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Transitioning to Operations

General

All Projects End

The CPOE PROJECT will end.

The project completion criteria mentioned in the project plan will be met.

The project sponsor will sign off.

The users will sign off.

There will be a celebration.

The project team will be dissolved or move on to another project. 

CPOE and the EMR will become critical components of normal operations. 

CPOE related processes must be managed and continually improved.

Like all other aspects of the project, the transition to operations takes planning and preparation.

Planning for this transition should begin early in the project. 

Consideration needs to be given to the following factors across many areas of the organization:

• Workflow
• Job duties
• Staffing levels
• Skills and training requirements
• Documentation and other knowledge tools
• Departmental and committee scope of service

Issues that must be addressed before the transition to operations:

1. Ongoing training of new physicians and other new employees on the CPOE system

1. Trainer staffing levels, skills and materials
2. Training facilities
3. A training system 

2. Ongoing support for physicians and others using the CPOE system

1. Special help desk number for CPOE support  
2. Support Analysts staffing levels and skills
3. Scheduling of super users and clinical analysts

3. Changes in staffing levels, job duties, skill requirements for unit clerks, nurses, pharmacists, and other ancillary staff

4. Ongoing support of the CPOE application and technology

1. Systems Analysts, Network Engineers, Server Admin staffing levels and skills

5. Ongoing governance committee for the CPOE application to determine how the system will be developed and used 

1. Process to manage system enhancement requests and changes to the system  

6. Ongoing governance for decisions about clinical content such as order sets, CDS, screens and forms

1. Process to manage requests for changes
2. Committee(s) to make decisions and prioritize work
3. Process to communicate decisions and roll out changes 
4. Physician involvement 

7. Changes in the work of existing committees:

1. Medical Records Committee
2. Patient Safety Committee
3. Medication Safety Committee
4. Pharmacy and Therapeutics Committee
5. Medical Executive Committee
6. Other quality committees

8. Changes in departmental responsibilities and scope of service:

1. Medical Departments
2. HIM  
3. Case Management
4. Utilization Review
5. Risk Management
6. Quality  
7. Other

9. The need to monitor physician satisfaction and receive their feedback

Operational Readiness Review (ORR) 

Many organizations have found it beneficial to conduct an Operational Readiness Review (ORR) prior to the go live. 

The ORR involves asking the managers of each area affected by the system change to review their readiness to continue their operational responsibilities subsequent to the system go-live. 

The ORR should be conducted several weeks before the go-live decision is to be made, and would be a key factor in the decision to go-live.