Advice from leading IT transformation and change managers
Five key thoughts for those leading system change
“People who have low psychological ownership in a system and who vigorously resist its implementation can bring a ‘technically best’ system to its knees.”
Nancy M. Lorenzi, PhD & Robert T. Riley, PhD
Managing Change: An Overview
Journal of the Medical Informatics Association
Practical implications of a study on IS change management: “…management should aim to increase the perceived value of change and organizational support for change to reduce user resistance.”
Hee-Woong Kim & Atreyi Kankanhalli
Investigating User Resistance to Information System Implementation: A Status Quo Bias Perspective
MIS Quarterly, Vol. 33, No 3, Sept 2009
“Lead your organization to a successful outcome, and speed up the process by treating your staff as customers first.”
Claire McCarthy, MA & Douglas Eastman, PhD
Change Management Strategies for an
Effective EMR Implementation
“In his article, “Leading Change: Why Transformation Fails,” John Kotter of Harvard Business School lists the major reasons for the failure of large-scale change initiatives (such as HIT systems): lack of a sense of urgency, no strong coalition, lack of a clear vision, missing frequent, clear communication, dis-empowerment of staff, no creation of short-term ‘wins’ to build momentum, and lack of ‘anchors’ for a change culture.”
Gloria L. Austin, Stephen Klasko, MD & William B. Leaver
The Art of Health IT Transformation
“In other words, recognize that you are not done at go-live; you’ve just started achieving technology adoption and changing behavior to get value from your investment.”
David E. Garets, FHIMSS
Change Management Strategies for an
Effective EMR Implementation
The importance of longer EFM views
Labor and delivery clinicians use EFM to identify fetal intolerance to labor to guide intervention and prevent hypoxic fetal injury. This task requires not only assessing the past and current degree of tracing abnormality and but projecting what is likely to happen in the near future. There is good evidence that tracing abnormalities generally evolve over hours (1-3). In addition, intervention guidelines usually recommend evaluating fetal response to supportive interventions over 30 to 60 minutes before resorting to cesarean delivery (4, 5). Thus long term assessments are essential. Standard computerized displays provide views of only 8 -10 minutes of tracing. Short term “snapshot” views can contribute to a failure to appreciate duration of tracing abnormality and the likely evolution.
PeriCALM Checklist analyzes EFM tracings in a consistent fashion. Its displays show long term trends over several hours, color coding regions of abnormality according to the criteria set by the institution. Such displays help clinicians see if a problem is intermittent or persistent, improving or deteriorating, stable or changing rapidly. A view of EFM trends may assist with situational awareness and helps clinicians in acute care settings more accurately project what is likely to happen and institute appropriate care. Checklist techniques and methods are especially pertinent in acute care settings during night time work when large amounts of data must be processed by the care givers over many hours. (6,7)
1. Vintzileos AM, Smulian JC. Decelerations, tachycardia, and decreased variability: have we overlooked the significance of longitudinal fetal heart rate changes for detecting intrapartum fetal hypoxia? Am J Obstet Gynecol. 2016 Sep;215(3):261-4.
2. Elliott C, Warrick PA, Graham E, Hamilton EF. Graded classification of fetal heart rate tracings: association with neonatal metabolic acidosis and neurologic morbidity. Am J Obstet Gynecol. 2010 Mar;202(3):258.
3. Clark SL, Hamilton EF, Garite TJ, Timmins A, Warrick PA, Smith S. The limits of electronic fetal heart rate monitoring in the prevention of neonatal metabolic acidemia. Am J Obstet Gynecol. 2016 Oct 14. pii: S0002-9378(16)30872-9. doi: 10.1016/j.ajog.2016.10.009. [Epub ahead of print]
4. Clark SL, Nageotte MP, Garite TJ, Freeman RK, Miller DA, Simpson KR, Belfort MA, Dildy GA, Parer JT, Berkowitz RL, D’Alton M, Rouse DJ, Gilstrap LC, Vintzileos AM, van Dorsten JP, Boehm FH, Miller LA, Hankins GD. Intrapartum management of category II fetal heart rate tracings: towards standardization of care. Am J Obstet Gynecol. 2013 Aug;209(2):89-97.
5. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 106: Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles. Obstet Gynecol. 2009 Jul;114(1):192-202.
6. Chapter 46. Fatigue, Sleepiness, and Medical Errors. AHRQ. (accessed December 2, 2016) https://archive.ahrq.gov/clinic/ptsafety/chap46a.htm
7. Fioratou E, Flin R, Glavin R, Patey R. Beyond monitoring: distributed situation awareness in anaesthesia. Br J Anaesth. 2010;105:83-90.
Cesareans stabilized, NICU admissions and resuscitation decline after implementation of PeriCALM® Patterns™
Becker’s Hospital Review just released the results of 10-year study on the impact of process improvement and the use of PeriCALM on the rate of cesareans, NICU admissions and CPR/ventillation/intubation.
The study, authored by Sam Smith MD and Lynette Philip RN of MedStar and Adi Zmiri MD, Emily Hamilton MD CM, and Thomas Garite MD of PeriGen, looked at data for 78,459 births for Cesarean rates, NICU admissions, and the use of extraordinary fetal resuscitation procedures before and after the introduction of a management focus on care processes and staff training combined with the use of PeriCALM Patterns.
Following is a summary of the results published by Becker’s:
- Despite an increase in factors associated with rates of cesarean sections, the rate of cesareans remained stable after the introduction of PeriCALM and advanced management strategies.
- NICU admissions declined by more than half after PeriCALM and the process improvement steps were introduced.
- The number of babies requiring unusual resuscitation measures in the delivery room decreased from 5.2% to 2.4%.
Our holiday wish to you
Amidst the briefing sessions and training meetings, for PeriGen’s North American team one afternoon was transformed to a gathering of joy and giving.
Click for more information about your local Big Brothers, Big Sisters or visit Big Brothers & Big Sisters of the Triangle (Cary, North Carolina)
A few of the trivia questions asked
during last week’s PeriGen team-building event
Here are a few of the questions we asked the PeriGen team as part of last week’s ‘Build-a-Bike Challenge.’ Teams that answered them correctly were awarded a point each and received a part of the bike they were building.
To see the answers, simply click on the questions. And, please, let us know how you do!
- What is a DAS?
- At what university was Patterns originally invented?
- In what state is it illegal to kill mice without a hunting license?
- Emily Hamilton's recent analysis of birth data indicates that cesarean rates did what since PeriCALM Patterns was installed at MedStar 10 years ago?
- What is an example of a standard interface?
- What were the wheels of the smallest adult bicycle made of?
- Covered California, the state's health insurance program, indicates that they will remove hospitals based on what childbirth metric?
- For WatchChild, what does BAM stand for?
- In what city was Patterns first tested in a hospital?
- Name the world's largest ocean.
- What is the WatchChild database storage requirement?
- What chess pieces can only move diagonally?
- What WatchChild solution allows caregivers to monitor patients at any network-enabled location within the hospital (e.g., ED/ICU) and external locations such as physician offices?
- How did the 17th president of the US, Andrew Johnson, start his career in Raleigh, NC ?
- Which PeriGen client often provides Emily Hamilton with historic birth data (depersonalized) for clinical data analysis?
- Name an EMR with which both WatchChild and PeriCALM can integrate?
- According to a recent AJOG article co-authored by Emily Hamilton, when are ACOG first stage arrest criteria most applicable?
This week, the PeriGen North America team met to collaborate, map the future, and socialize in our new hometown, Cary, NC. The event, including both PeriCALM and WatchChild team members, started as you would expect.
Lots of introductions and matching faces to the names made familiar through phone and email. Lots of handshakes and hugs. Lots of questions asked and answered over shared meals.
With the joining of PeriGen and WatchChild, purchased from Hill-Rom 10 weeks ago, the work to learn from each organization and meld them into a dynamic whole started from the get-go. This week’s event focused on expanding initial learning, cross-training, and developing an improved, expanded customer support team to provide an even deeper, more convenient customer experience.
And then the time for team building began.
Chip Long, PeriGen’s senior vice president of sales & growth, had arranged for a special surprise: PeriGen’s first ‘Build-a-Bike Challenge.’
Amidst the hard work and laughter, the team got together last Thursday afternoon to hold a trivia contest and build ten bikes for ten very special “Littles” from Cary’s Big Brothers, Big Sisters organization.
The challenge featured teams of four-five with six rounds of pretty tough trivia questions. Topics ranged from childbirth, technology, WatchChild, and PeriCALM to turkeys, geography, hunting licenses, and more. (Click here to take a stab at answering them yourself.)
Every correct answer resulted in one point for the team and the one part of their bike. At the end of the trivia challenge, each team started to build their bike. Although no prizes were awarded for the speed in which the bikes were built, you can guess that the rivalry continued!
First, second, and third place prizes went to the teams with the highest trivia performance scores, but the real reward came as a complete surprise to everyone when …
… after building their bikes and basking in the glow of jobs well done, there came a soft knock on one of the doors and…
PeriGen was joined by “Littles” from Big Brothers, Big Sisters in Cary, NC who each received a bike built during the “Build-a-Bike Challenge.”
The reaction was immensely heart warming for the PeriGen teams and, we think, a special event for the kids.
Protocol Management Tool again
recognized for innovation,
nominated for Edison Award
PeriGen announced today that their protocol management tool, PeriCALM CheckList, has been nominated for a 2017 Edison Award. The Edison Awards recognize and honor innovation and innovators who make a positive impact in the world.
The Edison Awards are named after Thomas Alva Edison (1847-1931) who developed 1,093 patented new products, including the incandescent electric light and the system we still use today to generate electrical power. His other products include the telephone transmitter, the phonograph, the first storage battery, and a motion-picture camera.
Edison Awards nominees are evaluated not only on their impact, but also the method of conceptualization, product value (advantages and differentiation), and marketing delivery.
PeriCALM CheckList, a module of the PeriCALM electronic fetal monitoring and analytics software solution, is designed to help bedside perinatal clinicians identify when patient EFM metrics match specific protocol parameters. Although it is highly customizable, it is most often used by hospital clients to monitor oxytocin protocols. The automation of protocol management that CheckList offers aims to save labor & delivery providers time by eliminating manual calculations and improve data accuracy. Published research on obstetric protocols, in addition, have been shown to improve outcomes and lower cesarean section rates.
The module also includes a unique export feature, saving additional time by sending EFM data to the EHR and to annotations after review.
PeriGen was incredibly honored to take part in this year’s Synova Perinatal Leadership Forum. The four day event took place in San Antonio and attracted 124 L&D leaders from across the US and Canada. A total of 63 hospitals were represented, most of them Baby Friendly or On The Journey and many magnet facilities.
PeriGen’s Allan Kyburz and Darcy Dinneny spent their time attending sessions, meeting nurse leaders, and demonstrating PeriCALM obstetric analytics software. Their main focus was the new Export feature added this year to PeriCALM Patterns and PeriCALM CheckList. This tools allows bedside labor nurses to automatically flow EFM data into annotations and the EHR without the need for time-consuming manual entry.
To highlight the feature, PeriGen sponsored a timed contest that awarded a Pebble Smart Watch to the attendee who could review and export data the fastest. The Pebble Smart Watch, like PeriCALM, integrates with a variety of devices.
The winner was Kristin Salyards of Gibson Area Hospital & Health Services (Gibson City, IL).
Pratt Regional Medical Center, serving Pratt, KS, went live this week on PeriCALM. They’ve added the Patterns patient safety tool, as well as the PeriCALM fetal surveillance tool. The installation includes an ADT interface and Coldfeed.
Pratt Regional Medical Center is a progressive provider serving south central Kansas and the pan-handle of Oklahoma.