Table 1 Barriers and facilitators for each of the three implementation phases: pre-implementation, implementation, and post-implementation
From: Patient reported outcomes – experiences with implementation in a University Health Care setting
Pre-Implementation | Implementation | Post-Implementation | |
|---|---|---|---|
Technical considerations | − Determine method of PRO delivery − Evaluate and decide on tablet device − Preparing IT infrastructure − Develop GUI for administration − Integration into EMR | − Add providers to portal − Configure tablets − Test the assessments | − Use release cycles for upgrades − Consider use of foreign languages Make data available in different analytic platforms |
Content aspects | − Determine assessment standard (e.g., PROMIS) − Create institution “core” assessment − Consider the use of specific instruments − Create implementation checklist for clinics | − Train staff and clinicians − Create education cards − Follow implementation checklist | − Provide completion metrics − Create self-service portal − Collaborate with research initiatives |
Organizational strategy | − Create Executive Steering Committee − Develop project charter − Identify clinic champions − Engage support teams, e.g., marketing − Determine assessment intervals | − Collect relevant metrics − Create executive level reporting dashboards − Executive promotion | − Create marketing for implementation − Provide executive level metrics − Integrate into organizational goals |
Staff training | − Create training materials (e.g., education cards) − Develop computer based training for employees − Perform hands-on training with staff − Explain trouble ticket submission process − Inform providers of go-live | − Provide additional training during go-live − Walk staff through workflow during patient encounter − Demonstrate results within EMR | − Follow up with staff at 1 week, 1 month and 3 months − Answer “pop-up” questions and modify training material accordingly |
Technical Support | − Create asset management model with established product life cycle for tablets − Create “gold image” for the tablet with the use of a Mobile Device Manager − Set up IT trouble ticket support system | − Delivery of tablets and storage unit with integrated charging − Go-live support for any connectivity issues | − Scheduled application or tablet upgrades / updates − Replacement of malfunctioned devices or cases − Continued support for any unexpected issues |