My first blog post published back in 2014 was called “Three Days and Counting…” written as we approached a major Epic go live at Michigan Medicine. This week’s post could be called “Five days and 
counting….” as we approach our Wave 1 Epic go live at University of Vermont Health Network on Saturday 11/9.
We were originally scheduled for a 11/1 go live. But in mid-October after much deliberation with operations and IT leadership, our CEO, Dr. John Brumsted, made the decision to move the go live back one week. As he said in his communication to the entire organization, “This decision is in the best interests of our patients, our people and our Network. It gives us the time we need to get to a place where we are confident to go live and it allows users additional opportunities to prepare”.
Planning for the two-week 24/7 command center and support structure started a few months ago. With just five days to go, the plan is pretty much finalized. Highlights and some tips to share based on our game plan:
- Physical setup/location – Where your command center is located will depend on space available but ideally it will be in the hospital. We are fortunate to have primary and secondary locations at the University of Vermont Medical Center where we’ll have approximately 80 people. We will also have a triage team (to review and route the tickets entered online) and trainers (to answer “how to” questions) co-located offsite. In addition, we’ll have local support centers at each of the hospitals involved in Wave 1.
- Overall call flow and phone setup – We have a documented decision tree/call flow starting with the super users reporting issues they can’t address. Phones are programmed to route calls to the appropriate support staff depending on user role and/or application involved.
- Reporting issues – When you are dealing with thousands of issues, you need to use a common tool and standard process. We use ServiceNow and all tickets will be entered and tracked through this tool. Dashboards have been created for leaders to monitor ticket volume and trends.
- Staffing – A command center operating 24 hours a day for two weeks means people are scheduled for 12.5 hour shifts including time for handoff to the next shift.
- Leadership roles – Multiple leadership roles have been defined and scheduled for these same shifts. Roles include a physician and nurse leader from IT, someone to monitor ServiceNow tickets and trends, and someone to be overall command center leader.
- Huddles – There are huddles scheduled throughout the day for each operational area to review broad issues and trends that will then role up to the executive huddle at the end of the day.
- Communications – This is a critical function to embed in any command center. As high impact issues are resolved and trends are identified, communications staff will work closely with command center leadership to push out daily updates and specific tip sheets.
- Reference documentation for support staff – Wwith the intensity and pace of a major go live like this, you can’t rely on personal knowledge. Documentation will be available to all support staff and will be reviewed in advance to ensure everyone is comfortable with the plan and what is expected of them.
- Logistics – And last, but not least, don’t forget about food, parking and transportation arrangements.
Our command center and support plans for go live are well defined. They may not be perfect, but a lot of thought and preparation has gone into them. The key is to be flexible and adaptive as the days go by.
As I always tell my IT teams, we are part of the extended care team. While we don’t touch patients directly, the staff who do depend on the systems and support services we provide. This is never truer than at go live time!
Related Posts:
Crunch time and why IT matters
Plans, processes, people: lessons from a successful EHR implementation