By Don Martin
Introducing integrated smart infusion pump technology management into the clinical environment to drive medication safety measures is a strong step toward achieving – and sustaining – patient safety and quality outcomes.
In our case study “The Smart Approach to Smart Technology”, we discussed our collaboration with one of the nation’s largest non-for-profit healthcare systems to upgrade its aged fleet of Large Volume Infusion Pumps (LVIP) with newer generation units. These newer “smart” units are supported with medication safety software, orders integration, EMR documentation integration and RFID-aided asset management capabilities.
As the first healthcare organization in the nation to take a “Big Bang” approach to implementing this range of functionality and technology, the organization faced several challenges that required innovative and creative thinking – and a large dose of enthusiasm.
In this series of articles on the smart approach to implementing Smart Technology, I’ll share valuable insights and lessons gained working alongside our client as they met those challenges – lessons that may help other organizations embarking upon similar patient safety initiatives. In this first installment, I’ll discuss some key foundational aspects of implementation planning your organization should carefully consider as you begin pre-implementation activities.
1. Begin with the end in mind
Create the vision and guiding principles that will drive your organization to the desired outcomes you want to achieve. Memorialize these principles in your project charter as well as in a multi-year strategic plan to guide implementation and post deployment optimization.
For our client, a guiding principle and desired outcome was to have metrics in place on Day One following activation supported by actionable data available to nursing staff to measure progress toward safer medication practices. This led to developing the integrated system, purchasing the appropriate software and ensuring the selected LVIP could support both. As a result, nursing managers now efficiently take high level compliance information and with the push of a few buttons, drill down to the actual instance and identifying the potential causes of the near miss. And they are able to trend the data and show compliance over time. This is one example of how beginning with the end in mind will lead to successful outcome.
Other insights gained from our experience include:
- Senior leadership should revisit the project charter regularly with the project team and organizational stakeholders to avoid losing focus and footing as you proceed through implementation.
- Take measures early in your pre-implementation planning activities to monitor and assess your organization’s willingness and readiness to embrace the clinical and operational changes this smart technology will bring to them. Continue to assess your team throughout activation and post-implementation.
- Be careful not to misinterpret successful technical implementation progress as a sign your clinicians have made the transition to successful adoption. If you do not see the signs of growing pains among your staff as they prepare for this transition, it should raise a flag that they are not readily adopting the changes and opportunities this technology delivers.
2. Preparation is key
Every project manager will tell you that thorough preparation is the key to successful project execution as it moves from conceptual development to device deployment. In an ideal setting, preparation begins with establishing a solid governance structure and lines of accountability prior to establishing a selection committee for new devices, software and technical infrastructure.
One of the key milestones during the planning phase includes plans for a thorough impact analysis, which should be on file in advance, and leveraged during the early phases of the due diligence process. One lesson we learned first-hand is the importance of ensuring the project team engaged for the RFI process has access to key documents such as the project charter, business needs analysis and feasibility studies.
3. Mapping the implementation course
The formation and adoption of a clear implementation strategy at the project outset will provide the project team and key stakeholders with the necessary vision to successfully navigate a project of this scope and complexity. In this instance, our client’s leadership adopted the following strategic approaches at the project outset:
- Map your implementation course to access organizational need and readiness with emphasis on safety and operational imperatives. In particular, investigate all areas of drug administration and look to expand the scope of pump integration to your entire line of infusion practices, including those that are done without technology (e.g., small volume, push, titration, free, flow).
- Facilitate client and vendor collaboration with emphasis on total cost of ownership, impact on operational costs, and nurturing vendor partnerships aligned with broader sourcing strategies. Develop and foster broad, inter-disciplinary organizational engagement and commitment with focus on the drug library build and governance structures.
I look forward to sharing more insights and lessons learned in the next series installment.