Staff Planning and Considerations for HIT Projects

It’s said that “failing to plan is planning to fail,” and that’s certainly true in large-scale health IT projects. In my experience, one of the biggest possible failure points in any project is an inadequate resource plan. Paying scant attention to—or simply underestimating—the staffing requirements for any major initiative may cause serious delays and frustration.

Fortunately, there are several preparatory initiatives that can be undertaken, to assure this area of risk can be reduced before a project gets to full swing.

Major areas to evaluate and plan for are:
1. Correct work-effort estimates
2. Proper allocation of resources
3. Knowledge Transfer
4. Leadership for support and motivation of staff

Estimating Work-Effort Resources

A comprehensive table of all roles is needed for the project, with total hours across project-duration and as a percent of each role’s FTE (i.e. 25% for 10 months). Mapping the suggested role/titles provided by the vendor to role titles used at your health system is a first step.

All large EMR vendors have work-effort estimates, sometime included in contracts. Use a vendor’s numbers with a grain of salt—as they are often conservatively modeled around idealized conditions.

A realistic estimate of work effort will allow for unforeseen issues along the way as well as some turnover, so it’s a safe bet to add 10-20% to your vendor’s estimates. (Related reading:  see my colleague's advice for estimating training staff)

I also recommend reaching out to peers and other customers to ‘gut check’ your conclusions. Talking to other hospital leaders about their resource plans for a similar-sized project is a helpful validation step.

Proper Allocation of Resources

The challenge here, of course, is that work ebbs and flows from week to week for the duration.

A 50% allocation role doesn’t equal 20 hours each week. It’s a weekly average that plays out over many months. Any given week might be 2 hours for a light week or a full 40+ hours for a busy event week.

Understanding these peaks and valleys and planning accordingly is critically important and each resource’s manager, including those in non-IT departments, must be supportive of time spent away from regular responsibilities to meet the goals of the project.

If an IT analyst is trying to support the current production system and implement a new system, they will be conflicted and stressed. Similarly, a departmental subject matter expert may be challenged to “do their day job” during peak weeks of design, testing and go-live. That’s why I feel it’s best to have fully dedicated resources for the most critical and high-allocation roles (>50% roles).

Knowledge Transfer

It’s not realistic for your staff to have deep experience in your new solution at the start of a new project. However, by the time you’re at the go-live conversion, you do want your IT Analysts and SMEs to be confident experts.

If the vendor is fully participating, in theory, they bring the experience to help get knowledge transferred to your team. However, the vendor consultants are not always fully experienced or allocated correctly themselves. Often your health system is competing for their time; some consultants have multiple client projects.

Don’t rely on the vendor intrinsically being a single silver bullet. Engage the vendor in defining their plan to inject experience. Separately, encourage your staff to:

• take ownership for their field (avoid victim mentality)
• have initiative to become ‘experts’ by seeking educational resources
• be creative and focused to overcome barriers to progress
• report issues and don’t be afraid to seek help when needed

Leadership

Strong and encouraging leaders can make the difference. Hoping every team-member does what is needed, is alone, not a winning strategy. Being hopeful is fine. But being hopeful and taking daily action to inspire, encourage, commend quality & productivity and expose and defeat problems, will surely improve results.

Leaders need to be actively engaged and supportive in the work-teams and tasks. If they only float above waiting for escalations, they cannot fully inspire and guide. Your staff will appreciate the right balance of support, encouragement and appreciation, without micro-managing.

Jim Beezley is Director, Cerner Consulting for Healthcare IT Leaders. Jim has led multiple, large-scale client engagements, supporting health system leaders with strategic goal setting & road-mapping, migration from legacy systems, implementations, optimizations, and user adoption.

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