Pre-Live Super User

1
Pre-Live Super User and Managers Briefing 
You can download a copy of this Presentation at
http//my-ehospital.org/support/information-super
-users
2
Agenda and Introductions
Executive welcome Introductions and
check-up Briefing Q A
3
How are you getting on with becoming Super?

1. The 'Art of being a Super User' guidance booklet 
2. Your eLearning modules 
3. Your Electronic Patient Record training
4. Sitting in as a 'classroom assistant' on further
   training
5. Further eLearning modules 
6. Practice and embed your new skills in the
   'playground
7. For doctors and clinical nurse specialists there
   will be personalisation labs
8. Participating in Dress Rehearsals 
9. Attend a pre-live Super User/Managers briefing
10. Keeping up to date

4
Information for all staff
Payslip attachment
Staff QA session(s) eHospital Times
5
Super User / Management Briefing what well
cover
Goals for Support Overview of Support What is the
Bronze CAM (eHospital Command Centre) Roles and
Responsibilities Be a Great Super User Zone
Support How to engage your Floor
Walkers Prioritising Incident Tickets Reporting
Options and Online Ticket Entry Patient
Safety Overview of Cutover Operations Issues
Bronze, Silver, Gold Command (Major Incident)
You can download a copy of this Presentation at
http//my-ehospital.org/support/information-super
-users
6
Go Live Support Goals

• Smooth transition from the current processes to
  Epic
• Solid Epic readiness
• Appropriate plan/processes/structure for managing
  transition
• Solid end-user and physician support structure
• Identify and manage issues
• Timely response to issues
• Maintain strict Change Control process
• Communicate to the organisation and our peers
  appropriately
• And, above all
• Minimise the risk to patients, as well as the
  organisations operations by providing quality 24
  x 7 support and transition management.

7
The First 10 Days of Go-Live You Should Expect

• Days 1-3
• Security, printing, and general workflow
  reinforcement
• Days 5-7
• There may be an increase in frustration on the
  part of users if issues are not resolved in a
  timely manner or support is not sufficient
• Days 7-10
• The excitement of go-live wears off be prepared
  for staff and project team fatigue
• In general, you will hear different perspectives
  from users, making it difficult to establish the
  facts
• Focus on the root cause instead of the symptoms

8
Happiness Curve for Implementation
9
Before Go-Live
The organisation as a whole will be increasingly
anxious Some individuals will be outspoken in
opposition to the project and/or the go-live
date The project team will feel overwhelmed You
will see some end user resistance to
training People will question your scope or
sequence
10
Overview of Support

• Bronze CAM Command Center Support Staff Located
  in the Deakin Centre
• Project Leadership, Application Functionality
  support, Security
• Infrastructure, Production Applications, EDI
• PC/Printer Support, Systems/Network Security and
  HP
• Support Roles
• Super Users Support End Users
• Floor Walker Float Support for Super Users
• Zone Leader Support Floor Walkers in their
  assigned Zone (Territory)
• Bronze CAM Commander w/ Deputy
• Silver Command
• Gold Command
• 24 X 7 scheduled from 23-10-14 thru 28-11-14
• Daily Communication schedule
• 0645 and 1845 Shift Transition Meeting for
  Inpatient areas
• 0930 and 2130 Silver Leadership Meeting
• 1000 Outpatient Leadership Huddle (M-F) TBD

11
Bronze CAMeHospitals Command Centre
12
Bronze CAM (Deakin Command Centre)

• Purpose is to provide support and issue
  resolution over the go-live period. Reports in to
  Silver Command.
• The issues reported in by Super Users and Floor
  Walker are tracked and resolved as Incident
  Tickets.
• Level 3 of the Deakin Centre
• 24/7 Operation planned from 24 Oct to end Nov
• Designed to seat 150 staff covering
• Leadership from CUH
• Epic Corporation Experts
• CUH Builder (Ticket Resolver) Teams
• HP
• A Priority 1 Call-In Service Desk.

Ticket Resolver Teams Will involved HP,
Security, Epic application modules
ASAP ED Beacon Cancer Beaker Pathology Bridges
Interfacing Clin Doc/Stork/ICU Clinical
doucmentation including ICU and Obstetrics Cupid
Cardiology HIM Coding, Chart and Film
Tracking Inpatient Orders Orders Kaleidoscope
Ophthalmology OpTime/Anesthesia Theatres
Outpatient Clinicals Outpatients PAS Patient
Administration Phoenix Transplant Radiant
Radiology Willow Pharmacy
13
Bronze CAM layout
14
End User Support Flow
End User needs help with Epic
Super User provides support
If Super User isnt available or cant resolve
Floorwalker provides support
If Floorwalker isnt available or cant resolve
Online incident ticket is created. If necessary,
a Priority 1 phone call is raised with Bronze CAM
service desk
15
Roles and Responsibilities
16
Roles Responsibilities, Super User

• Provide courteous, calm and reassuring support
  to end users during shift.
• Frontline support and frontline champion for
  Epic in your department.
• Reduce fear and anxiety Epic is a tool, it
  does not replace thinking and judgment
• Patient safety and good clinical practice must
  prevail
• Answer questions and provide workflow
  assistance.
• Consult Floor Walker if unable to resolve end
  user concerns
• Huddle with Floor Walker for updates as they
  make rounds after the Shift Transition meetings
  0645 and 1845. Shift meeting minutes and new
  tips and tricks online should be posted by 0900
  and 2100.
• Consult the eHospital website for latest tip and
  tricks, project updates and other information.
  Communicate, Review and Post daily Go-live
  Updates in department
• Identify trends and communicate with your Floor
  Walker
• Document Enhancement suggestions and review
  with Manager.
• Wear eHospital armbands for easy identification.

17
Art of Being a Super User
Full Copy Available At http//my-ehospital.org/su
pport/information-super-users
Troubleshoot issues and enter online and Priority
1 call in tickets with Service Desk Provide
one-on-one support to your hospital colleagues.
with an understanding that this is not easy for
everyone. Have empathy and support for your peers
and convey the long-term benefits of the system.
Act as an ambassador for eHospital and the
introduction of the EPR. Communicate with the
Floor Walker and Managers Stay Busy, Move Quickly
from One End User to Another.

• Expect to See
• Resenters
• Hecklers
• Gripers
• Experts
• Quiet types

• There are several types of people that you will
  want to look out for during the go live period
• Those who are asking others for help
• Those who appear hesitant or lost
• Those who are expressing frustration or anger
• Those with a negative attitude towards the
• implementation of the eHospital EPR
• Those who appear just fine

18
If All Else Fails......
19
Roles Responsibilities, Floor Walker

• Who Credentialed Trainers, Instructional Design
  staff , specialist staff from Epic Corporation.
• Floor Walkers will attend morning and evening
  Shift Transition meetings (0645/1845)
• At the end of each transition meeting, Floor
  Walkers will meet with Zone Lead at a designated
  location to receive assignments and pagers.
• Introduce yourself to Ward and Clinic leadership,
  Super Users and end users on assigned units and
  make sure they know how to reach you
• Post your name and confirm your pager number in
  each location you are responsible for covering
  post when you are on break or away from
  designated area
• Continually walk through assigned coverage areas
  and seek out end users and Super Users and offer
  assistance, answer questions and troubleshoot
  issues
• Provide courteous, calm and reassuring support to
  end users and super users
• If an end user approaches you, ask if they have
  approached their super user first.ask an
  available super user to join you in helping the
  end user to ensure the super user is part of the
  solution to enhance their troubleshooting /
  training skills
• If you are unable to resolve a question or issue,
  follow the documented Support Workflow
• Participate in Issue Review Sessions with
  Application Teams (2pm / 2am) Inpatient Only
• (Outpatient Floor Support will participate in
  10am OP Leadership Huddle)
• Enter Enhancement suggestions via online Web
  Ticket with Priority 5
• Identify and document trends and communicate at
  daily Transition Issue Review meetings
• Communicate daily Go-live updates with end
  users and Super users
• Wear a myEpic t-shirts and badges for easy
  identification.

20
Zone Support Example
Zone Leaders Support Floor Walkers and Arrange
Support
Dont worry. I am Here for end users on the Ward
Zone 4
Zone 3
Zone 2
Zone 1
End User
Super User
Im here to help too.. Just Dial my Bleeper
Floor Walker
21
Floor Walker Zones
Hospital Main Entrance
Zone 1 - ATC, CDC, ACCI/GSK and S Block Zone 2 -
Rosie and Breast Unit Zone 3 - Theatres, K Wards,
Dialysis and Pharmacy Zone 4 - Wards - CD,
EAU Zone 5 - Wards - FG, J, N, R Zone 6 - ED,
Labs, A Wards Zone 7 - Oncology Haematology,
Radiology Zone 8 - Main Outpatients and Medical
Records
3
6
4
8
1
2
5
7
2
22
Support Call Priority
23
Severity Description
Priority 1 Incident (Emergency) An incident exists that results in a total loss of service or functionality affecting the entire organization
    Non- exhaustive examples
  Critical system/service down i.e. Hyperspace A service affecting treatment is down Incident directly affects patient safety
  EpicCare Inpatient patient facing user reports that a report is displaying incorrect data.  i.e. Facesheet. EpicCare Outpatient orders are showing incorrect default dosages/instructions.  Weight-based dosages incorrect. ADT/Prelude Users are not able to admit patients.
 
Priority 2 Incident (High) An incident exists that results in a partial loss of service or functionality across the estate or within a significant user population
  Non-exhaustive examples
  Partial loss of service or functionality across the organization. Large number of users affected. EpicCare Inpatient patient facing users report long response times for data intensive reports. EpicCare Outpatient Order Transmittal not working as expected. Cadence Appointments are not displaying in the DAR.
   
Priority 3 Incident (Normal) An incident exists that result in a partial loss of service or functionality with no immediate business impact.
  Non-exhaustive examples
  Partial loss of service or functionality Individual user/Small number of users affected EpicCare Inpatient patient facing user requests additional information for reports. EpicCare Outpatient SmartLink no longer working. Cadence Copay stops appearing in the check-in/check-out flow.
Priority 4 Incident (Low) An incident exists that result in a partial loss of service or functionality with no immediate business impact and for which an alternative is available.
  Non-exhaustive examples
  Minor software bugs Individual user has problems accessing a non-critical function EpicCare Inpatient user requests changes to the organization of reports. EpicCare Outpatient User requests additional items to be added to the History navigator section. 
Priority 5 Incident Requests for information / Optimization / Enhancement Requests to be resolved with next Epic SU or upgrade. Requests requiring review by organization for viability. New report requests
 
24
Incident Reporting Options
Answered by Epic Support Teams Option 9 For all
Urgent Priority 1 eHospital Issues Option 1
Password/ Access issues Option 3 Printing
issues Answered by HP Support Teams Option 6
WP360 issue (Hidden) Option 4 Any other IT
issue For other lower priority Epic issues,
please log the incident online via the eHospital
project page.
Phone Call To the Service Desk x2757
Priority 1 Incident
Create Incident Ticket from the internet. Link
is available on the project homepage
Only Super Users or Floorwalkers are authorised
to create incident tickets online. https//cambri
dgeuniversityhospitalsnhsfoundationtrust.samanage.
com/login
Priority 2, 3, 4, 5 Incidents
25
How to Enter a Ticket

• Go to the eHospital Project Home Page
• Click on the link Enter an eHospital Incident
  Ticket
• Enter your User Name and Password
• Complete the fields accurately and with explicit
  detail of the issue effecting the end user.
• Using your best judgment Select a priority for
  the ticket and the correct resolver group.

26
Application / Service Effected
I DONT KNOW PRINTING ISSUE PASSWORD
ISSUE SECURITY/ ACCESS ISSUE TRAINING
ISSUE CUTOVER ISSUE Go-Live RESOURCES ISSUE OTHER
-Please Specify ASAP (AE) Beacon (Cancer) Beaker
(Pathology) Clin Doc Cupid (Cardiology) HIM Kaleid
oscope (Ophthalmology) OP Clinical
(OutPatient) Optesia (Theatres) Orders PAS Phoenix
(Transplant) Radiant (Radiology) Reporting Stork
(Maternity) Willow (Pharmacy)
Drop Down Menu
27
Where do I find the MRN?
28
Patient Safety and the Electronic Patient
Record.
29
Patient Safety the Electronic Patient Record

• Enter information into the software accurately
  and completely.
• Read information displayed carefully.
• Confirm the accuracy of critically important
  medical information (e.g. allergies, medications,
  relevant histories, problems, lab pathology
  results, radiology results) presented by the
  software, just as one would with paper records

30
Patient Safety the Electronic Patient Record

1. Use the software only in the way designed do
   not try and use fields / screens in a way that
   they not intended to be used
2. Please remember, the care of the patient is
   paramount if the computer wont let you then
   ignore it and carry on caring for the patient.

31
Reporting Potential Patient SafetyIncidents at
Go-Live

• Tell your Super User or eHospital Floor walker
• They will triage the incident to establish if
  the issue involves eHospital.
• If yes they will make a PRIORITY 1 call to the
  eHospital command centre to be escalated.
• AND
• Follow existing Incident Measures
• Inform the person in charge.
• Take appropriate immediate action
• Inform your senior management staff
• Submit an RMIS (Risk Management Information
  System) incident form.

32
Do Not Send Training Questions to the Service
Desk (Phone Support is for Priority 1 Ticketing
Only) Priority 1 issues must be called into the
Service Desk
33
Super Users Overview of Cutover
34
Terminology

• Conversions
• The process of historical data conversion for all
  patient information held in legacy systems, to be
  conducted in the days and weeks prior to go live
• A mixture of automatic conversions and manual
  conversions. Trust resources will be required to
  assist with manual conversions
• Cutover
• The manual input of data in the immediate hours
  leading up to go live, for live in-patients at
  the time of go live and those that will attend
  outpatients in the first 2 weeks after go live
• Trust resources will be required to assist with
  entering cutover data

35
Inpatient Cutover Sequence
6) Rolling Changes/Sweeper Teams - Friday pm -
Saturday morning
36
What happens after Cutover?

• 12midnight 2am Saturday 25 October
• Cease entering data into Epic. Complete
  Assurance Checks that we have the data we
  expect to have in Epic, all interfaces are
  switched over etc etc and we are safe to go live
• At First Logon
• Users are requested to perform a series of at
  first logon, and at varies stages within the
  first few hours. These range from assurance
  checks to data entry.
• Super users are asked to be familiar with these
  requirements and assist staff with these checks
  as required. Tip sheets will be provided on
  the eHospital Project Page

37
Example Nurse At First Login
38
Major Incident
How will Bronze / Silver / Gold Command Work?
39
Command and Control

40
Command and Control

GOLD Strategic Coordination Hands Off
Fran Cousins Dr Keith McNeil Dr Jag Ahluwalia
SILVER Tactical Management Hands On
On Call Director On Call Manager 24/7 in the
Boardroom
BRONZE Operational Delivery Hands In
Deakin Bronze CAM Operational Areas
41
Operations Escalation
If an end users discovers an operational issue,
they should check in with the super user to see
if it potentially involves Epic. If so, the
super user needs to enter a ticket online with
eHospital The end user will then escalate the
operational issue to the person in charge on
their ward or clinic. Following normal procedures.
42
Operational Workflow Escalation

• Silver Command to
• Prioritise
• Instruct correct action
• Obtain ETA for resolution feedback
• Communicate to the wider organisation

ESCALATION
Immediate resolution is required or unable to
resolve through normal means. Action Escalate
to Silver Command
Unable to resolve through normal means Action
Escalate to line manager
End user identifies operational issue Action
Review with super user
43
What Happens Next.

• Complete Your Training
• Attend Secondary Training (x4118)
• Spend Plenty of Time in the Playground
• Keep Up to Date
• (eHT, My-eHospital.org, Super User News)
• Become a Champion for your Ward
• Encourage Others
• Share the Long-Term Benefits of Epic
• Be Super and Be Seen as Super..

You can download a copy of this Presentation at
http//my-ehospital.org/support/information-super-
users
44
(No Transcript)