Staff Engagement in Early Planning Key for Health IT Implementations

Successful health IT implementations require cross-departmental staff engagement in the planning process, according to an AACC article written by Kacy Peterson MBA, MLS, laboratory director at Avera McKennan Hospital & University Health Center.

When the hospital first announced a comprehensive EHR implementation, Peterson knew that including laboratory staff in the planning process would be crucial, as the implementation included a laboratory information system (LIS).

LIS functions include storing patient data, receiving test orders, sending orders to laboratory analyzers, and transmitting orders to the EHR.

“An LIS is the brains of the laboratory, and disrupting that flow of data is a large event—even when planned, as in our hospital’s recent LIS conversion,” Peterson said. “A successful LIS conversion or implementation starts with planning and assessing risks from an early stage. It was imperative that our laboratory had a seat at the table from the very beginning of the project.”

She noted that LIS functionality has as much impact on patient care as those functions directly visible in patient care settings, such as emergency department tracking and nursing documentation.

“It was therefore vital to our success that our laboratory was vocal at the time when the hospital was making initial decisions forming the foundation of functionality,” Peterson wrote.

For example, as stakeholders built the EHR registration module, the hospital’s “patient access” team was the primary stakeholder. However, Peterson said that the registration structure also had to support patient visits that solely had an outpatient lab draw.

“Requiring a full and extensive patient registration for those visits was not efficient for high-volume lab service centers, so our laboratory needed to be an involved secondary stakeholder,” she explained.

Additionally, Peterson said that identifying risks before LIS conversion was crucial for patient safety.

“Transfusion services could be impacted, as patients may not have a historical blood type in the system,” she wrote. “The American Association of Blood Banks’ guidelines may require a second draw for blood type recheck prior to transfusion if blood bank history is not available, creating operational impact and potential delays for months after the go-live stage.”

Peterson also said that engaging laboratory staff to identify and bring up functionality issues during pre-live testing and post-go-live was vital in ensuring the health IT implementation supported laboratory workflows.

“For example, asking staff to use sticky notes to identify issues was a simple yet effective way to quickly document problems with functionality,” she said. “It also provided staff with visibility around which issues had been identified and were actively being worked on.”

Peterson noted that involving laboratory staff in the early stages of the LIS conversion also helped build strong relationships with IT partners and other stakeholders.

“Our close collaboration on planning created trusted partnerships that made navigating any go-live or post-go-live issues easier,” she said. “By starting these conversations early, we were able to educate our IT partners on reasons for any pushback and change requests.”

For instance, during the beginning of the project, staff gave lab tours which helped IT developers understand real-world, day-to-day operations and workflows.

“Early on, we also identified a few individuals within the IT team that would be the laboratory advocates and developed those relationships further,” she added. “When crunch time came on go-live day and after, we communicated and resolved problems more efficiently with those foundational relationships already in place.”

Peterson noted that having a debriefing post-go-live with all stakeholders was another important step in the implementation as it provided the organization time to document lessons learned.

“While it may be a decade or more before another total LIS conversion or implementation is needed, this blueprint can help you navigate any future changes or developments within your current LIS or larger EHR system,” she concluded.