Goodbye to old habits
The healthcare platform will give healthcare personnel, patients and their families better and easier access to information, as well as improving the treatment of patients on Zealand.
Interview with Søren Truelsen, subprogram manager, implementation, through ProData Consult
But first, healthcare personnel in the Capital Region of Denmark and Region Zealand will have to adjust to an entirely new way of working. Because the new IT solution will change the division of labor currently prevalent at the hospitals. As Søren Truelsen, subprogram manager for implementation at Region Zealand, explains:
“It’s not an easy task: We’re changing traditions and attitudes which have a big influence on the day-to-day work of the personnel and which have existed at the hospitals for the past 50 years.”
Breaking with old habits
When the five hospitals of Region Zealand go live with the healthcare platform in late 2017, the healthcare personnel of the region will see the world through a different lens. The standard approach to change management is to provide information and assume that the next step will be acceptance. If this doesn’t happen, the advantages of the new solution are highlighted. But the healthcare platform presents a greater challenge, because it changes the division of labor among the hospital’s professional groups, which means that they have to change habits developed over decades of work and organization. For example, doctors will no longer be able to sit alone and dictate information and later ask the secretary to update the patient’s journal. Now the doctor will have to document information in an online journal while in the presence of the patient. This is the greatest challenge. The workflows of the healthcare platform are based on the principle of recording data where it is generated, which requires a major change of attitudes in relation to the division of labor among professional groups at the hospitals. As Truelsen explains:
“It’s about challenging habits, for example when we need to convince a doctor that it makes sense for him or her to perform documentation in the presence of the patient. We can take the first steps along that path and communicate why the workflows make sense, but it’s going to take years to get everyone on board.”
The first results from the hospitals in the Capital Region of Denmark indicate that while younger doctors are more willing to rethink the division of labor and how they perform their work, the healthcare platform pushes every-one out of their comfort zone. Naturally, some doctors question why, considering their time costs more, they are being required to perform tasks their secretaries usually handle, with the result that they may have trouble treating the same number of patients, at least until the new workflows have become routine. These arguments must be addressed, in addition to the question of the new working relationships among professional groups. However, this is not done during the implementation phase, where the focus is on ensuring stable operations.
“A lot of new conditions can be prepared and planned, but we can only see where behaviors are taking place after the system goes live, so this is when the change management process really takes off,” says Truelsen.
On many projects, a few people determine the strategy for a change process, and selected key stakeholders are involved. The healthcare platform is different: a complex puzzle with a huge set of stakeholder pieces. This makes it impossible to simply set a course and command everyone to march in the same direction. Region Zealand is one of just three principal stakeholders, and must cooperate with the hospitals and the program steering committee - in addition to all of the cross-regional functions. All have stakes in the project: from the financial administration department and personnel law to PFI, a cross-regional center which supports the entire organization and contributes to setting a strategic direction. As Truelsen explains:
“The implementation project can’t simply decide how the implementation is going to proceed. We have to bring the relevant stakeholders from a wide range of focus areas together to make sure that we create consensus and share a common approach. Because after all, the goal is precisely a uniform and standardized implementation at all of the region’s hospitals.”
Fewer glitches - more opinions
The Capital Region of Denmark is implementing the system first, while the hospitals in Region Zealand will first get started in earnest in November 2016. This is an advantage in relation to smoothing some of the glitches out of the implementation before the start gun sounds in Region Zealand. At the same time, delaying implementation also creates some challenges.
“It’s a lot harder to manage the communication aspect when the opinions of the personnel are being influenced by public debate and the opinions of professional organizations in the media. This is not the kind of change management communication we’re used to. One question is when to start, and another is whether Region Zealand should have an opinion about the Capital Region of Denmark – this is another huge challenge,” says Truelsen.
The goal of the implementation team is to provide the most nuanced possible information about the functionality of the healthcare platform. At the same time, the various professional groups need to know that the system they are using isn’t necessarily the final version. The new healthcare platform is a dynamic, flexible system, and many adaptations can only be made after the individual specialists have gained hands-on experience and familiarized themselves with the many new possibilities offered by the system. As Truelsen describes:
“We need user experiences, after which we will definitely find things in the individual specializations which can be improved. This is taking place right now in the Capital Region of Denmark at Gentofte and Herlev Hospital, where they’ve been working with the system since May.”
Only necessary information
However, the major challenge is ensuring a holistic, cohesive approach across the entire organization, even while the implementation team immerses itself in different silos in connection with the daily tasks of the process. What motivates Truelsen are the people in the project: the healthcare professionals at the hospitals need to know what is expected of them, and how they will perform their jobs in future. For this reason, Truelsen’s goal is to provide only the absolutely essential information about the implementation process, while at the same time providing a clear picture of the future operating situation, in order to allow personnel to understand and discuss the new situation prior to startup.
“It’s such a big change, and there’s so much at stake. Just working together on the project is a complex challenge, but it’s exciting to be a part of, because the healthcare platform can ultimately make a big difference for patients. It’s not an easy solution, and it won’t be optimal from day one, but it’s a historic project which will change the foundation for providing better and more effective treatment going forward.”
3 valuable project management tips
1) When managing a project of this size, it’s extremely important to have structure and governance in place from day one.
This allows everyone in the project to avoid a lot of confusion, frustration and discussions of how the setup should work. That said, there are usually political interests which must also be taken into consideration, and these aren’t dealt with just by having your governance and structure in place.
2) You have to quickly create a shared understanding of what the overall project is about.
Almost all major stakeholders want the big picture: what the project means for them, what implementation tasks will affect them, and so on. The picture is constantly changing, so it’s difficult to give them an overview from day one. At the same time, there’s a lot of information which isn’t available, because the healthcare platform is under implementation at the hospitals in the Capital Region of Denmark and won’t formally start implementation in Region Zealand until November. You also need to remember that we are becoming wiser along the way. The healthcare platform is constantly being improved through the experiences gained at Gentofte and Herlev Hospital, and the implementation concept will be evaluated and adjusted along the way.
3) When you have a large, complex project with a lot of people from a lot of organizations working together, breaking down and delimiting tasks into a manageable size is a necessity.
When communicating how the project is to be performed, ensuring coherence and cohesion between the individual components is a challenging necessity.
Søren Truelsen’s responsibilities on the healthcare platform project
Søren Truelsen is subprogram manager for the overall implementation of the healthcare platform at Region Zealand’s four hospitals, psychiatric institutions, hospital pharmacy and five self-governing institutions. His subprogram includes four focus areas:
- Readiness and change management
- Training and support
- IT and technology
- Internal and external communication
Name: Søren Truelsen
Education: MSc in strategic management
Title: Subprogram manager, implementation
Experience from Capgemini Sogeti, Arthur Andersen and other major consulting firms.