FrontPage => Building Blocks =>
Implementation Strategies
Two basic strategies are to role out CPOE throughout the organization at once, the so called "big bang" approach and the incremental approach. Most organizations have done an incremental approach or a "partical big bang" that may exclude units with different workflows such as OB in an initial rollout. Another key decision is if only physicians will use the system or if nursing (and other clinical staff) will also use the system. If all clinicians use the system, nursing can help train physicians. If only physicians use the system, it may be easier to "clean up" the paper order sets if nursing does not have to enter "legacy paper order sets" for physicians who are not using the system. If a rollout is done incrementally two options are by location and by specialty. By specialty may be easier in many cases since it allows the implementation team to focus on a limited number of order sets at one time.
Strategy | Positives | Negatives | |
Big Bang |
|
|
|
By unit |
|
|
|
By specialty group |
|
|
|
Progressive pilot strategy folowed by residual big bang |
|
To ensure a smooth technology adoption, target the following elements:
¨ Project sponsorship: Include nursing leadership as soon as possible.
¨ Reporting structure: IT and nursing must work together, viewing the initiative as an organization-wide endeavor. Consider moving clinical resources into your facility's IT department.
¨ Project champions: Incorporate the clinician's/end-user's perspective into design and implementation decisions.
¨ Delegation: Create teams to facilitate the initiative's success, from conception to follow-up.
¨ Support structures: Develop resource libraries for all involved teams. In addition to training for core team members, make available recent publications that address CPOE issues
Alamance Regional Medical Center
How to implement CPOE successfully at your Hospital by John Halamka, MD