4 Go-Live Checklist

Section4.19 Implement

Section 4 Implement—Go-live Checklist - 1

Go-live Checklist

Use this go-live tool to ensure that you are truly ready to go live with a system after all other elements of implementation have been performed.

Time needed: 12 hours
Suggested prior tools: Section 2.1 Communication Plan, Section 4.2 Project Plan for Excel, Section 4.16 Training Plan

How to Use

Members of the health information technology (HIT) steering committee should use this checklist to validate that everything on the list has been performed.
In some organizations, the go-live checklist is accompanied by a rehearsal of the go-live day. The organization uses its test environment to perform each of an application’s functions. Staff members may role play activities to make sure they know what to say to a client when first getting ready to use a computer at a visit, how to handle a relative who is curious about what the new system is doing, and to perform other functions associated with electronic health record (EHR), health information exchange (HIE), or other HIT.

Transition Planning

Set a date for go live during a period of time that is as quiet as possible.

Inform the vendor of this go-live date and use it to plan all aspects of the implementation, scheduling backward from that date. Allow for contingencies.
Determine your rollout strategy. Some organizations go live with only a portion of the staff at one time, or with all staff using limited functionality (see Section 2.X Rollout and Turnover Strategies). Don’t forget that other staff members must be present to assure complete coverage of duties during go live.
Plan to notify third parties and other vendors of your go-live date when it appears certain and request their support, or at least their patience.

Several Days Prior to Go Live

Review evidence of testing

Network: devices, connectivity, security
Hardware: computers, monitors, navigational devices, cables, printers, scanners, servers, universal power supply (UPS), storage, backup server
Interfaces: lab, billing/clearinghouse, registration-admission/discharge/transfers (R-ADT) as applicable, other
Software: unit, system, integrated and HIE testing

Check process redesign

Ensure changes to workflows and processes are documented and practiced.
Ensure that the chart conversion process has begun or is completed, depending on your process (see Section 2.15 Chart Conversion and Pre-Load Planning).
Review use of system in client’s home, power supply, where to place device, printing if applicable, etc.
Obtain signoff on each workflow and process map for the new system—from each user for each process they will be using.

Review policy for use and achievement of goals with key stakeholders and re-affirm; make any necessary changes if software precludes goal accomplishment. Also, set expectations that not everything will go perfectly on go-live day, but that the organization will be fully staffed with the vendor standing by to do everything possible to provide assistance.

Review staff schedules

All staff must be ready to use the system on the go-live date.
Super users, the people who were selected to be the support team during go live and who received intensive training, should be prepared for calls and emails for field communication.
Buffer breaks should be provided for staff to catch up if necessary. This may require some overtime for staff to work an extra partial shift.
Plan a mid-day huddle to evaluate progress.
Plan end-of-day debriefing to identify and address issues and celebrate getting through the first day.

Check training

Every user has completed basic computer navigation, keyboarding, and other applicable training; provide refresher if necessary.
Every user has completed EHR and/or HIE training as needed; remedy immediately if someone has not.
Every user has a user ID and password, and they remember them.
Role play with every user who will be using EHR at point of care to ensure they are comfortable, and simulate use of EHR with a staff member playing the role of a client.
Plan with the support team what to do if things go really wrong:

Have paper process backup ready in the event of downtime or significant system issues.

Identify situations where go livemight need to be suspended.

Notify clients and their families of impending go live.Consider distributing a flyer or brochure to clients and family members a few weeks in advance.

Day Prior to GoLive

Update the organization’s main telephone message to say thatthe organization is implementing a new computer system and request patience for any delays.

Verify schedule for go-live day.

Verify readiness:

Computers, including tablets, smart phones, etc. are plugged in or charging.
Computers have connectivity to network:

All user IDs and passwords have been tested by each individual (this verifies the user has this information and that the connection works).

Secondary Internet Service Provider has been tested.

All computers, including those on wireless, can connect to appropriate printers.

Printers have appropriate paper.
E-fax capability works, if applicable.

Review escalation procedures to follow in the event of a problem:

First-level support staff
Second-level vendor staff onsite
Third-level vendor help desk
Fourth-level vendor management

Review who within your organization has the authority to make/approve critical system changes on the fly

Day of Go Live

Encourage all staff members to approach the day with patience and a sense of humor.

Support team double checks all readiness.

Support team members prepare to respond to any contingency as planned. Certain staff will not perform routine duties that day, but dedicate the entire day to being in a state of readiness (including being prepared to “do nothing” if all goes well).

Whether or not there appears to be a need, conduct all planned bufferbreaks, huddles, and debriefing—if only to celebrate success. This reduces stress and relieves pressure to do more than what was planned.

Determine staff schedule for Day 2 and adjust as necessary. Go live may require several days of similar scheduling.

Section 4 Implement—Go-live Checklist - 1