Going Live on Epic: 10 Takeaways from the Command Center

A few weeks ago, we began week 2 of our Epic go-live, and we’re continuing to learn and adjust. Building on my previous Epic Go Live and Command Center planning posts, there are more lessons to share.

The last point in my most recent piece was about camaraderie – defined as “mutual trust and friendship among people who spend a lot of time together.” I should add, in close quarters!

I continue to be impressed with the hardworking, dedicated IT team at the University of Vermont Health Network. I have seen many examples of teaching, helping one another, and stepping up to new roles since the November 9^th go-live.

The rate of new tickets slowed down as Week 1 ended, but the issues became more complex, as expected. We have resolved over 65 percent of the tickets opened since cutover and addressed many cross-cutting issues.

As promised, more lessons to share:

• Handoffs between shifts. Ensure that key issues and work in process is reviewed and turned over to the next shift to keep things moving smoothly. Try to have people scheduled several days in a row for continuity versus on one day and off the next.
• Seeing the “forest for the trees.” For the first few days the focus is on closing tickets, but as cross-cutting issues and themes emerge, the focus needs to shift. As broad issues are defined, clarity is needed on what teams and modules are involved, who is on point to lead the issue resolution, and what help is needed.
• Escalations. It is very helpful to have highly engaged executives and operational leaders rounding and raising up the greatest pain points for users that need more focus. These escalations may come through in-person visits to the command center or email.
• Ticket analysis. Have resources available who know the tool and can slice and dice the data to help leaders and teams see trends and where to focus.
• Hospital daily huddle. If the organization has a daily huddle, the command center lead should attend. It’s a good way to hear firsthand how all departments are doing, and what their key concerns are.
• Command center “walk-ins.” If the main command center is at the hospital, you may get walk-ins – well intentioned users who want to escalate a specific ticket or issue. Command center leaders need to manage this so that the teams working on tickets aren’t given conflicting directions on priorities.
• Email management on steroids. Staff working tickets stay in the system and don’t watch their email. But leaders get a lot of emails, and it’s hard to keep up given the pace. At the end of each command center shift, go back through your inbox to ensure that any escalations are dealt with – other email can wait.
• Multiple locations for support. If there is a main command center and multiple other locations for support staff and triage, ensure they are well coordinated with good communication between.
• Document management. Everyone involved needs easy online access to reference material. Dynamic information such as shift schedules needs to be maintained. Having at least a few binders of printed reference information helps as well.
• Ramp down plan. When you start adjusting command center hours, it will help to have a checklist ready on what needs to be considered and implemented (i.e. staff schedules, re-location of teams, communication to users, logistics like food and transportation, etc).

Stay tuned for more reports from the field…

[This piece was originally published on Sue Schade’s blog, Health IT Connect. Follow her on Twitter at @sgschade.]