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Write a 3 page executive summary that outlines a comprehensive plan for go-live
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Write a 3 page executive summary that outlines a comprehensive plan for go-live and ongoing support for a major upgrade of a hospital’s EHR and other HIM systems.
Write an executive summary that outlines a comprehensive plan for go-live and ongoing support for a major upgrade of a hospital’s EHR and other HIM systems.
Describe the concept of go-live for HIM technology.
Identify the HIM technology workflow support needs at Vila Health.
Recommend organizational change management techniques for supporting the implementation of new health HIM systems or upgrades.
What evidence do you have to support your recommendations?
Develop procedures that address downtime for the HIM systems at Vila Health.
What evidence do you have that informs your procedures?
Explain how the downtime procedures minimize organizational risk and maintain uninterrupted patient safety and clinical operations.
What evidence do you have to support your assertions and conclusions?
Provide your best practice recommendations for designing a comprehensive go-live and ongoing support plan for Vila Health.
What evidence do you have to support your recommendations?
Saint Anthony Medical Center in preparing for a major upgrade of its EHR and other health information systems, In your role as a health information manager, you are expected to help ensure as smooth a transition as possible. Your most current task is to develop a support plan and documentation for end-users. In order to develop these items, you need to understand what kinds of help will be available to users both during the go-live and also in the weeks and months that follow.
You have an email from Evelyn Unger.
From: Evelyn Unger, Project Coordinator
Subject: Support Plan
Following up on our last conversation, I wanted to let you know that I reached out to several people around the hospital, letting them know you wanted to speak to them briefly about the support plan you’re working on. Just a heads up – these individuals will probably be hard to pin down for follow-up interviews, so I’d suggest you choose your questions wisely and take notes!
As always, let me know if you need anything.
Please download the pdf (https://media.capella.edu/CourseMedia/mha5066element20670/documents/MHA5066-FlowSheet-EmailThread.pdf) for more information.
Question: What are your concerns about end-user support for the units?
My biggest worry is that people are going to be freaking out and as a result, they’re just going to email or call IT instead of following the procedures.
Follow up: Why do you think this might happen?
To be honest, the average user can’t distinguish the kind of problems they are experiencing so they want to just have one answer person they go to. The trouble is the system not working correctly is a whole different problem than someone not knowing how to do something on the new system. If they’re coming to us instead of using the support people we have in place it wastes our time and to be honest doesn’t give them the best answer.
Follow up: What impact will it have on the go-live if end users respond as you fear?
It takes time away from responding to real technical issues when we have to route people to the right place. There are going to be plenty of glitches that need a technical solution and we have to protect those resources so that we can solve those problems as fast as possible.
Follow up: How have the escalation procedures been communicated?
Primarily through e-mail and the hospital intranet. Management should have a good understanding of the process and they are supposed to be making sure their people understand it.
Question: What kind of support will we receive from the vendor?
They’re providing the help-desk support. Users can call, email, or access via a live chat. That’ll have extra staffing for go-live and for the four weeks following go-live. After that, it’ll still be available, but with normal staffing levels. Additionally, we’ve contracted for “at-the-elbow” support for the providers.
Follow up: Is there anything else you’d like from the vendor?
We might want to consider bringing in the contract support prior to go live so they can work one-on-one with physicians to get templates and order sets in place. Also, some people have been asking for cheat sheets for different modules… If the vendor has anything like that already made, we might want to consider distributing those to the units.
Follow up: Will end-users be getting support services from our internal IT department?
If you mean the traditional “call IT,” we’ve been told to try to avoid that if at all possible. We aren’t the experts on the system, and our primary responsibility according to the implementation team is going to be working on interoperability problems and other technical support. There’s going to be the user support command center set up in the boardroom and all help related calls will be routed through there. My understanding is that the plan is to forward all lines from our internal IT department to that area. Obviously, some people are going to need to contact us directly so we’ll need to provide them with our cell phone numbers, but the average user is going to get routed to the vendor support people.
Follow up: Do you think we’ve contracted for an adequate number of support staff?
I think we have enough people…I’m a little nervous about how long we’ve arranged to have them. The current plan is for the week before go-live and three weeks after. That does include all shifts and weekends, but I’ve been reading on the user’s groups for this software and some hospitals have found that it takes a month for providers to really get comfortable with the basic features. Having the super-users available for a week or two beyond that seems to make a big difference in how much the physicians and other providers progress to more advanced features of the system.
Question: What is the status of user training on the new system?
I know that every user has been signed off on basic computer navigation and/or refresher training. The last time I checked every user has their user ID and has set a password. Based on past history, we’ll probably have a couple dozen people who won’t remember their user ID or password the day we go live. Training on the EHR is not complete. I’ve sent lists of people who still need to complete their training to department heads, managers, and supervisors. My plan is to review that twice a day until we are at 100% compliance.
Follow up: Is there anything else our training staff can do to ensure a smooth go live?
Probably not…. I’m assuming that they’re in communication with the vendor we’re using for user support. Now that I say that aloud, though, I wonder if that’s a good assumption to make? They definitely need to coordinate with the vendor and they should probably talk to the units and departments to hear from them what they need.
Follow up: What kind of feedback have you received about the training?
Overall, good. Well, as good as training can be. The people who were involved in role-playing training seemed to like that quite a bit. Not everyone has done that, though.
Follow up: Can you describe what training we have provided thus far?
We had people do an online, self-paced module on basic computer skills and when they completed that, they were scheduled for the first round of training for the EHR. When people did the basic EHR training, they were given some “cheat sheets” specifically for the workflows they are part of. When people were done with the basic stuff, they were set up with the roleplaying. But… because there were some bumps in scheduling and getting everyone through it, some people have only just recently finished the basic training. And, like I said…. There are a few outliers who haven’t even done that. Not many, but some.
Question: From a technical perspective, how ready do you feel for go live?
I’d say we’ve done everything we could to prepare, but I’m assuming there will be hiccups on the day of go-live. That’s just inevitable. Overall, though, I think there will be a somewhat greater impact on the clinical people. Though, I will say, this go-round isn’t going to be as dramatic as when we made the initial conversion to the EHR. Whooo… that was interesting.
Follow up: Do the members of your staff know where to go for support?
Yes. We’ve addressed that in detail with managers and supervisors and I’m confident that they have the information they need to resolve problems as quickly and smoothly as possible. And, of course, I plan to be available to deal with any problems that require a higher level of escalation.
Follow up: Has system testing been completed?
Oh yes. Interoperability is much better with this upgrade. I think that once we’re through the go-live phase, people are going to be very happy with the improved functionality. I’m anticipating workflows to be much smoother for everyone, but obviously, I’m most hoping to see improvements in the billing and coding department.
Follow up: Are there any hardware issues you’re still working on?
Not in my departments. Now… I will say that one area where we could see problems concerns hardware. All the units and departments are going to be working with scanners — some for the first time. Pharmacy and the labs have been integrating this technology for a while, but the units haven’t, so… That could be a source of trouble and obviously, that could ripple up to billing and coding or medical records. I’m planning to run some audits and checks during go-live to make sure the EHR is capturing data accurately for billing purposes. If there are problems, we’ll need IT to address them right away.
Question: Can you give me a sense of your staff’s overall readiness for go live?
I don’t want to be complacent, but I think we’re in good shape. Because admissions and discharge is one of the critical points in many workflows, we’ve tried to ensure readiness. I know that we’ll have our share of problems, but I understand that there will be super-users available to walk us through any issues we run into. It’s my understanding that really ramping up the support has been a priority and I think it will make a difference.
Follow up: Do your managers know how to get support if there are problems?
Absolutely. There are going to be super-users available on the floors who can be tapped right when needed. Additionally, the managers have been told to print out the escalation procedure and keep it near every workstation. We’ve reviewed the process in detail.
Follow up: Have all changes to workflows and processes been documented and practiced?
Yes, and everyone in admissions and discharge has reviewed the workflows and documented that they understand the process. Obviously, people forget things, but we’ve gone through the workflow revisions extensively. I think most people see them as an opportunity for process improvement.
Follow up: What is the status of training in your departments?
There were a few people who hadn’t completed training as of last night. I’ve spoken with supervisors to get those people through the training ASAP. I’ll continue to follow up on that until we’re at a hundred percent.
Question: What kinds of things have you done to promote enthusiasm and morale in your departments?
That was something new for me, but I do think it helped. We tried to make it fun… there were some giveaways for individuals and also for teams. The first ten people to complete all training received passes to the amusement park at the Mall of America and as each team documented that everyone was trained, they were served Dairy Queen treats… Dilly Bars, I think… by members of the leadership team. It sounds somewhat silly, but I do think it lightened the overall attitudes toward the upgrade.
Follow up: What actions have you taken regarding staffing in your departments?
We’re scheduling extra people for admissions and discharge and other key functions for the next several weeks. After the first week of the new system, we’ll review staffing needs on a daily basis and adjust as necessary.
Follow up: Is there anything else our training staff can do to ensure a smooth go live?
I’d say not. They’re working with the vendor and I think the important thing is that we don’t put out contradictory information.
Follow up: What kind of feedback have you received about preparations for go live?
I’ve had several of my managers and supervisors comment that they believe it’s going to be smoother this time. There is a general sense that our preparations have been more thorough and contingency planning has been better communicated. I guess we’ll see when we actually get to go-live, won’t we?
Question: How prepared do you feel your unit is for go-live?
On the one hand, I’d say we’re fine. All my nursing staff have been through the EHR training. They’ve reviewed the workflows and we’ve even had some opportunities to practice in role-playing scenarios. The one area I have concerns about is the physicians. Most of them have completed the training, but I’m not sure if all of them have. Obviously, I’m not the person who coordinates training and support for the doctors, but if they have problems with the system, it will affect the whole unit.
Follow up: Do you have all the equipment and hardware you need?
I’m still waiting for the scanners. I’m told we’ll have them before the actual go-live, but I won’t really believe that until they’re on my desk. Also, we were supposed to get two mobile workstations, but now there’s talk that we won’t get them before go-live – if at all. That might be an issue if there aren’t enough workstations for people to access the system.
Follow up: How are you planning to help staff or providers who are struggling on the day of go-live?
What we’ve been told by the implementation team is that there will be support staff available who will be able to work one on one with anyone who needs it. The focus for this one on one people is supposed to be physicians, but my understanding is that anyone who needs that kind of help will be able to get it.
Follow up: What is your number one concern about go-live?
To be honest it’s the fact that we don’t really have any providers who are excited about this upgrade. I’ve heard some… well, let’s just say that I am concerned that the providers may come into this with a somewhat passive-aggressive attitude.
Question: What has the implementation team done that you think will help ensure go-live is smooth?
Hands down, it would be the integration of nursing into the planning. Not just the informatics nurses, but nurse leaders across the organization have been included in planning this upgrade. They’ve been able to help in a number of ways, such as integrating the provider’s workflow with what’s being done at the unit level. Having nurses involved has been particularly important for helping make everyone aware of potential risks around barcoding meds. For example… take the risk of a barcode having been entered into the system incorrectly. Nurses made sure the workflow includes visual inspection of the dose.
Follow up: How confident are you that you or your staff will be able to access the right support at the right time?
For the first couple of days, I’m sure it will be fine. What I’m more concerned about is that we know who to call after the initial buzz is over. We aren’t going to be able to swing a cat without hitting a contract support person on go-live day, but I haven’t seen anything that explains how long we can count on these “at-the-elbow” people or who exactly we should contact if there are problems. To be fair, though, I know that we’re going to have 24/7 help-desk support for at least three months.
Follow up: Is your staff clear on escalation procedures?
The nurses and other clinical staff are. I’m not sure what the physicians are clear on. However… we do have the procedure in a laminated sheet at all the work stations. I’d actually like to have more materials on-hand like that. The compounding pharmacy we use gave all the providers a little pack of laminated cards to help them write scrips for compounded creams and such. Very nice little tool. Anyhow, something like that for the various order sets and workflows would be helpful, but I’m not sure if we have such a thing available.
Follow up: What is the plan if things go very wrong?
(chuckles) Good question! I know there was talk of having a back-up paper process, but I don’t have anything that actually tells me what that is or how to implement it. I believe the implementation team has addressed what situations would warrant stopping the go-live, but I don’t know what those situations are.
Question: How well has training prepared your staff for transitioning to the new system?
Better than adequately, I’d say. I would have liked to see more of the simulation sort of training for the nursing staff, but I’m as much to blame for not all my nurses receiving that training as anyone. We’re chronically short-staffed in this department, so coordinating schedules with training has been a challenge.
Follow up: What forms of help and support are going to be available?
There are training videos and self-paced online training modules; there are some printed guides, though not as many as I’d like. Of course, that’s my preferred way of doing things, so that’s what I looked for. There will be phone or chat-based help from the vendor, and there will be on-site support staff providing what they’re calling “at-the-elbow” support. That’s my understanding of what we’ll have.
Follow up: How have users been made aware of their support options?
Oh my Lord…. How haven’t they? It’s been in emails, posters, daily updates to the intranet… there are little table tents in the cafeterias and break-rooms… you really can’t work here and not know all the ways you can get help using the system.
Follow up: Have the workflow changes been communicated clearly?
Yes, they have. Everyone has had to review the revised workflow process diagrams and sign off that they understand it. Of course, signing off doesn’t necessarily mean that you really do understand it, but there’s only so much that the implementation team can be held responsible for. We users have to accept our responsibilities, too.
From: Evelyn Unger, Project Coordinator
Subject: Re: Support Plan
How did your interviews go? I hope you got what you needed. The implementation team would like to see a draft of the support plan next week, so I imagine you’re going to need to get right on it. Let me know if there’s anything else you need from me.
Congratulations! You’ve completed the HIM Technology Support Plan challenge.
You should now have the information you need to design a support plan for go-live and ongoing support.
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