“I don’t have time for that.”
If you’re responsible for managing your community hospital’s IT, this phrase is probably seared into your mind.
Unfortunately, many users today see hospital technology as a burden instead of a facilitator. Sometimes, it’s possible to chalk that up to bad technology, plain and simple. But technology isn’t always to blame.
Buying a new system and hoping for a miracle cure won’t help. If you want users to get on board with your IT plan and actually use your technology as intended, follow these steps:
1) Create User-Friendly Hospital IT
If you want users to adopt your technology, every system must be user friendly. Design technology with patient flow in mind to encourage the right end user behavior. Technology that delivers little to no patient value breeds more workarounds than results.
Take CPOE, for example. Your clinicians should be able to select common diet and activity orders from a pre-populated, pre-checked list. If they can’t, they’re spending unnecessary time clicking through every option for every patient.
Similarly, provide your staff an automated physician documentation option. Have your coding department create physician-requested macros that quickly generate common, standardized statements. Your physicians should be able to build documentation for most patients in just a few clicks or choose to enter specific items manually, depending on their patient and preference.
2) Make User Training Mandatory
This is critical to avoid future workflow problems. Believe it or not, just four to eight hours of training can be all it takes to get hospital staff using IT systems productively.
If your staff thinks you don’t value your new IT, they won’t be invested enough to make it work. Champion your IT investment by making training mandatory. Adjust staff schedules so they have adequate time to train, and train in groups of 12 or fewer to keep discussions on track.
3) Then, Follow Up On Training
After training, engage clinicians and other users in one-on-one sessions to give their individual questions the time they deserve and make clinicians feel valued.
Questions generally include the very simple (“Where do I find these test results?”) to the relatively complex (“Can you show me how to reconcile home medication in the system?”).
4) Get Leadership Buy-In
Your community hospital’s leadership team plays an integral role in driving user adoption. The CEO should partner with other leadership team members to educate clinicians and staff on your IT’s patient and business value. To ensure no lapses, the entire hospital staff should be held accountable for IT success.
Sometimes, drastic measures are required. In one hospital we worked with, the CNO banned all printing of lab or radiology results after too many workarounds emerged. When physicians accepted that nursing would no longer print results, they learned how to access information in line with the hospital’s best practices and EHR adoption improved.
When leadership supports the process, progress is made. Hopefully, you’ll see success using just the proverbial “olive branch” — training and one-on-one support — and only turn to the “sword” as a last resort.
5) Implement Single Sign-On
Logging into multiple systems takes up a lot of user time, especially in organizations where the hospital and office work in separate systems. Reduce wasted time and make your hospital technology more user-friendly by implementing single sign-on.
Don’t underestimate the cumulative power of small changes. In one community hospital with a clinician staff of 319, single sign-on implementation reclaimed 14 minutes per shift. That added up to 18,597 hours per year across all 319 clinicians:valuable patient time that would have otherwise been lost.
6) Make Mobility A Priority
As “bring-your-own-device” (BYOD) plays an increasingly important role in workplace communications, hospitals should leverage mobile technology to improve workflow and elevate the patient experience, keeping in mind at all times the paramount importance of confidentiality, integrity and accessibility.
EHR and other vendors are developing applications that interface with tablets. Your hospital should at least be developing a plan for integrating these technologies, improving patient flow and boosting organizational productivity.
For example, you might swap cumbersome paper intake forms for digital, kiosk-style patient applications with pre-populated fields and drop-down menus.
Remember to keep HIPAA compliance in mind when developing your BYOD strategy. Devices connected to your network, for instance, should only be able to download specific applications from an approved list. To do this, you need to resource carefully and create a mechanism that carefully balances end user accessibility with security requirements.
7) Measure, Measure And Measure Again
Successful IT is only possible if it’s measured. Fortunately, EHR and other HCIS user adoption is very measurable.
Reports you might want to keep an eye on to evaluate EHR usage include (but are certainly not limited to):
- Patient Management: Number of late charges, billing exclusions, missing bill tags and statement tag exceptions. Patient management metrics should be checked on a routine basis as frequently as possible.
- Medical Records: Possible duplicate persons, uncoded charts and physician documentation rejection queue. You should check duplicate persons reports monthly, uncoded charts at least weekly and physician documentation rejections daily, if possible.
- Materials Management/Accounts Payable: Invoice discrepancies, open purchase orders and unpaid vouchers. These should be viewed at least weekly.
Don’t get lax. You should be measuring all metrics at least monthly to refine your processes and reduce the amount of information that slips through the cracks. This is how you stop workarounds from becoming the standard.
8) Don’t Just Speak: Listen
Patient surveys are commonplace in community hospitals today; staff surveys should be, too. Direct feedback is necessary if you want to adjust your plan and make meaningful change.
If you’ve effectively educated your staff on how your hospital’s IT accelerates your care and business goals, feedback should be constructive. Listen for ideas on improvements that help meet these goals and place less stock in personal workaround requests.
Consider using anonymous surveys as a baseline, then gain deeper insight by “rounding”: walking the floor and asking important, open-ended questions, like “What do you spend the most time doing in your EHR,” or “If you could change one thing about our IT, what would it be?”
Too often, clinicians don’t have time to pick up the phone as soon as they encounter a problem. You’ll be amazed at what you learn by taking a few extra minutes to have face-to-face talks.
9) Use Planned Downtime Wisely
Pay close attention to your staff’s performance when your hospital’s IT is taken away from them. Even if they’ve complained about IT, they’ll often quickly realize how good they had it and request you get things up and running as soon as possible.
Instead of saying “I told you so,” use downtime to observe behavior. Measure exactly where IT provides tangible improvements. Identify the paper processes they revert to quickly; these are your most likely workaround candidates when the technology is up and running.
Your Success Hinges On User Adoption
High user adoption isn’t a “nice to have.” It’s essential for ensuring timely, accurate information and guaranteeing patient safety. The last thing you want is sloppy handwriting drawing out your care timeline (as nurses go on the hunt to complete information) or worse, leading to care mistakes.
High adoption is, in a word, invaluable. It frees time for your clinicians, allowing them to carry out their most important job function: spending time with patients. It shortens revenue cycles, reduces materials management mistakes and helps you gather the information necessary to make informed, analytics-driven business decisions.
Use these nine steps to improve your community hospital’s IT user adoption and watch as your organization grows stronger each day.