both opinions valid?

Human beings by nature are resistant to change. Those in healthcare are doggedly so, and  with good reason. But it’s important to remember that most people are not totally averse to change. Some providers have embraced technology. Many attribute their adoption to being  involved in the decision-making process and/or being well trained in preparation. It’s a debate that will likely go on as more surveys come out around EMR dissatisfaction and HIT/ROI conversations play out.  
 
Tiffany Crenshaw is president and CEO of Intellect Resources of Greensboro, NC.