In Brief: Part one of this this two-part series reviews the steps leading up to a pilot program go-live.
In an era of declining reimbursement, increased regulatory burden, and high demand for novel, patient-focused services, IT and operational initiatives have become increasingly important ways for hospitals and health systems to realize efficiencies while providing high-quality care and improving the patient experience.
Before jumping in headfirst with any transformational initiatives across the entire organization, consider starting with a pilot. Pilot programs allow organizations to cost effectively jump-start organization-wide IT and operational initiatives. This post focuses on planning the perfect pilot in advance of go-live, while installment two will review what to do once the pilot has gone live.
Benefits of a Pilot Diagram
A pilot allows an organization to introduce novel operational changes and test their impact on the organization in a setting that is relatively low cost and low risk.
Pilot Participant Selection and Cultural Considerations
Participant selection: One of the most difficult aspects of planning a pilot is the selection of appropriate pilot participants to test the impact of proposed operational changes. Pilot participants should include specialties or practice areas that are representative of day-to-day operations. Operational extremes can be addressed once the pilot is shown to be successful and the decision to expand has been made.
Prior to the start of a pilot program, organizations should make sure they have an adequate change management strategy in place. This will ensure that the organization is culturally ready for the operational changes that result from the pilot. The following steps are critical in the development of a change management strategy:
- Review Prior Operational Improvement Efforts: Positive and negative aspects of prior improvement efforts should be reviewed by pilot leadership. Any issues with key stakeholders that are the result of previous improvement efforts should be rectified before the new pilot begins.
- Engage Provider and/or Staff Champions: The input of individuals is essential when planning the pilot’s communication strategy. Internal champions can also work with providers and frontline staff who might resist change.
- Steering Committees: A steering committee composed of clinical and administrative leadership allows for shared decision making to guide the overall direction of the project.
- Working Groups: Working groups composed of frontline staff and providers can actively participate in work flow redesign in advance of the pilot go-live.
- Patient Advocates: The voice of the patient is essential in any pilot that aims to change patient behaviors.
Data Collection: Preparing to Measure Success
Although determining the metrics that a pilot should impact is straightforward, understanding how to collect and analyze the required data is often quite complicated.
- Locate Operational Data Sources: Determine the clinical and nonclinical IT systems from which pilot data will be extracted.
- Verify Data Accuracy: Verify that data elements can be collected easily from clinical and nonclinical IT systems. Extractions should be verified with stakeholders to ensure that they match the current operational environment.
- Avoid Manual Data Collection: While a pilot’s small size might allow for manual data collection, it should be avoided at all costs. Along with being prone to errors and process variance, manual data collection is extremely labor intensive and typically not feasible once a pilot is scaled upward.
- Assign Future Reporting Responsibilities: To avoid process variance, future data extraction and reporting responsibilities should be assigned to a single team.
Meaningful change in healthcare rarely happens overnight. Understanding the benefits of an effective pilot program, selecting pilot participants, and preparing to measure success are the initial steps in fostering organization-wide change through operational and IT initiatives.