Question

Real-World Case 5

Home Health of America is about to implement the new EHR. This EHR will be used by all of the nurses, nursing aides, therapists, and other staff members who work with patients in the patient’s home. It will also be accessed in the home office for billing and other administrative purposes. The chief executive officer mandated the big bang go-live strategy. He also mandated that the go-live begin on Monday, which is their busiest day. His thoughts were that if the EHR could handle Monday, then it could handle anything. The users ran into several problems on the first day. Some of the functionality did not work, the cellular connections used to connect to the IS did not work at some of the homes, and the documentation was slow, which prevented them from seeing the patients in a timely manner. They had planned for some overtime as they knew that documenting in the new EHR would be slower. The overtime ended up being twice what was expected, and they still did not see three of the patients. The decision was made to go back to the paper system while the problems were worked out.

1. Identify the implementation issues in the case.

2. If you worked for Home Health of America and the chief executive officer mandated the big bank go-live strategy, what would you have done?

Answer 1

1.

Implementing a particular system in health care is a crucial step and is indicated by proper planning and monitoring. The case given above has some major implementation errors that led to failure of the change facilitation in the setting.

FIrstly, the introduction of the new EHR has to be done through testing and analysis system and not on full fledge day out pattern where the risk of exhaution from new changes and retention due to failure are more.

Secondly, the system needed to be well communicated, trained and explained to the staff members in the setting. Inability to perform the tasks using the new system makes the individual frustrated and resist changes.

Thirdly, the implementation of the new EHR on the bisiest day is too soon and this was the major error that led to failure, as new changes require some time to freeze in back as per the Kurt Levin's change model. Introduction of changes without proper planning and development leads to such failure.

Thus, it can be concluded that the case here lacked appropriate planning, management and implementation that led to failure of the program.

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