Week 4

By: Max Vrooman

          I was very glad to see that we addressed change management as its own topic within informatics rather than as simply an unmentioned component to every case study we encounter.  The largest IT change that I have ever been a part of was while volunteering for Virginia Mason.  At that point in time I had never taken any kind of change management course or had any notion about some of the difficulties of implementing a CPOE system.  It is very interesting now in hindsight to re-examine the experience and try to piece together the ways in which they either succeeded or failed to do a proper job in facilitating the change.

          One of the first things I noticed at the time was that before any of the training began they played a video from the CMO explaining why this was a necessary step for the organization to take.  He acknowledged that there are a number of ways in which the new system would be scary or disrupt workflow but that in the end this was the in the best interest of the patient and that was the most important consideration for the organization.  This is a key step to placate physicians who may oppose the system or feel it is being forced upon them by administrators who don't know anything about medicine.  The CMO is a powerful stakeholder and is a voice that the majority of physicians trust.  Even if it doesn't change the mind of every physician the hope is that it will at least influence enough of them to change the current of the discourse from negative to positive.
       
          Secondly, they made the change small.  Each week they rolled out the changes to two or three units with each one starting on a different day.  This made it so that each unit had the entirety of the organization's resources making sure they adjusted well to the CPOE system and could have any questions addressed.  As a super user I was assigned to the new units and was there in-person to help with concerns.  This made it so that physicians didn't have to call the IT help desk and get stuck waiting on hold when there was potentially an urgent situation that had to be addressed immediately.  This took a lot of the stress off of the physicians when they realized that there was an extremely accessible source of expert information should a problem arise.