Tag Archives: leadership

10 Go Live Command Center lessons from the field

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Week 2 post Epic Go Live has begun. We continue to learn and adjust. Building on my previous Epic Go Live and Command Center planning posts, there are more lessons to share.canstockphoto15204222 (1) keep calm

The last point in my most recent post was about camaraderie – defined as “mutual trust and friendship among people who spend a lot of time together”. I should add, in close quarters!

I continue to be impressed with the hardworking, dedicated IT team at the University of Vermont Health Network. I have seen many examples of teaching, helping one another and stepping up to new roles since the November 9th Go Live.

The rate of new tickets slowed down as Week 1 ended but the issues became more complex as expected. We have resolved over 65% of the tickets opened since cutover and addressed many cross cutting issues.

As promised, more lessons to share:

  • Handoffs between shifts – Ensure that key issues and work in process is reviewed and turned over to the next shift to keep things moving smoothly. Try to have people scheduled several days in a row for continuity vs on one day and off the next.
  • Seeing the “forest for the trees” – In the first few days, the focus is on closing tickets but as cross cutting issues and themes emerge, the focus needs to shift. As broad issues are defined, you need clarity on what teams and modules are involved, who is on point to lead the issue resolution, and what help is needed.
  • Escalations – It is very helpful to have highly engaged executives and operational leaders rounding and raising up the greatest pain points for users that need more focus. These escalations may come through in-person visits to the command center or email.
  • Ticket analysis – Have resources available who know the tool and can slice and dice the data to help leaders and teams see trends and where to focus.
  • Hospital daily huddle – If the organization has a daily huddle, the command center lead should attend. It’s good way to hear firsthand how all departments are doing and what their key concerns are.
  • Command center “walk-ins” – If the main command center is at the hospital you may get walk-ins – well intentioned users who want to escalate a specific ticket or issue. Command center leaders should manage this so the teams working tickets aren’t given conflicting direction on priorities.
  • Email management on steroids – Staff working tickets stay in the system and don’t watch their email. But leaders get a lot of emails and it’s hard to keep up given the pace. At the end of each command center shift, go back through your inbox to ensure that any escalations are dealt with – other email can wait.
  • Multiple locations for support – If there are a main command center and multiple other locations for support staff and triage, ensure they are well coordinated with good communication between.
  • Document management – Everyone involved needs easy online access to reference material. Dynamic information such as shift schedules need to be maintained. Having at least a few binders of printed reference information helps as well.
  • Ramp down plan – When you start adjusting command center hours, it will help to have a checklist ready on what needs to be considered and implemented (i.e. staff schedules, re-location of teams, communication to users, logistics like food and transportation, etc).

Stay tuned for more reports from the field….

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Epic Go Live – report from the field

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Many of you have been through a major EHR implementation and go live. I’ve been through them before as well. The teamwork of a go live is like nothing else I’ve ever experienced.canstockphoto16071239 (1) teamwork

There is the overnight cutover period that was practiced numerous times as “cutover dry runs” with the goal of making sure it goes smooth and can be done in the shortest time possible. After all, you are asking a hospital to go to downtime procedures until you can bring up the new system.

There is the excitement as others gather for the proverbial “flip the switch” moment. The applause and high fives for people who have been working hard towards this moment for many months. The appreciation from operations leaders on hand.

There is the wait for the first user calls and tickets to roll in. The wondering if all the planning for the command center and support structure was on target.

There is the settling in as ticket volume increases, teams start working them, and tickets start getting resolved.

There are the periodic reports from operational leaders who are rounding on the floors. They report on the pulse of staff who are dealing with a new system while trying to care for patients. They report on the issues that seem most problematic.

There is the dashboard monitoring to see which teams are getting the most tickets and whether adjustments in staffing need to be made. There is the ongoing review of tickets to ensure they are prioritized appropriately. Continue reading →

Leaders as mentors

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Since late May, I’ve had the chance to work with a new group of talented and committed IT professionals at the University of Vermont Health Network. Everyone is working hard towards a common goal with our canstockphoto13471338 (1) mentorupcoming Epic go live. I am impressed every day with the depth of knowledge, flexibility, resilience, and dedication of so many.

I’ve learned much from all of them and would like to think they have learned from me as well. I try to be a good role model in all my words and actions. But no one is perfect! With the pace we are all working these days, it’s a very dynamic environment. We’re heads down addressing issues and getting final tasks done.

If we really believe as leaders that our people are our greatest asset, then in spite of being in crunch time, we need to ensure we are modeling the right behaviors and fostering the kind of culture that people can thrive in. Hard as that may be on our busiest of days, we owe it to our teams.

In a few weeks, we’ll be working long shifts together in the 24/7 command center. There will be many issues to address and problems to fix. The stress will be high. But we will also be sharing the joy of having crossed the finish line together. I have been with this team on their Epic journey for only a few months. Most of them have been on this journey together for a few years. Continue reading →

10 best practices for project success

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It’s the final few weeks before our major Epic go live at the University of Vermont Health Network on November 1st. Yes, we have some parts of the project still in yellow or red status as of our 30 day Go Live canstockphoto19779100 (1) gearsReadiness Assessment (GLRA). But the majority are green (on track) or blue (complete).  I’m seeing many best practices that have us on a path towards success. Individual and team behaviors and practices that are worth sharing:

Flexibility – On any given day, you don’t know what issues you might need to deal with or what meeting you’ll have to add to your calendar.  Be willing to adjust as needed throughout the day and know what can wait for another day.

Raising issues – Don’t be afraid to raise issues that need resolution. Don’t assume someone else has more time or knowledge to handle the issue – be willing to take ownership if you can.

Utility players – You need generalists who can be put into a variety of situations to temporarily help. If you are one of these people, don’t hesitate to raise your hand when you see gaps.

Step up and lead – Leadership takes many forms. Even if you may feel unready, don’t be afraid to step in and fill a leadership gap if needed.

Cross coverage – Being dependent on one person’s knowledge and skills can create delays when that person is unexpectedly unavailable. Knowing who you can hand off to and having confidence in that person stepping in is critical to projects staying on schedule. Continue reading →

Project in trouble? Some dos and don’ts

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If you work in IT, you’ve probably seen your share of projects that need help getting back on track. I could share a lot of stories from my many years in IT in multiple organizations. The complexity and scale of what canstockphoto12827499 (1) dowe do in IT continues to amaze me. Drawing on that experience, I want to share my tips on what to do and not to do if you find yourself taking on a troubled project.

What to do if you want to ensure success:

  • First, stop the churn
  • Get up to speed on the project scope, issues, and challenges as quickly as possible
  • Seek to understand enough of the past to inform the future
  • Focus on getting the project back on track and moving forward
  • Figure out who’s who, what their respective roles are and who owns what
  • Assume positive intent
  • Show respect and gratitude for all involved
  • Ensure all issues are surfaced, assigned to an owner for resolution, and tracked
  • Remove obstacles as they arise
  • Be transparent with leadership about the status and issues
  • Track progress using key metrics
  • Use daily huddles to ensure team members are on the same page, focused, and raising issues
  • Manage expectations for all involved and impacted
  • Document decisions so you don’t have to revisit or rehash them later
  • Consider what levers you can pull such as timeline, resources, budget, or scope
  • When you can’t change the timeline, be ruthless about scope changes
  • Keep calm – reduce team stress, diffuse conflict, and avoid finger pointing

And some tips on what not to do: Continue reading →

What’s the why?

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Yet another best practice from my IT colleagues at the University of Vermont Health Network (UVMHN). We emphasize “the why” in all our work and communications. From the updates on our upcoming Epic go canstockphoto4362942 (1) the whylive to agenda topics to user communications about scheduled downtimes, explaining the why helps everyone understand the context and reasons for what we do.

Our University of Vermont Medical Center (UVMMC) Chief Nursing Officer, Kate Fitzpatrick, reconnected us all to “the why” again at our IT All Staff meeting this week. With about 70 days left until go live, she spoke to the staff who are working long hours to implement a common, integrated EHR throughout the network.

She drew on the stories that were part of the Green Mountain Care Board Certificate of Need (CON) presentation when UVMHN first got the project approved.

Those stories were like those of every other healthcare system with a regional reach that cares for their patient population through integrated and coordinated services provided by an academic medical center and community hospitals. A common patient health record accessible by clinicians at all care locations.

I remember when my daughters were very young. Continue reading →

Hate has no place

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The most recent horrific mass shootings are not due to video games, the Internet, nor mental illness. There are more guns in the United States than people. Let that sink in.canstockphoto45815739 (1) no hate

Hate speech, racism, and white supremacy exist and are tolerated by some of our elected leaders who are supposed to keep us all safe. Let that sink in.

This is not who we want to be as a country. It is time for responsible, moral leaders to act.

I am saddened and outraged yet again by the mass shootings in El Paso, Dayton and Gilroy. We have seen hate target Jewish people at worship in Pittsburgh. We have now seen hate target Hispanic people shopping on a Saturday. These are people like you and me who go to stores, festivals, and churches like you and me.

I have no new messages. I have said it all before in one way or the other.

I wrote about every day racism last year after stories surfaced about incidents at a Starbucks, an Airbnb, a common dormitory room, and a college tour: Teaching moments – every day, everywhere

I wrote about the inhumane treatment of immigrants at the border: Heroes among us: pediatricians

I wrote about the strength and leadership of the Parkland students who started a national movement for gun reform after a mass shooting at their high school: What will you speak up for? and This can’t be the new normal

I wrote about gun control after the largest mass shooting in this country at a music concert in Las Vegas: When can we talk about it?

I wrote about the mass shooting at the Pulse nightclub which targeted gay people: Who do we want to be?

I wrote about what I want for my grandchildren as I watched a gun control debate back in 2016: On being a grandparent

And I wrote about the need to build bridges as I listened with both sadness and fear to the divisive rhetoric during the 2016 presidential election: Build bridges, not walls

We must speak up for love and justice every chance we can. We must challenge those who hate and divide us as a people. And we must vote for the kind of leaders that we are willing to trust the future of our children and grandchildren to. Please join me.

IT takes a village

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GLRA is an acronym recognized by anyone who has been through a large-scale system implementation. Spelled out it is Go Live Readiness Assessment. It is typically done at the 90, 60, and 30-day mark before canstockphoto16594838 (1) hands puzzlea go live. At the University of Vermont Health Network (UVMHN), our 90-day GLRA for Epic Wave 1 was this week.

Dr. John Brumsted, UVMHN CEO, kicked the day off with a powerful message on how important the Epic project is to the network and our patients. He talked about why we are doing this for the region that includes six hospitals, a medical group, many ambulatory locations and home health and hospice in both Vermont and New York. He set realistic expectations saying it wouldn’t be perfect and there would be issues. But he expressed confidence in the project, and everyone involved in making it a success. His presence for a good portion of the morning spoke volumes about his support for this massive initiative and appreciation for all involved. The network CFO and the University of Vermont Medical Center (UVMMC) president, CNO, CMO and VP for Medical Group Operations were also there for a good portion of the morning.

Dr. Adam Buckley, UVMHN CIO, followed Dr. Brumsted by talking about how the journey to a common, fully integrated EHR began back in 2013.  A journey that included a Certificate of Need (CON) review and approval by the Green Mountain Care Board. He too set realistic expectations about how many tickets we’ll have at go live just like every other major EHR implementation around the country and thanked the interdisciplinary team involved.

Lori Boisjoli, UVMHN VP Application Portfolio, then framed the day for everyone. The morning would be focused on the UVMMC with revenue cycle and the full suite of specialty modules going live. The afternoon would be focused on the three affiliate sites where ambulatory clinical and revenue cycle are going live. She highlighted that GLRA is the time to raise any significant issues and risks so project leadership can capture them for follow-up. Continue reading →

Good intentions – a midyear checkup

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Remember those things called New Year’s resolutions? Do you make them? Do they last past January? At the start of 2019, I stepped back and did some soul searching (sounds deeper than it was!) and came canstockphoto9123549 (1) calendarup with three broad “intentions” rather than resolutions. They are balance, passion, and engagement.

By balance I wanted to figure out how to make my goal of working closer to three quarters time rather than full-time a reality. Being two plus years into our business, StarBridge Advisors, I was working much more than I initially intended. One of my goals when I stepped off the permanent CIO track in early 2016 was to have more flexibility in my career and work more like three quarters time over the course of the year. When I do an interim engagement, it is obviously a full-time commitment but then there are breaks in between.

So, in January, I decided I would be more intentional about scheduling down time. A great way to do that each week was to block off Tuesdays when I could and spend them with my daughter and two grandkids as that was her day off each week as a nurse practitioner. We had many fun Tuesdays together.

Since I said “yes” to another interim engagement in May it’s been more like having two full-time jobs considering how busy StarBridge Advisors is these days. Evenings and weekends are very full to say the least. A good problem to have for anyone with their own business! But I need to get back to a better balance during this period. It’s a work in process for sure. But I am loving the work I’m doing these days and the people I’m working with.

By passion I wanted to focus some time on developing next generation leaders which has long been a passion of mine. I’d been thinking about an idea for some time focused on developing next generation women leaders. Continue reading →

Modeling leadership, empowering others

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I had the opportunity to meet all the IT interns at The University of Vermont Health Network this week. Several of them are working on infrastructure teams that I am now responsible for as the interim Chief Technology c change key image update right align 2Officer. They are all excited to be working with us, learning and contributing.

When it was my turn to introduce myself, I told them I’m committed to developing next generation leaders and am happy to make time to meet with any of them this summer if they want to talk and get career advice. My days are busy, but I hope at least some of them take me up on the offer. I will find the time.

We all need role models and people who are willing to help us develop and grow professionally. Female leaders in health IT represent only 30% of senior leadership so it’s not yet a level playing field. With our StarBridge Advisors C-change service, we focus on developing women leaders in health IT through online courses and coaching.

On June 18, Gale Thompson and I will be presenting a webinar, “Develop Women Leaders, Transform Leadership” as part of the HIMSS Women in Health IT series.

The learning objectives are to:

  • Recognize that you are not the only one struggling with how to be effective, successful, and fulfilled.
  • Learn how you can make foundational shifts with intention to craft the leader you want to be and the life you want to live.
  • Discover clear, thoughtful steps you can take to steer your career progression while attending to your personal and family commitments. Explore ways you can be proactive in getting what you need/want both professionally and personally.
  • Learn to give yourself permission to invest in your own well-being and leadership growth and commit to taking that next step.

For more information or to register for the webinar, click here.

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