AHIS Presentation with Capital Health

1
Changing Gears
Lessons Learned Implementing Large Projects in
the Health Sector Presented by Natalie
Klaus-Capital Health
Stephen Abbott-Bell Aliant
2
Capital Health

• Capital Health is Nova Scotias largest provider
  of health services, and a hub of learning and
  research.
• We operate hospitals, health centres and
  community-based programs throughout HRM and
  Western Hants County, and provide specialist
  services to the rest of Nova Scotia and Atlantic
  Canada.
• We are 11,000 employees, physicians, learners and
  
• volunteers providing
• Medical and Surgical Care
• Mental Health Care
• Community Health Programs
• Public Health Services
• Addiction Prevention Treatment Services
• Environmental Health Services

3
Bell Aliant Family
4
Setting the Stage

• Telephony environment
• PBXs that were no longer supported and
  replacement parts could not be found
• 4 digit dialing was location specific
• 9 voice mail systems that were stressed
• Running out of locals at the QEll site
• The challenge
• Upgrade 10 hospital locations
• Open a new ER with a Distributed IP Capable
  Telecommunications Solution
• Introducing a 7 digit dialing plan
• Implement a centralized voice messaging service

5
Setting the Stage

• All with little to no impact on patients and
  hospital operations
• Try adding the increasing threat of an H1N1
  Pandemic along with sporadic crime family
  shootings and a correctional facility riot
  resulting in unannounced hospital lockdowns.

6
Project Scope

• New Emergency (5 years from Conception to
  Opening)
• Part of the 10 part plan Department of Health
  Plan
• Over 20 million dollar spend
• 1.6 million dedicated to equipment
• PBX Upgrade
• Timelines
• Planning began 2007
• Estimated completion date is October 2009
• 10 PBXs 9 Sites
• Centralized Voicemail
• Introducing 7 Digit Dialing
• QOS Network (Private SIP Trunking)
• Introduction of VOIP (Wireless ER)

7
Managing Change Control

• Formalized well defined change process for
  changes in scope
• All users believe their request are the most
  important!
• Prioritization
• Escalation
• Ensure all of the points of escalation are well
  documented and have a well documented process
  within the Team for escalation
• Budget Considerations
• Plan for contingency
• Timeline Impacts
• Expect the unexpected and plan for those
  situations that arise-construction delays,
  weather events etc.

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The Solution
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The Benefits

• New PBX Technology
• Replaces antiquated unsupported technology
• Quicker call handling, greater capacity, greater
  redundancy
• Opportunity to introduce Centralized Services
• 7 Digit Dialing
• Addresses Future Growth
• Improved numbering scheme
• Future Reductions in LD costs (IP Network)
• Centralized VM for all Capital Health Employees
• Replaces 9 Voice Messaging platforms
• CDHA Broadcast Messaging
• Reduced calling costs (using VM)
• IP Capable supports future VOIP Applications
• Future cost reductions (virtual MACs)

10
Slow Start, Rough Start

• After a significant delay in starting the
  Telecommunications
• Program coupled with a less than passing grade on
  our first
• attempt at upgrading a major hospital location
  it was time to
• introduce more rigor, regimen and make it
  right.
• Building the Right Team
• Introduced Program Management
• Introduced Governance Model
• Implementation Approach
• ITIL Best Practices for Service Delivery
  Support
• Contingency Management
• Business Change Management

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Building the Right Team

• Understanding skills required to tackle such a
  large implementation
• Planning
• Execution
• Knowledge and Experience
• Do not under estimate resources required in the
  planning stage
• Construction drawings.not all people work well
  from drawings use mock-ups 3 dimensional images,
  site visits etc.
• Partnering with a Vendor that has the numbers and
  depth of resources for all situations

12
Program Management

• Applies a Governance Model approach
• Single Point of Interface with Customer
• Coordinates Partners Deliverables
• Direct access to Steering Committee
• Issue Management Escalation/Resolution
• Manage/Mitigate Scope Creep
• Centralized Risk Management Mitigation
• Comprehensive Updates Regular Reporting

13
Governance Model
Program Sponsor CDHA Director
Joint Program Steering Committee Bell Aliant
Steering Committee plus Capital Health Steering
Committee
Program Manager Bell Aliant
Program Manager Capital Health
Vendor/Partner Involvement
Solutions Architect Solution Developer, CSE,
Engineers
DAY 2 Operations
User Migrations Project Manager
Hospital Implementations Project Manager
Emergency Room Implementation Project Manager
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Recommended Implementation Approach

• Break project into small milestones
• Document and validate assumptions continuously
  throughout the project
• Well defined Team structure and contact lists
• Secure Resources (competing projects)
• Locating
• Vendor Support
• Senior Resources
• Contingency (People, Process, Technology, )
• Downtime Procedures defined
• Dry Run (New ER) invaluable feedback tool)

15
ITIL Best Practices

• ITIL incorporates industry standard Best
  Practices
• Processes Procedures for ICT Service Delivery
  Support
• Creates cooperation and understanding of
  deliverables as activities move from
  Implementation into Production
• Prescribes a single, definable, repeatable and
  scalable processes that span departmental
  boundaries
• Release Management
• Change Management
• Configuration Management
• Incident Management
• Service Level Management monitoring, measuring,
  reporting

16
Contingency Operations

• You simply cant shut down hospital operations,
• however you can operate critical operation units
  and at
• a reduced capacity at the right times.
• Business Change communications during migrations
• Implementing Red Phones (always on) for critical
  areas and 7/24 operations (redirecting lines)
• Redirecting non critical operations to
  centralized off-site answering services
• Implementing Cell Phones as back up and for
  mobile workers performing multiple roles.
  (redirecting lines)
• Switch Translations (timing is everything)

17
Business Change

• Its not enough to execute smoothly on technology
  
• changes implementations people need to know
• who, what, when, where why Changes are being
• introduced.
• Advanced Communications
• Site Prime meetings, negotiations and
  clarifications
• Reinforce change impacts, response and benefits
• Training, FAQ Guides, Broadcast VM, Corporate
  Intranet
• Follow-up post cutover
• HD Scripts, Broadcast VM, Corporate Intranet
• Provide access to experienced users-Vendor Support

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Communications

• How much and when?
• Just in time and consistent
• Ensuring all stakeholders are informed
• Include patient input where feasible
• Downtime/Move procedures
• Face to face instruction for high impact areas
  ER

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Questions