Nurse Implementation Trainer

Creative EMR Solutions: Neighbor Nurses and Students as Go-Live Support

I’m convinced that going live with new or upgraded systems gives some providers at least half of their gray hairs. The months of implementing a new system, particularly a new EMR, are the months that health system most needs to go right but ​feel the most unstable. After all, KLAS’ Arch Collaborative research has shown that initial EMR training is ​a top predictor of EMR user satisfaction.

I get stressed just listening to my provider friends talk about go-lives. However, I also love hearing various ways in which these leaders get creative as they prepare for and face their go-lives.

For example, I recently spoke with a provider friend whose organization tried several new things during a recent implementation process. Someone on their nursing team brought up the first idea, “We’re surrounded by hospitals that use the same EMR we’re implementing. Why don’t we get some help from nurses at those facilities?”

Neighbor Nurses

This suggestion sparked the leadership’s interest. Before long, the hospital had solicited more than 60 nurses from nearby hospitals to provide go-live support. These nurses participated in an orientation and were told about unique aspects of the hospital that could affect the physicians’ workflows in the hospital’s new system.

I have to smile at the wisdom of this organization’s idea. Not only had the neighboring nurses gone through training on the EMR before, but they also had invaluable experience with using the software in their everyday work. These nurses must have carried a special kind of authority as they supported my friend’s physicians during the hospital’s go-live process. The data also bears out that training done by a peer often goes much more smoothly than training from a non-clinician.

Local Students

The hospital reached even further outside of their employee circle, to local university students. This may sound strange or even harebrained to some, but it’s hard to argue with results. First, the organization gathered and vetted over 100 interested candidates, focusing on the IT and HMI students - interviewing the candidates one by one. The best students were then selected and went through beta training with the hospital clinicians.

This setup was brilliant for several reasons. For one thing, the hospital offered internships or practicum experience to many of the students they’d chosen. This was an inexpensive option for the hospital and a remarkable opportunity for the students, who got to add real-life, in-the-trenches experience to their résumés.

The students were wildly successful in training and supporting the hospital’s physicians. I imagine the students’ recent education, youthful energy, and familiarity with technology made them the kind of trainers who could help ​more experienced physicians. And as single-task interns, they could dedicate all of their attention to facilitating a great go-live.

To top it all off, several of the students were even hired by the hospital at the end of their internships. The hospital would never have been able to find and groom this talent if they hadn’t been willing to try an unconventional idea for go-live support.

The Power of Creativity

HIT leaders feel immense pressure to do everything possible to smoothly direct their implementation and go-live processes. Most of them probably believe that strictly following best practices is the safest—and they’re right. But how we define those best practices can make an interesting difference.

Organizations that feel compelled to copy their neighbors’ exact procedures to a T may be limiting themselves. The number of resources to bring in and where those resources come from are aspects too specific for every organization to follow successfully. The true best practices for go-lives aren’t logistics—they’re things like providing effective training and creating a positive culture.

My friend’s successful go-live proves true the following quotation attributed to St. Augustine: “In essentials, unity; in non-essentials, liberty[.]” Once an organization’s HIT leaders have settled on their essential goals for a go-live, they should seek as much feedback and ingenuity as possible in choosing the methods of accomplishing these goals. Whether it’s through inviting students to be your teachers or another innovative idea, let creativity make your next implementation a success.