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Monitoring and Controlling Your Implementation

FrontPage => Stages of Implementation => 

 

Monitoring and Controlling Your Implementation

  1. General 
  2. Monitoring of compliance
  3. Setting Expectations
  4. Dealing with noncompliance.
  5. Contributers

General 

Now that your plan and team is in place, it is time to do the build.

 

The Monitoring and Controlling process is important in the overall project design so as to ensure the project is on course. Concurrent monitoring porvides the opportunity to identify variances early so that corrective action can be taken to meet overall project objectives. Monitoring and Control processes include status reports, quaity management, communication plan, risk and issues management, scope/change management, as well as time and expense reporting. By having quality monitoring and control activities the interaction with the medical staff advisors can be productive and efficient. Individuals involved in monitoring and control activities include: Project Sponsor, Project Steering Commitee, Medical Staff advisors, Project Manager, Trainers, IT team, and the Execuitve leadership. CPOE projects can be high risk projects as the workflows to support clinical decision making and order execution are impacted. The clinical advisors must be confident that the team is managing the project as to ensure the safety and quality of the care processes. It is important for the clinical advisors to have access to key performance data to fulfill this oversight responsibility.

 

  • Building Order Sets
  • Building Order Management Order Codes
  • Develop Order Hold Reasons
  • Develop Override Reasons

 

Change control system needs to be in place

Governance structure needs to be in place

What are your process to monitor how you are doing in the project?

How do you keep the process on track

 

Monitoring of compliance

  • Must find method to calculate and track compliance of clinicians with CPOE
  • Can use “order method” if that is tracked in the system (written, verbal, electronic, etc.)
  • If not done in the system, consider random chart audits – nursing can help identify potential trouble areas

Setting Expectations

  • The oversight committee should set expectations regarding utilization: Mandatory use versus recommended (but not required).
  • Expectations regarding utilization need to be communicated to the clinicians.  The method of tracking and calculating utilization should also be communicated.
  • Consider providing monthly updates regarding utilization to the Departmental Chairmen.
  • Consider increasing utilization expectations over time to allow for acclimation by the clinicians
  • Once “critical mass” is achieved, the decision for mandatory use becomes much easier.  

Dealing with noncompliance.

  • The plan for dealing with noncompliant clinicians should be developed and discussed with the oversight committee and medical staff leadership.
  • The plan should include the following:
    • Method and frequency of measurement
    • Plan for communication with noncompliant clinicians
    • Plan to provide one-on-one support and training for noncompliant clinicians
    • Ongoing tracking of compliance
    • Consequences of persistent noncompliance
  • Note that the plan will be very different depending on the decision regarding mandatory or optional use.
  • When CPOE use it is mandatory, a formal plan for progressive disciplinary action should be developed
    • This can include warning letters from the Department Chair; mandatory re-training sessions; and ultimately suspension of privileges
    • Must consider political implications of disciplinary action 

 

Contributers

Shelly DiGiacomo

Don Levick

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