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Rumor Control: These are the Facts

Posted on January 16, 2017 I Written By

For the past twenty years, I have been working with healthcare organizations to implement technologies and improve business processes. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog, I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

Why is it that one of the largest challenges on any project is miscommunication and out of control rumors? While many projects need and would benefit from more communication, even with the best of communication plans, project teams can spend more time dispelling false information than proactively communicating.

I believe in strong communication plans for EHR and ERP projects that include a wide range of communication including town halls, newsletters, emails, signage, internet sites, and other methods of sharing correct information. But on every project, no matter how much we communicate, certain hospital staff will find other sources of information.

I can see the rumor coming when an email or conversation starts with “I heard that…” or “Is it true that…”. These are telltale signs that I am about to hear a rumor. Rumors can range from minor details to far-reaching implications such as a perceived change in project scope or even the live date. While most rumors are just annoyances, responding to them and controlling them can be a significant strain on the project team’s time.

I believe that hospitals have a unique challenge in that proactive communication is more challenging than in many traditional businesses because it is common for a large portion of the staff, including nurses and physicians, to rarely check email. As a result, they are often in a position where “hallway conversation” is how they first hear information and are more likely to give it credibility.

While I admit that I have personally never been able to fully eliminate the rumor challenge, I’d like to share several ideas about what I have seen as an effective way to keep the rumor mill under control:

1) Establish a clear Source of Truth – From the very beginning of the project, communicate to every possible audience how decision and communications will be distributed and who they should contact with questions and information. If it doesn’t come from one of the accepted Sources of Truth, its not true. When I lead a project, I prefer to be the Source of Truth – if it doesn’t come from me verbally or in writing, it isn’t true.

2) Encourage questions and respond to all of them timely – When I am running a project, my motto is “Ask me anything, anytime”. At times, I will get dozens or even hundreds of questions a day through meetings, phone calls, texts, and emails. I respond to every question, providing the truth if I have it, or getting them to the person who can provide the truth. Rumors often start because staff members are not getting answers or don’t feel their questions are welcomed. How do I respond to so many requests? I do it immediately so they can’t accumulate – which also helps inspire confidence and a feeling that they can ask rather than assume.

3) Town Halls – I strongly believe that a change management and communication strategy must include town halls. During town halls, project teams should provide an overview of what is occurring that is relevant to the staff, do occasional software demonstrations, and most importantly – field questions. Creating those proactive communication channels is a powerful way to avoid people creating their own truths.

4) Provide the complete truth – Sometimes the answer to a question is not known because it has not been determined, or has not been considered. Sometimes it is not what the person wants to hear. Regardless, provide the truth – and the complete truth. There is nothing wrong with saying that you don’t know – but can find out. Or that a decision has not been made, but now that they have raised the concern we will make it and get back to them. Responding immediately doesn’t always mean providing an answer immediately, as long as the follow-up is done once the answer is available.

5) Communicate Everywhere – A communication plan must be extensive and include many different points of contact. Intranet sites can look impressive and have lots of great information on them – but usually only a small percentage of the staff will check them. Consideration must be given as to how to communicate with contracted employees, physicians, and traveling nurses. This is particularly challenging during an EHR roll-out when all of these parties must be enrolled in training classes and kept up-to-date on the go-live. Find and use every possible communication challenge. There are always questions about how much communication is too much – but they apply to the volume of communication you push through a particular communication channel – not the number of different communication channels you use.

Finally, accept that no matter what you do, rumors will form and will need to be dispelled. Its part of project management and change management that always had existed, and always will. Properly controlled, the rumors can be a minor distraction at worst – entertainment at best.

Please share any ideas you have found to be successful in keeping rumors under control.

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

Does Green Mean Go? The Importance of Transparency in Status Reporting

Posted on February 19, 2016 I Written By

For the past twenty years, I have been working with healthcare organizations to implement technologies and improve business processes. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog, I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

A common method of reporting project status is to use the familiar traffic light system, with a status of green, yellow and red. This method of reporting, in theory, makes it easy to determine whether a project is on track and allows the reader to glance quickly at a status report and determine whether there is any cause for concern that requires their attention.

A status of green simply suggests that no such action is necessary, and that the reader has no required actions. A status of yellow or red may require some discussion or resolution. In concept, this system makes sense and allows a project sponsor, who is likely involved in multiple projects and has limited time for each, to quickly determine which projects require their attention.

In reality, this system results in a false sense of security regarding the status of a project and often covers up issues that require attention until they inevitably become serious, at which point the result is most often a project delay, an increase in budget, or more often than not, both.

No project is perfect
The reality is that any project that will result in real change in your organization — including software implementations, cost savings initiatives, and organizational changes — will have problems. It is not the existence of problems that will make or break the success of a project; it is how these problems are addressed. Addressing a problem properly almost always requires early identification and action. Too often, the status reporting system delays the identification of problems, causing them to fester and build to the point at which they can no longer be easily repaired.

The politics of project status
Status reports are inevitably a very political process as the project manager must gather information from the leads or key members of the project team who are completing sets of tasks. In some cases, the project manager is an employee who is overseeing a combination of internal and external resources to complete a project. Quite often, the reverse is true, where the project manager is an external resource who is managing a combination of internal and external resources.

Regardless, the motivations of project managers are in conflict. They want to ensure that they report issues early enough that they can be addressed, but have to balance multiple political realities.  A project manager must be careful not to burn bridges and gain the trust of the team members. Changing a status report to yellow will increase the pressure on team members and potentially make them look bad to their management. Those team members may resent the project manager for the action and be reluctant to share information with him or her in the future.

Therefore, a project manager will often hide the truth, buying the team time to address the issue on its own before escalating the issue by properly reporting the actual status of the project. The result is that often the status that appears on a report is a matter of negotiation between the project manager and the respective team members.

This issue can be even more significant when the project manager is an external contractor managing a project that includes resources from the same company. The project manager in this case has a split loyalty. The first is to the project, and the second is to the employer. To protect the employer, project managers might be reluctant to report a status that will indicate a delay or issue caused by their team, resulting in overly optimistic status reports that hide the project realities.

This is further complicated by the reality that status, particularly status with a green-yellow-red option, is highly subjective. One might interpret a red status as one that is halting the project, but a problem could have serious implications down the line even if it is not halting the project today. A green status could be interpreted as one in which the project remains on track even if there are issues.

Properly reporting status
How does a project sponsor ensure that the true status of a project is reported?

First, there needs to be an acceptance that the status of a complex project cannot be simplified into the equivalent of a system that is designed to let us know whether it’s safe to proceed through a traffic light. Sponsors must be prepared to take the time to fully read through reports and understand the events and issues that have occurred and be prepared to ask questions to challenge the project manager and team leads about the urgency of any issues to see if they require sponsor involvement.

Second, project managers and team members need to be informed that the expectation is that all issues, challenges, and risks will be raised in status reports and status meetings without any fear of repercussions from project sponsors or project team members. These issues should be included in status reports, even if resolved before the report is created, to create visibility into any challenge the project has to overcome. The discussion about issues in status meetings should be open and honest, with proposed solutions provided by team members. Often issues can be resolved timely with the proper allocation of resources, expedited decision making, or simply through discussion.

Finally, the motivations of the project manager must be considered and factored into discussions. In many cases it may be preferable to have the project manager be an internal resource or an external resource that is not from the same company as your implementation or software partner. In cases where they are the same, extra attentiveness to the status and issues presented should be considered to ensure that the reports are being prepared without bias.

While the green-yellow-red method may allow for efficient review of status reporting, it can lead to missing the important details of the actual status that are vital to the success of the project. Proper communication can ensure that red lights change to yellow, and yellow to green, ensuring that the project will not face a true stopping point at a critical point, leading to costly delays.

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