Discussion: Health Collaboration for Change
Discussion: Health Collaboration for Change ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Discussion: Health Collaboration for Change HI!! , for this assignment I need help creating a transcript for a video. I attached the assignment instructions. I also attached the resources and an example of another students transcript. Discussion: Health Collaboration for Change resources_1_.docx vila_health_hospital_scenerio.docx transcript_example.docx resources1.pdf resources.docx SCENERIO Vila health: collaboration for change The only constant in the world of health care is change. When changes happen at health care facilities, the process can go roughly or smoothly, depending on how well the collaboration among staff is with the process. Last year at Clarion Court Skilled Nursing Facility, which is in Shakopee, MN, and part of the Vila Health network, the implementation of Healthix, a new electronic health record (EHR) system, was very bumpy for all involved, leading to serious risks to patient safety. Vila Healths central QA office has asked you to travel to Clarion Court and talk to several staffers on both the management and patient care sides to get some perspectives on what went wrong (or right!) and what lessons can be learned for the future. Discussion: Health Collaboration for Change First, talk to management. Stephen Silva Administrator, Clarion Court I understand why youre here, and I dont want to be uncooperative. But I want you to keep something in mind as you talk to everyone here: this situation happened because of problems upstream in the Vila Health network. If we were allowed more autonomy at the facility level, this wouldnt have gone so roughly. What do I mean? Well, the pressure from Vila Health Corporate to keep costs low and run a steady profit is intense. And I mean, I understand that this is a business. Of course! But we need to balance short-term thinking with long-term perspective. Anyway. Just day to day, it was getting clear that our old record system was being held together with duct tape and bailing wire, and we needed to upgrade. But rather than let us run our own search for the right system for our situation, we get a mandate from Corporate that if we were going to upgrade, we would need to buy Healthix, because Vila Health has an ongoing relationship with them and wed get a deal. And: I mean, I like a deal! I need to keep costs down, so thats great. But its not great to wind up with the wrong tool just because we got a deal. Healthixs designed for hospitals and were a skilled nursing facility. And those are related things, but theyre not exactly the same thing. If you need to screw something together, you dont go and buy a hammer just because theyre cheaper. But nobody at corporate would listen to me when I tried to make that point. After running roughshod on us there, corporate stomped down on us again by insisting we use an implementation coach that they had an existing relationship with. So we get some guy flying in from Baltimore who doesnt know us, our staff, our needs, or anything other than how to make Healthix work in the big hospitals he usually works at. I think that was 90% of our trouble right there, this guy from the outside coming in and just refusing to listen to everybody here when we told him over and over that this or that detail just wasnt quite right for us. People talk about staff buy-in as an important thing, and ours pretty much evaporated after the second day of that clown stomping around in here ignoring everyones suggestions. Discussion: Health Collaboration for Change Im sure youll hear more about this, but thats the main thing. Excuse me, Ive got to go on to a meeting. But remember: sometimes things go smoother if you let the people on the ground make their own decisions. Elise Wang Director of Operations I guess Im glad someones asking about the EHR implementation. God, that was a nightmare. I think that ended up chewing up an entire year of my life, with different phases of rampup, and then implementation, and then, I dont know, fallout. There were long stretches where Id just wake up in the morning and have to force myself to get out of bed because I didnt want to go in and deal with the days mess. I know Stephens upset with a bunch of the process stuff, how we ended up using Healthix instead of a system more suited for our facility, and so on. And hes got a big point! But to be honest, I think the trouble was a lot more localized. We were always going to pick *some* system, and every system has its quirks. I think the whole thing was a massive, massive failure of change management. A place like this only works when theres teamwork and collaboration. And that stuff doesnt just happen, you have to make it work. And I was trying to lay the groundwork- I know the staff here, I know who responds to what, and I was trying to get things rolling with the kind of slow, collaborative process that we value here. But we had this abrupt, crash timeline with the corporate implementation coach coming, I think his name was Josh, and he just keeps bulldozing ahead and ignoring what people said to him, and thats just a recipe for disaster. He irritated our IT guys when they had some concerns, and then they stopped cooperating. You know, absolute do-the-bare-minimum-required-and-nothing-further type thing, just short of a strike. And if I could kind of understand that on the human level, WOW was that unhelpful and disruptive. And pretty childish. It took Stephen calling them into his office and chewing them out for them to participate even grudgingly. But I dont know. I could have told him that if our IT people felt shut out of a thing theyd eventually be responsible for, theyd react badly. I *did* tell him that. But he didnt listen. We had kind of the same sort of situation with the nurses, too. But less childish in their case. They felt like the training process was leaving them unprepared and left behind, and they had to start making choices about using Healthix the right way or just taking care of patients. And they chose patients, of course, but that wasnt good in the long run. Im sure youll hear more about that from them when you start talking to them. Discussion: Health Collaboration for Change Chad Cook IT Manager Hey, there. Im happy to talk to anybody and everybody about that stinking EHR. I came so close to quitting so many times with that thing. I gotta tell you, running IT in this place isnt a picnic in the best of times. I like my coworkers and respect the other managers, but since this is a skilled nursing facility everyone acts like IT is an afterthought. And I kind of get that- for a long time, it was! But cmon, were a couple of decades into the 21st century now, and technology is core to everything! Its like trying to have a car without brakes or something. So were underfunded and understaffed and overstretched to begin with. That means it takes most of our capacity to keep things running, not leaving us a ton of bandwidth for planning and for special projects. Which sucks, and is no way to run a railroad, but when I try to tell Stephen that he just sighs and says the budget is what it is. So you shrug and move on and wait for the whole thing to blow up. My gut tightened up when Stephen decreed that we were doing a new EHR, then. I could see the need, for sure. But I could also see that we didnt have the staff to really do it right, and probably werent going to take the time to even try. It was just rush rush rush, boom, heres this new system thats getting rammed down our throats by corporate, sprinting the whole way. And then this joker from corporate swoops in to tell us what to do and how to do it, never taking a moment to listen to me or my guys if we had something to say. By the sixth round of that, yeah, we got pretty irritated, and yeah, I might have taken my guys aside and told them itd be fine by me if they did what was specifically asked of them and not a thing more. I mean, Corporate Josh is going to ignore our knowledge from making this place work? Fine, well keep that knowledge to ourselves. But you know what? Corporate Josh got to fly back to Baltimore and I had to sit here with my team and help the medical staff fight their way through the worst user interface Ive ever seen. Had to be calm and patient when they got mad at the clunkiness and took it out on us because we were the only ones handy, even though we didnt have any say in picking the stupid thing. Or then be the guy having Stephen yell at me that patient care is sliding because the care staff are having so much trouble with Healthix that theyre falling behind and crucial stuff isnt getting entered and peoples medication schedules got blown. That was fun! I still get to be the guy who has to sweat through patch installations every two weeks and then go around apologizing for the bugs that pop up every. Single. Time. I guess weve gotten through the worst of it, and nobody died because of it, but wow was that bad. And it would have been a whole lot easier if I could have at least felt like I was defending my own decision instead of something forced on me.Shonda McCrae RN Ohhhhhhh, Healthix. I hate Healthix. I got into this line of work because I wanted to help people, not because I wanted to fight with computers. I can barely work my phone! I mean, I dont think Im a dumb person by any means, but weve all got our strengths and being good with computers isnt one of mine. But OK, I know its a tool of the trade these days. I understand that. I liked the paper chart system, but I knew that we were way, way behind the times with it, and I was excited when Administrator Silva said we were getting with the times. But it just hit us like a tidal wave! No time to talk about what we needed, no time to figure out what was best for us! Just this burst of workers showing up to install computers in all the roomsand boy did that cause a mess, playing some kind of shell game with our patients from room to roomand then a couple hours of really half-assed training and then here we go, on our own. That coach they brought in, Josh Whatshisname, I tried to tell him that it takes me a while to learn how to do things on computers. He just kept pushing me away and telling me that the IT folks here would always be able to help me. As if. Those guys sit around and watch YouTube videos all day and wont get off their butts unless Administrator Silva is on the phone personally telling them to go help out. I remember the first week we were using Healthix, I kept having all kinds of trouble just logging in to the system to enter vital signs. You know, something that just takes a second with a paper chart. And should just take a second with a computerized system! But you try to log in and just get this error message saying invalid security domain or something like that. You re-enter your stuff, over and over, just getting more and more panicked and falling behind on your rounds! Then you get one of the IT guys to leave their YouTube to come and help you and they just shrug and have you try again for the tenth time, and then they tell you that its a known problem that Healthix has trouble with authentication sometimes. A known problem! Well thats sure helpful! I ended up just writing vitals down on paper again and then trying to catch up and reenter it all later in the shift when there was quiet time and I could try logging in again. But that didnt work so well, because sometimes theres not a quiet time, and sometimes you lose the sheets of paper, and its just a mess. And thats not counting the times you couldnt see some important note about a patient thatd been left in Healthix because you couldnt log in! Were lucky we got through that. Discussion: Health Collaboration for Change Lisa Cotrone LPN I am so tired of talking about Healthix. I go home and complain about it to my husband every night. Hes sick of hearing about it. Im sick of talking about it. But I hate it so much I cant stop. Im a real practical person. If theres something I need to get done, I want to get it done by the straightest route possible. I dont want to have to monkey around with logins and go to this screen and then that screen and go through this pull-down list and try to remember what all the new abbreivations mean that are just a little bit different from the old abbreviations. Im not dumb. I can see why people want to use a system like Healthix. But holy cats did we do a bad job of setting it up here. After you log in, you have to click through three pages to get to the page we nurses need the most often to enter vitals and check for status notes. Why cant we just make it so that that page is the first thing that comes up? I dont know if thats possible or not, because every time I suggest it, the IT guys just get huffy. I just dont like being told that all of this is the way it is, this or the highway. Take the time to explain it to me and Ill be a lot more on board. Especially if you sit and listen to what I have to say. You might not even agree, just make me feel like Im part of the process, not some little kid just being told whats what. Also: you better not tell her I said this, but I got really sick of Shondas cutesy oh-I-cant-help-myself routine as we were trying to make it work. Sure, we were all frustrated, and sure that system was a stubborn mess. But suck it up and figure it out! Dont just get all woe-is-me. I got so tired of getting yanked off of my own rounds so that I could come to her rescue. Especially when she knew that I wouldnt be able to help her! It was tough not to feel like she just needed an audience for her little show. I guess its better now, but there are still a lot of little pockets of hurt feelings here and there. Of course, there always are. Discussion: Health Collaboration for Change Nora Church RN Wow do I hate Healthix, and I especially hate the way we brought it in here. I was really excited when it was announced that we were installing it. It sounded great, and the list of stuff it was supposed to help us with sounded so awesome. But then once it got installed, the reality didnt match the sales job at all! We got told this story about how our lives were going to be so easy, just entering information and having easy access to whatever we needed to see. But then we just get thrown to the wolves, barely any training. A lot of our patients have been in the system for a while, and their info is all garbled and messed up in there. And thats if you can get to it! Once it lets you log inwhich might take a while, depending on what kind of mood the systems inyou open the system and see 20 tabs you have to pick through, and maybe three of them are actually useful to you. And then as youre poking through, every now and then the whole thing freezes up and just gives you a spinning circle for half a minute. When youre in with a patient, you always want to be paying attention to them! But since weve installed Healthix, youre always distracted by fighting with the computer. Am I mad that management and IT here just left us hanging to figure it out on our own? You bet I am, but Im not surprised. Im used to that. Heres the thing that really burns my butt: some of the nurses on staff who wont help anyone else out. I hate to name names, but take Lisa Cotrone. She got her head above water faster than anyone else with this thing. It was still clunky for her, but she could get by. But you ask her for help and she gets all snippy at you really fast. I figured it out, why cant you? is her whole approach to the world. Thats not helpful, and it doesnt really leave me full of warm feelings for the long term. I bet you heard this a lot, but Im one more person who spent a couple of weeks carrying a little notebook with me on rounds, writing stuff down to enter later. I know a couple of patients missed meds because of that. It was a disgrace, and were lucky it wasnt a full-on disaster to get us in the newspapers. Discussion: Health Collaboration for Change Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10