“If I knew then what I know now…”
How many times have we all uttered that phrase? It’s easy to see mistakes or opportunities for improvement once a project or event is complete. The trick is taking that knowledge and utilizing it for current or future projects to avoid unnecessary headaches.
Nowhere is that truer than when you’re implementing an EMR. Learning from your experience during implementation helps you fill in functionality gaps and optimize your EMR as you go. If you’re like most organizations, your EMR projects represent a huge undertaking. With the resource management, legacy systems to adjust, and new processes to be put into place, you will find it hard to keep track of all the details. You can often be left wondering how you’ll maintain the project on time and on budget, let alone how to optimize the change.
But there is a way. With careful planning and a bit of foresight, you can capture all that working knowledge in a “lessons learned” document that can help you make the leap from a merely functional EMR to a fully optimized one. Unless you gather and use those lessons, however, they won't provide any value-added to ongoing phases of a project. This is especially important in projects with continuous rollouts to multiple facilities using a "standard" EMR product.
A “Lessons Learned” collection and documentation are normally defined deliverables of any managed project. From the beginning of the project, train your staff to develop a living, on-going document of hiccups, processes that could be expedited, or mistakes that could be avoided in the future. Lessons learned are, in many projects, seen as only part of the closing phase of a project - collected and documented, then filed away and never looked at again. But to take advantage of those valuable lessons, they must be documented and utilized to optimize future or current projects, reduce redundant work, and save time, money, and resources.
How do you close the knowledge gap from the start of a project to an optimized EMR? How do you train your staff to realize the invaluable potential of a lessons learned process? Based on hands-on industry experience I’ve had with EMR projects, I’ve noted three keys to building an effective Lessons Learned document: clear communication, effective delegation and ownership, and defined requirements.
Ensure sure your team understands and knows how to identify “lessons learned” and why they're so important. Too often smaller details fall to the wayside during project implementation because team members don’t understand how important the little things can be and how they can be leveraged in the future.
Clearly defining, gathering and documenting lessons learned with your team is not just identifying what isn’t working or outlining the negatives of the project. It's also highlighting what worked successfully and should be duplicated in the future to meet organizational goals. This document should be considered a continuous quality improvement tool. Having your team understand the purpose behind this tool greatly increases the chances of it being used to aid current project implementation and ultimately, to streamline future projects.
Delegation and ownership
Who will be responsible for the on-going gathering and documentation? Assign a key team member as the keeper of this invaluable document. Information should be collected not only from your project team, but from all teams, stakeholders, and subject matter experts connected to the project. Involving all relevant parties ensures a collaborative and thorough effort to collect the information and fosters a sense of ownership over the process and project. Delegating a single owner or keeper of the document also eliminates confusion over who is responsible for data gathering and provides everyone a specific, go-to person whenever they’ve discovered a new lesson that should be included.
Have clear requirements
Specifically define the parameters around lessons learned including when they should be collected, how they are to be documented and who will periodically be reviewing them.
Because lessons learned are part of quality improvement, they should be viewed as an integral process throughout the entire life cycle of a project. They should be finalized at the close, and reviewed at the beginning and during any subsequent project. Clearly define the requirements for inclusion in the document, ensure that everyone is contributing and collectively establish milestone review points. Through constant evaluation, you will ensure that the best practices have been saved and future projects will benefit from the most important lessons learned.
Unfortunately, lessons learned have not been part of every project on which I've worked. It struck me several times in the last few months how many times someone has asked "didn't we have that issue in the last project?" but no one could remember the details. By following these simple steps and requiring comprehensive documentation, you can often resolve issues before they occur.
Outline this process from the beginning and follow it throughout the entire project. Treating lessons learned as a continuous quality management tool is the most effective way to add value and reduce the likelihood of recurring issues. It provides an ideal way to be proactive, not reactive, when optimizing your EMR project.
For more information on project management and clinical optimization, feel free to download our infographic, The Ripple Effect of Clinical Optimization.