Emphasis on Support in Decision Support
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"The biggest concern for clinicians was how much time it would take for them to use this system, and how it would impact their work flow," Restuccia says. "We were successful because we worked side by side with our physician community to make sure that what we developed actually was developed by them."
Physicians and nurses are included in the planning, implementation, and optimization of all technology initiatives, Restuccia says. By incorporating their feedback, Penn Medicine created customized solutions that addressed the needs of the users and generated enthusiasm and support for the projects.
A concern for the physicians was that they would still be able to use their judgment when appropriate rather than having a computer dictate patient care to them, Restuccia explains. Also, Penn Medicine assigned dedicated project managers to each of its physician practices during IT implementations.
"Designing decision-support systems requires the coming together of two very different skill sets," Restuccia says. "Clinicians know how to deliver care, and they know the work flow of their employees and coworkers. They generally know what will work and what won't. Then you need to partner that with the skills of the information services team, who tend to be structured, programmatic, detail oriented, and they're management oriented."
Restuccia recalls how it took three months of discussion with all the interested parties to determine what type of device would be used for entering documentation into the new system—a device in the room, a cart that would be wheeled from one room to another, or a device at the nursing station. The consensus was to use a device in each room. The partnership with clinicians, he says, is the reason for success.
"If I had told them it was going to be a cart because I unilaterally decided that was the best option, the installation would have been a disaster," he says. "In fact, I'm sure that if I told them it was going to be a device in each room—the same decision they came to—it still would have been a disaster because we didn't take the time to get the buy-in."
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