The Healthcare IT staffing challenge

One of the most critical success factors for your Healthcare IT implementation will be the staff you have working on it.

Whether drawn from the wider organisation to support the implementation, added new from outside organisations or recruited directly or your existing IM&T team – the quality, skill set and dedication of these staff will be critical to success.

Whether you are just thinking about your EPR/PAS strategy, considering growing what you have, replacing it, taking a major step forward, writing the business case, procuring – whatever stage you are at – how do you know what and who you need to resource up your team to deliver successfully. How do you know how much it will cost? And how do you know it’s the right shape of team?

There have been numerous EPR/PAS implementations in recent years in the UK. Some have gone reasonably well, some have gone less well. We know that whatever the level of success and smoothness at go live, it will be hard, it will be challenging. It is such a cultural change to your organisation. It’s not just an IT system, but a change to the way you work, a change to how things are done. And the further and faster you push the clinical elements of the change, the greater the challenge, and the increased risk that something will go wrong.

So how do you know who you need to deliver a successful EPR/PAS implementation? How many software integrators? How many help desk staff? How many training staff? The range of staff is wide – how many you need is harder to predict, and often based on others lessons learnt, your experience – even guesswork as to what “feels right”. All of these are valuable, but are they the best way?

The further you can move along this line of knowledge, the more you can predict, the more you can know in advance, the greater your chance of success. You can also build more into your business case, and make this more accurate – should your organisation choose to take resource out, then they will clearly see where the risk increases.

It’s not just staff in the IM&T team either. What about the additional resources that may be required in administration areas such as outpatient receptions during go live? Or after go live? Will the new system really be quicker, or will it actually be slower with a higher quality of data, but taking more time to do? What about the call on clinician’s times? Will doctors spent more time noting, like their GP colleagues have for some time? Will nurses take longer to record observations electronically? Will this be a temporary “blip” at go live, or will it be a permanent state of affairs?

Then there are the very specific local factors to consider:

  • Are you a small, single site hospital, or a large campus, multi-site operation?
  • Do you have numerous community hospitals and basis or are you largely contained in one geographical location?
  • Are key areas such as theatres in a single block or two, or are they spread out across the site, or even across multiple sites?
  • To what level are you planning to push the PAS and EPR elements at go live? Are you doing a lots of new clinical functionality day one? Do you plan on going live with a big bang approach or a phased approach? Is it a long phased approach or short over a few weeks say?

All these factors and more need to be taken into consideration when arriving at the right result – when reaching the point where you know that you have the right number of staff too, in the right places, at the right time, to deliver a successful implementation and then sustain that success to drive out the benefits.

The Ideal Solution

Drawing on a wide range of research, experience, lessons learned and constantly up dating its learning and understanding, Ideal has developed an approach that enables you to better forecast and estimate the level of support you will require to achieve a successful PAS/EPR implementation.

The elements of this approach are:

  • Draw on research, as per earlier examples, to benchmark, test and validate thinking around resource levels.
  • Utilise the extensive lessons learned experience from across the UK, and our own direct experience of being involved in many of those implementations, to bring “what works” to the table.
  • Consider all specific influences on your organisation, such as whether you are community based, hospital based, multi-site, IT maturity of workforce, etc.
  • Consider the phases of the programme and the phasing of staff across the programme.
  • Develop the right resourcing model for you, based on our budget and affordability.

Ideal can engage at any stage of your programme – we prefer to engage as early as possible. Engaging around the resource modelling before you have finalised your business case, reduces the likely constraints of engaging post business case. The business case can be very accurately informed, and issues of risk, constraint and “stress points” better understood and managed, by the team, organisation and the Board.

However, the modelling still works post business case, and indeed post procurement; these are just further factors to take into account when building the resource model for your implementation.

We bring our experience to bear about creating the right team.

  • Appropriate governance structures to oversee the programme and the requirements on the time of your most senior people.
  • Who will run the programme, clinical and operationally, and who will make up the project management support required?
  • What staffing is needed as you move through the phases – mobilisation, project set up, build and configure, go live, and then business as usual.
  • How much change are you doing or how much is just replacement of existing functionality? What new things will people need to incorporate into their daily work and what does this mean for this current roles and jobs?
  • How will you ensure you continue to get paid, that your data quality is maintained, and that you have the reporting capabilities that you need?
  • How will you continue to absorb the normal operational and clinical changes demanded by the organisation, and at the same time manage the implementation of the new system(s)?
  • Can you phase the implementation to reduce costs, and reduce risk?
  • How are you structured as a Trust – are you single site or spread across multiple sites? Do you have the same level of IT infrastructure and support in all locations?
  • What training will your IT team need and what about the wider workforce? Are there many basic requirements to be met before you can start training on the new system? And how do you go about integrating the new workflows into your business?
  • Can we use existing programmes of change that can be utilised to deliver some of the change needs or do these programmes need starting from scratch?
  • And what support will you require “at go live” and to ensure you smoothly transition to the new system?

We are able to offer a range of tools, experience, detailed analysis and review to work with you to draw up the right resource solution for you – but a key advantage is that we are not starting from scratch – we know what works in many areas, based on evidence and experience – we also know that each organisation is different, and so our model can be flexed to meet your needs. Some of the classic resource models for EPR/PAS implementations too inflexible. It’s not enough to say “put some numbers in, and some numbers come out” – this does not take account of your specific requirements, or your specific needs and constraints.