Pre-Live Super User
and Managers Briefing
You can download a copy of this Presentation at:
http://my-ehospital.org/support/information-super-users
Agenda and Introductions
Executive welcome
Introductions and check-up
Briefing
Q&A
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How are you getting on with becoming Super?
1.
2.
3.
4.
The 'Art of being a Super User' guidance booklet
Your eLearning modules
Your Electronic Patient Record training
Sitting in as a 'classroom assistant' on further
training
5. Further eLearning modules
6. Practice and embed your new skills in the
'playground‘
7. For doctors and clinical nurse specialists there will
be personalisation labs
8. Participating in Dress Rehearsals
9. Attend a pre-live Super User/Managers briefing
10. Keeping up to date
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Information for all staff
Payslip attachment
Staff Q&A session(s)
eHospital Times
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Super User / Management Briefing – what we’ll cover
Goals for Support
Overview of Support
What is the Bronze CAM (eHospital Command Centre)
Roles and Responsibilities
Be a Great Super User
Zone Support – How to engage your Floor Walkers
Prioritising Incident Tickets
Reporting Options and Online Ticket Entry
Patient Safety
Overview of Cutover
Operations Issues – Bronze, Silver, Gold Command (Major
Incident)
You can download a copy of this Presentation at:
http://my-ehospital.org/support/information-super-users
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Go Live Support Goals
• Smooth transition from the current processes to Epic
•
•
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•
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Solid Epic readiness
Appropriate plan/processes/structure for managing transition
Solid end-user and physician support structure
Identify and manage issues
Timely response to issues
Maintain strict Change Control process
Communicate to the organisation and our peers appropriately
And, above all
Minimise the risk to patients, as well as the organisation’s
operations by providing quality 24 x 7 support and transition
management.
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The First 10 Days of Go-Live You Should Expect
 Days 1-3:
◦ Security, printing, and general workflow reinforcement
 Days 5-7:
◦ There may be an increase in frustration on the part of users if
issues are not resolved in a timely manner or support is not
sufficient
 Days 7-10:
◦ The excitement of go-live wears off; be prepared for staff and
project team fatigue
 In general, you will hear different perspectives from users, making it
difficult to establish the “facts”
 Focus on the root cause instead of the symptoms
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Happiness Curve for Implementation
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Before Go-Live
The organisation as a whole will be increasingly anxious
Some individuals will be outspoken in opposition to the
project and/or the go-live date
The project team will feel overwhelmed
You will see some end user resistance to training
People will question your scope or sequence
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Overview of Support
Bronze CAM Command Center Support Staff – Located in the Deakin Centre
Project Leadership, Application Functionality support, Security
Infrastructure, Production Applications, EDI
PC/Printer Support, Systems/Network Security and HP
Support Roles
Super Users – Support End Users
Floor Walker – Float Support for Super Users
Zone Leader – Support Floor Walkers in their assigned Zone (Territory)
Bronze CAM Commander w/ Deputy
Silver Command
Gold Command
24 X 7 scheduled from 23-10-14 thru 28-11-14
Daily Communication schedule
06:45 and 18:45 Shift Transition Meeting for Inpatient areas
09:30 and 21:30 Silver Leadership Meeting
10:00 Outpatient Leadership Huddle (M-F) TBD
Floor Walker and Command Center staff will have pagers and phones for communication as assigned.
Incident management ticketing system is called SAMANAGE for tracking issues and resolution
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Bronze CAM
eHospital’s Command Centre
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11
Bronze CAM (Deakin Command Centre)
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Purpose is to provide support and issue
resolution over the go-live period. Reports
in to Silver Command.
The issues reported in by Super Users and
Floor Walker are tracked and resolved as
Incident Tickets.
Level 3 of the Deakin Centre
24/7 Operation planned from 24 Oct to end
Nov
Designed to seat 150 staff covering
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Leadership from CUH
Epic Corporation Experts
CUH Builder (Ticket Resolver) Teams
HP
A Priority 1 Call-In Service Desk.
Ticket Resolver Teams – Will
involved HP, Security, Epic
application modules
ASAP ED
Beacon Cancer
Beaker Pathology
Bridges Interfacing
Clin Doc/Stork/ICU Clinical
doucmentation including ICU and
Obstetrics
Cupid Cardiology
HIM Coding, Chart and Film Tracking
Inpatient Orders Orders
Kaleidoscope Ophthalmology
OpTime/Anesthesia Theatres
Outpatient Clinicals Outpatients
PAS Patient Administration
Phoenix Transplant
Radiant Radiology
Willow Pharmacy
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Bronze CAM layout
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End User Support Flow
End User needs
help with Epic
Super User
provides support
If Super User
isn’t available or
can’t resolve
If Floorwalker
isn’t available or
can’t resolve
Floorwalker
provides support
Online incident ticket is created. If
necessary, a Priority 1 phone call is
raised with Bronze CAM service desk
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Roles and Responsibilities
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15
Roles & Responsibilities, Super User
Provide courteous, calm and reassuring support to end users during shift.
 Frontline support and frontline champion for Epic in your department.
 Reduce fear and anxiety– Epic is a tool, it does not replace thinking and
judgment
• Patient safety and good clinical practice must prevail
 Answer questions and provide workflow assistance.
 Consult Floor Walker if unable to resolve end user concerns
 Huddle with Floor Walker for updates as they make rounds after the Shift
Transition meetings 06:45 and 18:45. Shift meeting minutes and new tips
and tricks online should be posted by 09:00 and 21:00.
 Consult the eHospital website for latest tip and tricks, project updates and
other information. Communicate, Review and Post daily Go-live Updates
in department
 Identify trends and communicate with your Floor Walker
 Document Enhancement suggestions and review with Manager.
 Wear eHospital armbands for easy identification.

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Art of Being a Super User
Full Copy Available At: http://my-ehospital.org/support/information-super-users
Troubleshoot issues and enter online and Priority 1 call in tickets with Service Desk
Provide one-on-one support to your hospital colleagues. with an understanding
that this is not easy for everyone. Have empathy and support for your peers and
convey the long-term benefits of the system.
Act as an ambassador for eHospital and the introduction of the EPR.
Communicate with the Floor Walker and Managers
Stay Busy, Move Quickly from One End User to Another.
There are several types of people that you will want to
look out for during the go live period:
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Those who are asking others for help
Those who appear hesitant or lost
Those who are expressing frustration or anger
Those with a negative attitude towards the
implementation of the eHospital EPR
 Those who appear just fine
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Expect to See:
o
o
o
o
o
Resenters
Hecklers
Gripers
Experts
Quiet types
If All Else Fails......
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Roles & Responsibilities, Floor Walker
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Who: Credentialed Trainers, Instructional Design staff , specialist staff from Epic Corporation.
Floor Walkers will attend morning and evening Shift Transition meetings (06:45/18:45)
At the end of each transition meeting, Floor Walkers will meet with Zone Lead at a designated location
to receive assignments and pagers.
Introduce yourself to Ward and Clinic leadership, Super Users and end users on assigned units and
make sure they know how to reach you
Post your name and confirm your pager number in each location you are responsible for covering;
post when you are on break or away from designated area
Continually walk through assigned coverage areas and seek out end users and Super Users and offer
assistance, answer questions and troubleshoot issues

Provide courteous, calm and reassuring support to end users and super users

If an end user approaches you, ask if they have approached their super user first….ask an available
super user to join you in helping the end user to ensure the super user is part of the solution to
enhance their troubleshooting / training skills
If you are unable to resolve a question or issue, follow the documented Support Workflow
Participate in Issue Review Sessions with Application Teams (2pm / 2am) – Inpatient Only

(Outpatient Floor Support will participate in 10am OP Leadership Huddle)
Enter Enhancement suggestions via online Web Ticket with Priority 5
Identify and document trends and communicate at daily Transition & Issue Review meetings
Communicate daily Go-live updates with end users and Super users
Wear a myEpic t-shirts and badges for easy identification.
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19
Zone Support Example
Don’t worry. I am
Here for end users
on the Ward
Zone Leaders Support Floor
Walkers and Arrange Support
Zone 4
Zone 3 Zone 2
End User
Super User
I’m here to help
too.. Just Dial my
Bleeper
Floor Walker
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Zone 1
Floor Walker Zones
Hospital Main Entrance
Zone 1 - ATC, CDC, ACCI/GSK
and S Block
Zone 2 - Rosie and Breast Unit
Zone 3 - Theatres, K Wards,
Dialysis and Pharmacy
Zone 4 - Wards - C&D, EAU
Zone 5 - Wards - F&G, J, N, R
Zone 6 - ED, Labs, A Wards
Zone 7 - Oncology &
Haematology, Radiology
Zone 8 - Main Outpatients and
Medical Records
3
1
2
4
2
5
6
8
7
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Support Call Priority
URGENCY:
When does the incident need
to be resolved?
Medium
Low
High
IMPACT:
What is the scope of the
effect on the business?
(“Immediately”)
(“At the nextregular,
available opportunity”)
(“When you have time
/No
rush”)
High
(Patient care issue;
work cannot be done;
enterprise service
unavailable)
Medium
(Workaround
available)
P1
P2
P3
P2
P3
P4
P3
P4
P4
Low
(Service affected is not
business-critical; only
affects 1 person;
enhancement request,
etc.)
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Severity
Description
Priority 1 Incident (Emergency)
An incident exists that results in a total loss of service or functionality affecting the entire organization:
Non- exhaustive examples:

Critical system/service down i.e. Hyperspace

A service affecting treatment is down

Incident directly affects patient safety
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Priority 2 Incident (High)
EpicCare Inpatient: patient facing user reports that a report is displaying incorrect data. i.e. Facesheet.
EpicCare Outpatient: orders are showing incorrect default dosages/instructions. Weight-based dosages incorrect.
ADT/Prelude: Users are not able to admit patients.
An incident exists that results in a partial loss of service or functionality across the estate or within a significant user population
Non-exhaustive examples:
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Priority 3 Incident (Normal)
Partial loss of service or functionality across the organization.
Large number of users affected.
EpicCare Inpatient: patient facing users report long response times for data intensive reports.
EpicCare Outpatient: Order Transmittal not working as expected.
Cadence: Appointments are not displaying in the DAR.
An incident exists that result in a partial loss of service or functionality with no immediate business impact.
Non-exhaustive examples:

Partial loss of service or functionality

Individual user/Small number of users affected

EpicCare Inpatient: patient facing user requests additional information for reports.

EpicCare Outpatient: SmartLink no longer working.

Cadence: Copay stops appearing in the check-in/check-out flow.
Priority 4 Incident (Low)
An incident exists that result in a partial loss of service or functionality with no immediate business impact and for which an alternative is available.
Non-exhaustive examples:

Minor software bugs

Individual user has problems accessing a non-critical function

EpicCare Inpatient: user requests changes to the organization of reports.

EpicCare Outpatient: User requests additional items to be added to the History navigator section.
Priority 5 Incident
Requests for information / Optimization / Enhancement

Requests to be resolved with next Epic SU or upgrade.

Requests requiring review by organization for viability.

New report requests
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Incident Reporting Options
Priority 1 Incident
Phone Call
To the Service Desk
x2757
Answered by Epic Support Teams
Option 9 = For all Urgent Priority 1
eHospital Issues
Option 1 = Password/ Access issues
Option 3 = Printing issues
Answered by HP Support Teams
Option 6 = WP360 issue (Hidden)
Option 4 = Any other IT issue
For other lower priority Epic issues,
please log the incident online via the
eHospital project page.
Priority 2, 3, 4, 5
Incidents
Create Incident Ticket
from the internet.
Link is available on the
project homepage
Only Super Users or Floorwalkers
are authorised to create incident
tickets online.
https://cambridgeuniversityhospitalsnhsf
oundationtrust.samanage.com/login
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How to Enter a Ticket
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Go to the eHospital Project Home Page
Click on the link: Enter an eHospital Incident Ticket
Enter your User Name and Password
Complete the fields accurately and with explicit detail of the issue
effecting the end user.
Using your best judgment – Select a priority for the ticket and the
correct resolver group.
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Application /
Service Effected
I DON’T KNOW
PRINTING ISSUE
PASSWORD ISSUE
SECURITY/ ACCESS ISSUE
TRAINING ISSUE
CUTOVER ISSUE
Go-Live RESOURCES ISSUE
OTHER -Please Specify
ASAP (A&E)
Beacon (Cancer)
Beaker (Pathology)
Clin Doc
Cupid (Cardiology)
HIM
Kaleidoscope (Ophthalmology)
OP Clinical (OutPatient)
Optesia (Theatres)
Orders
PAS
Phoenix (Transplant)
Radiant (Radiology)
Reporting
Stork (Maternity)
Willow (Pharmacy)
Drop Down Menu
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Where do I find the MRN#?
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Patient Safety and the Electronic
Patient Record.
Patient Safety & the Electronic Patient Record
1. Enter information into the software accurately
and completely.
2. Read information displayed carefully.
3. Confirm the accuracy of critically important
medical information (e.g. allergies, medications,
relevant histories, problems, lab pathology
results, radiology results) presented by the
software, just as one would with paper records
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Patient Safety & the Electronic Patient Record
4. Use the software only in the way designed – do
not try and use fields / screens in a way that they
not intended to be used
5. Please remember, the care of the patient is
paramount – if the computer “won’t let you” then
ignore it and carry on caring for the patient.
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Reporting Potential Patient Safety
Incidents at Go-Live
1. Tell your Super User or eHospital Floor walker
•
•
They will triage the incident to establish if the issue involves eHospital.
If yes – they will make a PRIORITY 1 call to the eHospital command
centre to be escalated.
AND
2. Follow existing Incident Measures
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Inform the person in charge.
Take appropriate immediate action
Inform your senior management staff
Submit an RMIS (Risk Management Information System) incident form.
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Do Not Send Training Questions
to the Service Desk
(Phone Support is for Priority 1 Ticketing Only)
Priority 1 issues must be called
into the Service Desk
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Super Users Overview of Cutover
Terminology
•
Conversions
 The process of historical data conversion for all patient information held
in legacy systems, to be conducted in the days and weeks prior to go
live
 A mixture of automatic conversions and manual conversions. Trust
resources will be required to assist with manual conversions
•
Cutover
 The manual input of data in the immediate hours leading up to go live,
for live in-patients at the time of go live and those that will attend
outpatients in the first 2 weeks after go live
 Trust resources will be required to assist with entering cutover data
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Inpatient Cutover Sequence
2) Height & Weight
– commencing Thursday 23 October
3) Allergies & Medications
– commencing Thursday - Friday pm
4) Orders (known orders for Saturday, Sunday &
Monday)
– commencing Friday pm
5) Lines, Drains and airways
- commencing Friday pm
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6) Rolling Changes/Sweeper Teams
- Friday pm - Saturday morning
1) PAS Admission / episode creation/ transfers /
Deficiencies
– commencing Thursday 23 October – Friday pm
What happens after Cutover?
•
12midnight – 2am Saturday 25 October
– Cease entering data into Epic. Complete ‘Assurance Checks’ that we have the
data we expect to have in Epic, all interfaces are switched over etc etc and we
are safe to go live
•
‘At First Logon’
– Users are requested to perform a series of ‘at first logon’, and at varies stages
within the first few hours. These range from assurance checks to data entry.
– Super users are asked to be familiar with these requirements and assist staff
with these checks as required. ‘Tip sheets’ will be provided on the eHospital
Project Page
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Example ‘Nurse At First Login’
Assurance Checks – Nursing Staff
Ensure the following have been completed:

The latest height has been entered into Epic for the patient (if applicable) – if not present, add this.

A weight from has been entered into Epic for the patient, including type of weight (i.e. dry weight) – if not
present add this

Patient allergies, as described on the paper Medicine Administration chart, have been added to Epic – if
not present, add this


Patient current inpatient medications have been entered into Epic, including IV infusions, Insulin
regimes, Immunosuppression, feeding prescriptions – if not present advise a member of the patients
treatment team
UFTO has been entered into Epic – if not present advise a member of the patients treatment team

Treatment Team (Consultant, Specialty, Junior team i.e. renal team) has been assigned in Epic

Radiology and Pathology orders for Saturday 25, Sunday 26 and Monday 27 October have been entered
into Epic – if not present and you are unable to enter the orders, advise a member of the patients
treatment team
Within first hour of go live – Nursing Staff

Document midnight cumulative input and output for patient in Epic (create an entry for midnight and back
enter this balance). Add any input or output since midnight into relevant (hourly) columns = this will
create a correct running balance for your patient

Check, enter or remove lines, drains, airways for patient
Within First Shift – Nursing Staff

Commence documenting all nursing information in Epic, inclusive of:

Vital signs and other observations assessments

Medication administration

Input and Output

Care plans

Isolation
When next due – Nursing Staff

All weekly nursing assessments
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Major Incident
How will Bronze / Silver / Gold Command Work?
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Command and Control
SILVER
Tactical Management
‘Hands On’
BRONZE
Operational Delivery
‘Hands In’
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Innovation and
DIRECTION
RESOLUTION
GOLD
Strategic Coordination
‘Hands Off’
Command and Control
GOLD
Strategic Coordination
‘Hands Off’
Fran Cousins
Dr Keith McNeil
Dr Jag Ahluwalia
SILVER
Tactical Management
‘Hands On’
On Call Director
On Call Manager
24/7 in the Boardroom
BRONZE
Operational Delivery
‘Hands In’
Deakin Bronze CAM
Operational Areas
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Innovation and
Operations Escalation
If an end users discovers an operational issue, they
should check in with the super user to see if it
potentially involves Epic.
If so, the super user needs to enter a ticket online with
eHospital
The end user will then escalate the operational issue to
the person in charge on their ward or clinic. Following
normal procedures.
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41
ESCALATION
Operational Workflow Escalation
Silver Command to;
• Prioritise
• Instruct correct action
• Obtain ETA for resolution – feedback
• Communicate to the wider organisation
Immediate resolution is required or unable
to resolve through normal means.
Action: Escalate to Silver Command
Unable to resolve through normal means
Action: Escalate to line manager
End user identifies operational issue
Action: Review with super user
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Innovation and
What Happens Next….
•
•
•
•
Complete Your Training
Attend Secondary Training (x4118)
Spend Plenty of Time in the Playground
Keep Up to Date
•
•
•
•
(eHT, My-eHospital.org, Super User News)
Become a Champion for your Ward
Encourage Others
Share the Long-Term Benefits of Epic
Be Super and Be Seen as Super..
You can download a copy of this Presentation at:
http://my-ehospital.org/support/information-super-users
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Our largest ever investment in improving healthcare quality