Now that the fog of implementation has lifted, what are the next steps you can take to ensure that the specialties you support run efficiently? Do the services have all the necessary tools, and, more importantly, are those tools working optimally? Where do you even begin? There are probably numerous issues discovered during the implementation phase that slipped through the cracks. How do you prioritise the task list that has come out of this implementation? The next upgrade cycle is around the corner with additional functionality and improvement; however, it comes with additional notes to review and build.
Governance Structure: Have a good Governance Structure in place.
The success of every project relies on stakeholder engagement throughout the project, and the optimisation phase is no different. Having a small sample group of clinicians and users from each specialty that you support can help drive the successful optimisation of the system. Now that the users have full access to the system and use it every day, they might have identified workflow or configurations that are not working for them. Having a lead analyst responsible for said specialties can also help translate the needs and wants of the group. Analysts can run searches in the system to identify utilisation, see where gaps persist, and bring this to the attention of the Governance group. Collation of these lists, along with advice on priority setting, is the ideal way to build a priority list. Schedule recurring meetings with the Governance group so you can check in frequently and define clear goals and processes for meetings before they start. It is also ideal to communicate optimisation project timelines with this group to get buy-in.
Specialty Workflows: Specialties like, but not limited to, Cardiology, Orthopaedics, and Surgery derive good benefit from a focused post-go-live optimisation phase. Services have many unique workflows and nuances that can sometimes be missed during an initial go-live. The volume of patients seen in specialties can be higher, bringing additional focus on efficiency and optimisation that can be achieved in Epic. Going over all the individual workflows, and removing any documentation and ordering redundancies, has proved to be helpful. Removing or hiding navigator sections, activities not is use; Smarset review and order panel customisation are some things we have noticed that add a lot of value to the clinician workflow. For clinicians seeing patients in specialties like Internal medicine, express lanes add a lot of value. Creating specialised workflows with targeted documentation during flu or allergy seasons can also optimise workflows. A focused effort to gain efficiencies in all these workflows can help streamline and speed up visits significantly.
Doctors in training: If your organisation runs teaching programmes, running an optimisation phase explicitly focused on doctors in training can be beneficial. As the trainees rotate through specialties, optimised workflows created for them can translate into successful documentation for the patients they round on. The optimisation phase is also a good time to review the sign-off process for notes and orders and ensure it is seamless and goes to the right clinician at the right time.
