Changing GearsLessons Learned Implementing Large

Projects in the Health Sector

Presented by: Natalie Klaus-Capital Health

Stephen Abbott-Bell Aliant

Capital Health

Capital Health is Nova Scotia’s largest provider of health services, and a hub of learning and research. We operate hospitals, health centres and community-based programs throughout HRM and Western Hants County, and provide specialist services to the rest of Nova Scotia and Atlantic Canada.We are 11,000 employees, physicians, learners and volunteers providing:

Medical and Surgical Care Mental Health Care Community Health Programs Public Health Services Addiction Prevention & Treatment Services Environmental Health Services

Bell Aliant Family

• Telephony environment: • PBXs that were no longer supported and

replacement parts could not be found• 4 digit dialing was location specific• 9 voice mail systems that were “stressed”• Running out of locals at the QEll site

• The challenge:• Upgrade 10 hospital locations• Open a new ER with a Distributed IP Capable

Telecommunications Solution• Introducing a 7 digit dialing plan• Implement a centralized voice messaging service

Setting the Stage

• All with little to no impact on patients and hospital operations…

Try adding the increasing threat of an H1N1 Pandemic along with sporadic crime family shootings and a correctional facility riot resulting in unannounced hospital lockdowns.

Setting the Stage

Project Scope

New Emergency (5 years from Conception to Opening) Part of the 10 part plan Department of Health Plan Over 20 million dollar spend 1.6 million dedicated to equipment

PBX Upgrade Timelines

• Planning began 2007• Estimated completion date is October 2009

10 PBX’s; 9 Sites Centralized Voicemail Introducing 7 Digit Dialing QOS Network (Private SIP Trunking) Introduction of VOIP (Wireless ER)

Managing Change Control

Formalized well defined change process for changes in scope All users believe their request are the most important! Prioritization

Escalation Ensure all of the points of escalation are well documented

and have a well documented process within the Team for escalation

Budget Considerations Plan for contingency

Timeline Impacts Expect the unexpected and plan for those situations that

arise-construction delays, weather events etc.

The Solution

The Benefits

New PBX Technology Replaces antiquated & unsupported technology Quicker call handling, greater capacity, greater redundancy Opportunity to introduce Centralized Services

7 Digit Dialing Addresses Future Growth Improved numbering scheme Future Reductions in LD costs (IP Network)

Centralized VM for all Capital Health Employees Replaces 9 Voice Messaging platforms CDHA Broadcast Messaging Reduced calling costs (using VM)

IP Capable – supports future VOIP Applications Future cost reductions (virtual MACs)

Slow Start, Rough Start

After a significant delay in starting the Telecommunications Program coupled with a less than passing grade on our first attempt at upgrading a major hospital location … it was time to introduce more rigor, regimen and ‘make it right’.

Building the ‘Right’ Team Introduced Program Management Introduced Governance Model Implementation Approach ITIL Best Practices for Service Delivery & Support Contingency Management Business Change Management

Building the ‘Right’ Team

Understanding skills required to tackle such a large implementation

PlanningExecutionKnowledge and Experience

Do not under estimate resources required in the planning stageConstruction drawings….not all people work well from drawings use mock-ups; 3 dimensional images, site visits etc.Partnering with a Vendor that has the numbers and depth of resources for all situations

Program Management

Applies a Governance Model approach

Single Point of Interface with Customer

Coordinates Partners & Deliverables

Direct access to Steering Committee

Issue Management – Escalation/Resolution

Manage/Mitigate Scope Creep

Centralized Risk Management & Mitigation

Comprehensive Updates & Regular Reporting

Governance Model

Program ManagerBell Aliant

Vendor/Partner Involvement

Joint Program Steering CommitteeBell Aliant Steering Committee plus Capital Health Steering Committee

Program SponsorCDHA Director

Solutions ArchitectSolution Developer, CSE,

Engineers

User MigrationsProject Manager

DAY 2Operations

Hospital ImplementationsProject Manager

Emergency Room ImplementationProject Manager

Program ManagerCapital Health

Recommended Implementation Approach

Break project into small milestones

Document and validate assumptions continuously throughout the project

Well defined Team structure and contact lists

Secure Resources (competing projects) Locating Vendor Support Senior Resources

Contingency (People, Process, Technology, $$$)

Downtime Procedures defined

Dry Run (New ER) invaluable feedback tool)

ITIL Best Practices

ITIL incorporates industry standard Best Practices Processes & Procedures for ICT Service Delivery & Support

Creates cooperation and understanding of deliverables as activities move from Implementation into Production

Prescribes a single, definable, repeatable and scalable processes that span departmental boundaries Release Management Change Management Configuration Management Incident Management

Service Level Management – monitoring, measuring, reporting

Contingency Operations

You simply can’t shut down hospital operations, however you can operate critical operation units and at a reduced capacity at the right times.

Business Change communications during migrations Implementing Red Phones (always on) for critical areas and

7/24 operations (redirecting lines) Redirecting non critical operations to centralized off-site

answering services Implementing Cell Phones as back up and for mobile workers

performing multiple roles. (redirecting lines) Switch Translations (timing is everything)

Business Change

It’s not enough to execute smoothly on technology changes & implementations … people need to know who, what, when, where why Changes are beingintroduced.

Advanced CommunicationsSite Prime meetings, negotiations and clarificationsReinforce change impacts, response and benefits Training, FAQ Guides, Broadcast VM, Corporate Intranet

Follow-up post cutover HD Scripts, Broadcast VM, Corporate Intranet

Provide access to experienced users-Vendor Support

Communications

How much and when?

Just in time and consistent

Ensuring all stakeholders are informed

Include patient input where feasible

Downtime/Move procedures Face to face instruction for high impact areas – ER

Questions