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Planning for Activation (aka Go Live)

The keys to activation success include having the right resources, in the right place, at the right time to support end users and resolve issues. You will need a well-trained and prepared support team.   Failures in activation often arise from lack of planning, lack of resources and/or lack of ownership.

While activation success is dependent on a variety of organizational people, process, and technology factors, experience proves that there are common factors that contribute to activation success.  Proper pre-activation planning and preparation, experienced activation leadership teams, accurate and effective activation training, and the definition and measurement of key metrics are just a few of the many critical factors that make the difference between organizations that have successful activations and that have less than optimal results. 


1) Develop Conversion Strategy
a. Develop draft and review with project team, project sponsor and others as appropriate.
b. Update as appropriate throughout conversion planning process.
c. Determine exactly when activation will take place, including specific downtime start and end times.
d. Consider staffing up to accommodate for lower productivity during go-live.


2) Identify Super Users (SU)
a. Super Users are staff members who function primarily for training of others and to give ongoing support during and after activation
b. Estimate the number of super users needed to cover a geographical area (e.g. each department, each floor, etc.) and how often a SU needs to be there (e.g. 1 SU per department per shift)
c. Decide if one on one support from super users needed for providers.
d. Estimate how long SU support will be needed and at what times (e.g. 24 hours a day for 7 days)
e. Define roles & responsibilities for super users.
f. Send a request to department leadership (at least 2 months in advance) detailing the above information and requesting names of Super Users
g. Create a SU schedule for activation and identify leadership who will need access to this list (e.g. managers, command center lead, hospital supervisor, etc.)
h. Decide how super users will be identified (e.g. t-shirt, hat, vest, etc.) and place order as needed.
i. Determine need for outside conversion support resources.  If necessary, identify vendor, determine # resources, define schedule and negotiate contract.


3) Confirm all end user training has been completed.


4) Decide on whether or not to have a Command Center
a. Identify the purpose of the command center (I.T. centric, clinical operations centric, a combination of both)
b. Estimate the length of time the Command Center will be open (e.g. typically 1-2 weeks)
c. Identify the Resources who will need to be in the Command Center (e.g. Project Manager, Order Set Analyst, etc.)
d. Determine if a Command Center Captain is needed for all shifts, and who assumes this role during each shift.
e. Define roles & responsibilities for all who are supporting the go live, including super users, leadership and project team members.
f. Reserve the Conference Room(s) where the Command Center will be located
g. Identify the items needed for the Command Center
i. Phones (this document assumes issues will be logged by super users; if some or all issues will be called into the Command Center, take this into consideration when determining number of phones needed)
ii. Phone number that will be used to call in questions/issues
iii. PC’s or Laptops
iv. Applications needed on the PC’s or Laptops
v. Fax/Copier/Printer(s)
vi. Tables & Chairs
vii. Food


5) Communications to all staff regarding impending CPOE activation
a. Start weekly communication blitz one month prior to activation
i. E-mails
ii. Posters
iii. Articles in enterprise publications
iv. Faxes to physician offices
b. One week prior to activation increase communication
i. 7 days prior
ii. 5 days prior
iii. 3 days prior
iv. Day/night before activation
c. Review Downtime Policies, Procedures, and Tools.  Ensure that all departments are aware of how to address issues that arise during activation downtime and have the potential to affect productivity and/or patient care.
d. Create Conversion Handbook to be distributed to everyone supporting conversion
i. Consider including contacts lists, support schedule, cutover schedule and checklist, Issue management process, communication plan, roles & responsibilities document, change management process for the go-live (i.e. who can make changes in production and what approval is needed)
ii. If bringing in outside resources, include map of city, map of hospital, list of restaurants, hospital information (e.g. cafeteria hours) and policies (e.g. smoking policy), overview of project (including unique characteristics of this implementation)


6) Hold an “All hands meeting” prior to activation
a. Review the activation timeline (especially if a downtime is associated with CPOE activation)
b. If downtime associated with activation, review downtime procedures and remind staff to ensure enough downtime forms are available on their units
c. Discuss the Command Center (CC) purpose, location, how to contact the CC, and who will be manning the CC
d. Discuss the Super User staffing plan and schedule
e. Discuss the issue management process
f. Orient outside vendors and ensure they have security badges as needed.  Check with HR in advance to determine if outside vendors need to fill out paperwork, need proof of immunizations, or need to fulfill any other requirements.


7) Create “Issues” document
a. Ensure Super Users have an issues document to record items that occur during their shift
b. Issues should be recorded if the SU is able to answer the question and if they are unable to answer the question
c. Review Issues Document at the end of each shift to identify themes of questions that may need additional education or communication
d. Issue documents should be delivered to the Command Center where they can be logged, tracked, triaged, prioritized and assigned as appropriate.


8) Create a report to monitor CPOE levels
a. During activation monitor CPOE percentages by physician (you may also want to have it separated by location, for example Hospital A, Hospital B)
b. Ensure your report shows each order type (e.g. verbal, phone, written, CPOE, etc.)
c. Decide on other metrics to be reported on.


9) Plan for several meetings during activation
a. At change of shift ensure all Super Users report to the Command Center to discuss the events of their shift
b. Once a day have an “All Hands Meeting” and ask leadership to attend (as appropriate) to review the events of the day
c. On a daily basis evaluate how the activation is going and based on its success, estimate the need to keep the Command Center open for a shorter or longer period of time
d. Review CPOE percentages on a daily basis with appropriate leadership


10) Daily Communication to the enterprise on the status of activation
a. Provide a daily communication to all staff and physicians on the status of the activation
b. Communicate any issues that have arisen that need clarification or mini-education


11) Create Communication Plan documenting all communications planned for the go live, including meetings to be held, status reports, updates to departments and any other types of communications.
a. Determine if feedback mechanism other than issue documents needs to be defined (e.g. for providers).


12) Consider conducting a combined mock go-live with all team members and operational areas.  The areas addressed during this activity should include timeline for cutover, plans and tools for data entry, staffing plans for each department and the Command Center, contact lists with phone, cell, and pager numbers, for each operational area and the Command Center.


13) Post Activation – Prepare for Lessons Learned Meeting
a. After activation is complete, hold a “Lessons Learned” meeting with key resources to discuss what went well and what did not
b. Create a “Plan of Action” based on the outcomes of the Lessons Learned Meeting