Malaffi on Wheels (MoW) Initiative

Transcription

1 Malaffi on Wheels (MoW) Initiative

2 Best Project Award in Innovation Idea # Name Mobile 1 Nibal Abouras nras@seha.ae 2 Subhash Reddy mreddy@seha.ae 3 Karunakaran Ramanaathan karunakaran@seha.ae 4 Raja'a Al Dahdouh rdahdouh@seha.ae 5 Eiman Al Shamsi enshamsi@seha.ae 6 Vikas Ramanna vramanna@seha.ae 7 Maria Charisma Lopez mlopez@seha.ae 8 Mohamed Sheik Dhawood ndhawood@seha.ae 9 Maher Husni mhusni@seha.ae 10 Hakimuddin Jiwa Khan hakkhan@seha.ae 2

3 Content 4TMain Information4T The first criteria: Study and define project objectives4t The second criteria: Project Team4T The third criteria: Resource Management and Control4T The fourth criteria: Risk Management and Project sustainability4t The fifth criteria: Project execution4t The sixth criteria: Results4T TGlossary (optional)4t

4 Project Name Malaffi on Wheels - MOW Main Information A summary of the project and its reasons (15 lines maximum) Malaffi on Wheels is a reach out program to clinical areas to support the on-going users learning process and enhance EMR adaption improvement objective, frequent visits are scheduled in a weekly bases to different areas in the hospital. Our objectives are to enhance transparency and promote honest and direct feedback at users level, and empower Health care providers and System users to break down silos and build bridges to strengthen communication, provide clarity, education and direct answer to system related questions and problems. Each and everyone s points of view are freely expressed, listened to and safe from judgment and repercussion. Simply Solve Problems and Stop them Before They Happen. Additionally follow up number of issues and gaps such are training and denials which was significantly reduced. Department (section): IT Department/ Malaffi/Health informatics. Project Manager (Name and designation): Nibal Abouras Clinical System Analyst- Al Ain Hospital Main members of the project team (Name and role) Name Role Nibal Abouras Clinical System Analyst Subhash Reddy Senior Physician Application Analyst Karunakaran Ramanaathan Application Support Analyst Raja'a Al Dahdouh Application Support Analyst Eiman Al Shamsi Senior Application Analyst Vikas Ramanna Malaffi Site Manager Maria Charisma Lopez Senior Pharmacist Mohamed Sheik Dhawood Assistant Claims Officer, Revenue Development Maher Husni Senior Charge Nurse Hakimuddin Jiwa Khan Physician- Project Starting Date October 2016 Mobile nras@seha.ae mreddy@seha.ae karunakaran@seha.ae rdahdouh@seha.ae enshamsi@seha.ae vramanna@seha.ae mlopez@seha.ae ndhawood@seha.ae mhusni@seha.ae hakkhan@seha.ae The person who can be contacted in with any issues related to the project submission : Name Telephone Mobile Nibal Abouras nras@seha.ae 4

5 UThe First Criteria: Study and define project objective 1. Identify and set goals and project document Project Goals are set and determined to matches and satisfy SEHA Strategic plan (Appendix 2): Projects Goals: Provide direct answers for system related questions from the application specialist and subject matter experts. Provide hands on training on specific areas defined as training gaps. Answers to frequently asked questions. Provide tips and shortcuts. Setting favorites and end-user preferences Re-enforce Specialties specific system/workflows / documentation and Policy. Provide support for different machines interface. Attend end-users concerns and issue in documentation and new Malaffi changes. 5

6 2. Project Plan and Execution Malaffi on wheels initiative is a proactive way of support, by approaching system end-users in their working place to come across their issues and questions about Malaffi system and other technical issues that they may experience. Some of our project triggers is that we have found users are tend to find work around for their system issues that may not matches operation workflow which prolong their time using the system and withdraw them from patient care, other area of improvement is that users have difficulties catching up updates and system changes send by s or discussed in meeting, which drag the attention to the important to improve communication channel and close the gap of communication by updating users within their real time of system usage which in turn enhance users participating in providing feedback and reduce challenges of not able to express their concerns in Talabi request or . Malaffi on Wheels visits schedule are arranged and determined by the project lead to cover all hospital clinical areas and units and ensure each department will get a visit by Malaffi team at least once every month. Objectives of each visit are determined based on a specific targeted unit requirement that might be training, technical or workflow or can be a general knowledge and information about system usability, troubleshooting or compliance of specific operational workflow and policy. 6

7 Based on the overall Implementation strategy of Electronic medical record system (Malaffi) we have believed on the importance of staff buy-in and involvement. As people come with different backgrounds, frames of reference, experience with technology and comfort with change. users never start from the same place and they move through the ongoing change process at different speeds, and they require understanding of their fears, needs, hopes, and their reactions to the challenges that impact their ability to perform, here where Malaffi on Wheels came in place to address and cover all those Aspects to achieve the goal of sustainable results, growth, and organizational vision. 3. Develop an organized and comprehensive plan for internal and external communication Communication and introduction about the Malaffi on wheels visits and schedule was sent to all hospital staff to ensure awareness and readiness with questions and issues they want to raise to the team. Management made aware of the initiative to support, re-enforcement and compliance of defined workflows and process. All changes that are applied to the system are communicated through an announcement sent to targeted group of clinician to those who the change may impact, which gave them the chance to communicate and reply back if they have any question or clarification on the implemented change, in the other hand those changes are also uploaded to the hospital intranet (portal) to allow users to go back any time to review and understand the concept of the change. 7

8 Changes requested and applied to Malaffi System are going through an SEHA Enterprise agreed process, which is defined in the following diagram: 8

9 4. Develop a quality assurance plan Issue log record is maintained for all issues reported during the Malaffi on wheels visits, including education and training provided to specific training gap or area of interest that required action of process correction and compliance, all issues reported that require a third party or vender fix are logged in IT help desk system (Talabi) which in turn notify concerned user/staff of the action been taken to fix his/her issue. If any changes that are proposed by end-users and approved by the Inter-user committees, the Project lead is responsible for communicating the changes to concerned group of end-users. 9

10 The Second Criteria: Project Team Project team consist of Malaffi team who are the subject matter expert in the Malaffi applications that been utilized by different clinicians such as physicians, nurses, allied health practitioners, Pharmacists and number of administrative staff. Project lead Is responsible to communicate the visit schedule with the selected clinical area manager/ in charge, determine the list of issues and agenda to be discussed with the concerned department and staff, additionally maintain the issue log record and ensure issues that not been resolved and require vender support are logged through Talabi system and assigned to appropriate resource. Other involved Malaffi team members who may not present during the visits, but have a specific application question and issue: are responsible to contact end-users of their specialty and follow up on items and issue raised during the visit. 10

11 Third Criteria: Resource Management and Control 1. Manage financial resources related to the project Project was initiated and managed using the current resources and man power, existing devices and equipment was utilized to demonstrate data and processes of the specific visit objective. 2. Manage and direct knowledge resources and identify a systematic and comprehensive plan Resources assigned and managing the scheduled visits are Malaffi team who are the subject matter expert in system design, trouble shooting and knowledge of Malaffi system capabilities to accommodate new/proposed process or function requested by end-users. At the first stage of the project, we have the targeted the groups of direct patient s health care providers from physicians, nursing and Allied Health users, and the ongoing plan is to extend this to other Malaffi users from Pharmacy, Registration and administrative teams. Malaffi system consists of at least 15 applications and functionality that are currently utilized by the hospital clinical staff which require appropriate support and knowledge resources allocation, and within the first stage of the project we have resources defined who are able to cover more than 7 applications and specialized functionalities. 3. Manage and direct suppliers : Project sustainability plan is maintained by ensuring all provided information are accessible to all system users all the time either by sharing and uploading reference guides to hospital Intranet portal or provide printed guide to user in their work place: 11

12 4. Assure optimum Resources use Additionally to the Malaffi team members, number of Malaffi super users who were involved in the system implementation were empowered during the visits and helped to communicate knowledge to all unit staff and in turn they report issues to Malaffi team either through Help desk system (Talabi) or direct contact by phone or . All Malaffi system changes that are communicated by s are also uploaded to the hospital intranet (portal, in addition to Malaffi Insight website that contain all Malaffi system training guides and training which staff can refer to self-learning and education. 12

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14 Fourth Criteria: Risk Management and Project sustainability Risk management plan is maintained and tracked by the project lead with the appropriate mitigation and action plan to minimize effect of the project progress, number of risks are identified as per following table: Also refer to Fifth Criteria, point # 2 for the details on Project sustainability. Risk Description Category Probability Impact Risk Response Status Owner Limited Malaffi Resources Management Likely Moderate Determine the visit objectives based on resources available. Open Malaffi Management Unavailability of users in the clinical area specially physician organizational Likely Moderate Schedule the visit with consideration of physician round time and availability in the unit In progress Team members Unable to accommodate certain requested change in the system External May not occur Minimal Provide alternative option to run the task through available system functionally In progress Team members 14

15 Fifth Criteria: Project Execution 1. Develop a system for Managing Records and project activities and assure Document support and operation execution, Control, review, update and develop solutions and preventive and corrective action Issue and visit record is maintained to track all activities captured during the visit wither it was training, question or issue that require a service request to go to Cerner for a fix, issues that are not resolved on site are logged in the Talabi IT support system maintain the communication cycle with the concerned user who receives the notification in her/his on the progress of the raised issue till closer and fix. 15

16 2. Develop a comprehensive plan or methodology to close the project including all aspects of the project Malaffi on Wheels is an ongoing project that getting upgraded to different level of support to be extended to all other groups of Malaffi system users and Applications such as pharmacy, and registration (ESM, ERM) utilizing the Malaffi Pharmacy and registration support resources from Malaffi team to be available during the future scheduled visits to respected area. Methodology used in the project will ensure defining the system user requirement of any Malaffi system application utilized in the organization, design the visit to respected area and monitor results and follow up compliance: 16

17 Sixth Criteria: Results Project KPIs and results: Provide Education and learning to improve Health Care services: Over the last 11 month of the project, we have 63 visits to different hospital clinical areas and recorded more than 70 issues logged varied between training, compliance and change request, some of those issues resolved on site during the visits and other had required to go through a change process: Number of System clicks also shows improvement which in-turn improve Patient care by having users focus on patient need, by analyze the data based in Cerner Advance Health System to look at high opportunities across all venues Facilities/Specialties/Physician peers. We identified that Order set were bleakly utilized and targeted an Endocrinologist to start using the Power-Plan for the patient he sees, so that Insulin protocol is appropriately implemented Adaptation was good and we found that the user standard using the order-set. 17

18 Lights on Network Care Advance Insulin orderset usage Q and Q Additionally system usage alternatives tips provided during the visits did add value in saving users time on the system. One of the training gap identified was utilizing ECG functionality in Malaffi System using interfaced machine which required class room training session scheduled over 3 months to cover all nursing staff, OCT NOV Dec jan feb mar 18

19 Improve staff Satisfaction and engagement and enhance communication: Malaffi on Wheels Initiative focus on staff, therefore, we were much concerned to hear staff feedback, Survey has been conducted and sent to hospital nursing and physician groups and returned with % positive response on the effective of Malaffi on Wheels visits and the important to continuity this initiative. This survey was conducted for the period of time from August to October Based on the same survey, > 50 % of staff do agree that getting support by the team on their working place enhance the communication process and help optimizing their experience with Malaffi System especially when they had the chance to explain and show their issue to the support team that was not easy by raising request or . Reduction of Denials and insurance issues: Based on the report received from Revenue Cycle team on the number of claims and denials issues they experience due to staff noncompliance to designed system process and workflow, they have returned a positive result after attending all the raised issues and communicate the correct workflow and process with the concerned group of staff. 19

20 Team KPIs and results: Over the project time, team were able to attend and meet around 500 staff from nursing and physicians group and recorded number of issues that required Vendor support to perform the required changes that optimize system usability and adoption: 20

21 One of the issues reported that required correction to adhere with policy and JCI requirements is to add additional section to Time out form: And these added a value for the whole team when system design matches JCIA requirements and get our organization accreditation. 21

22 Project Effect Indicators Number of issues been closed: 70 issues were recorded that varies from training, Technical and new proposal /change that require build in the system and more than 60 issues are closed. 22

23 Glossary (optional) Appendix 1 Appendix 2: 23

24 Appendix 3: Abbreviation: MOW ERM ESM RCM ECG PPID OPD CCU ICU ED L&D NICU OT OB Malaffi On Wheels Enterprise Registration Management Enterprise Scheduling Management Revenue Cycle Management Electrocardiogram Positive patient Identification Out Patient Department Coronary Care Unit Intensive Care Unit Emergency Department Labor and Delivery Neonatal Intensive Care Unit Operation Theater Obstetric 24