Q&A:
IMPLEMENTATION OF EPIC AT HOUSTON METHODIST HOSPITAL Connie Lauw, HMH Epic Clinical Liaison, Process Optimization Specialist, Operations Integration & Optimization
The new Epic electronic records system went live at Houston Methodist Hospital on May 22. Nurse super-users played a critical role in the implementation of Epic, going through months of handson training to prepare for questions they’d receive during go-live. What was it like on the first day of the Epic Go-Live? We all started on Saturday morning at 6:45. The Epic team was already at OPC 3 to start the cutover and we had nurses coming in from the floors and from different hospitals to start the manual parts of moving from MethOD to Epic. We had two 12-hour shifts, a day shift and a night shift. Unfortunately it wasn’t quite ready when we got there – we had a bit of a lag time. So we kind of stumbled out of the block a little bit for the first couple hours. Once we got the information from registration, we came back through and started entering the information. Once everyone got going, it was really good. The nurses were excellent about getting in there and getting the information put in. A lot of questions came up, but once we got into the process of cutover it went pretty smooth. It was a long day and it was as coordinated as it could be – the logistics were just mind-boggling. Was there anything that stood out to you? Teamwork. It was all about teamwork. Once we got going, each of the groups were just working together. Even those who came in from other hospitals. The teamwork was just phenomenal that whole weekend. Early Sunday morning is when they went to the floors. MethOD went down at midnight and people went on to paper charts, and they needed to go on to the floor after that and enter the paper information into Epic. So everybody kind of paired up and went back to their home unit to get their floors ready to go.
assignments so they could be freed up to help. If they weren’t able to not be on assignment, then the directors and managers stepped up and became the super-users on the floor. We had the “Pay it Forward, Pay it Back” program, which is using the nurses from the other hospitals. They came over and stepped in to help out. So if a floor was struggling more with staffing and didn’t have a super-user on a given day, then I’d try to put one there. Now they will be “super” super-users for their go-live. We are going to keep them in the loop of information and that they stay up to date with what’s going on. How helpful was it to have nurses as part of the Epic planning team? We had a core group of nurses from all the facilities, for the past two years, working on building the documentation part, which is the biggest piece. And seeing how well nursing adopted to Epic speaks to how well they put it together. I talked with other places and other people who had come in as contractors about what we had done to Epic so far – a lot of times facilities will come in and do a little customization but for the most part they keep the foundation. They stick to what’s there, like “let’s just get it in then we’ll start working on customizing it.” We went straight into customization. We had to remind people that this wasn’t MethOD and that we needed to figure out how to do it better in Epic. If there was a chance to improve the process, we were like let’s go ahead and improve it. We went really far, and I think that speaks to how well it was adopted because we tried to think of it before it happened. What kind of advice do you have for the other hospitals as they prepare to implement Epic?
We even had OR nurses come in, who don’t normally do this kind of work. Most of them worked on the night shift, and were so eager to help. Their go-live wasn’t until Monday when their patients came in, but we so desperately needed the help. It was very good to see.
Lessons learned – communication. Have more activities for superusers to keep them engaged while they’re waiting for go-live. People got really anxious. Give the details of what cutover will look like a little sooner so people can wrap their heads around it — step by step, this is what we’re going to do. People were worried the week before. There wasn’t enough time for it all to sink in.
What value do you think it had for nurses to be a part of this process?
What has the overall response been?
When it came to training super-users, we all started out at square one. It didn’t matter if you’d been there two months or five years. We made a really huge effort for the super-users to not have
I think overall it’s been well-received. They really like the fact that it’s all in one chart. It’s easier to find information.
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