Changing Gears Lessons Learned Implementing Large Projects in

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  • 1. Changing Gears Lessons Learned Implementing Large Projects in the Health Sector Presented by:Natalie Klaus-Capital Health Stephen Abbott-Bell Aliant

2. Capital Health

  • Capital Health is Nova Scotias 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

3. Bell Aliant Family 4.

  • 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 5.

  • 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 6. 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 PBXs; 9 Sites
    • Centralized Voicemail
    • Introducing 7 Digit Dialing
    • QOS Network (Private SIP Trunking)
    • Introduction of VOIP (Wireless ER)

7. 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.

8. The Solution 9. 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)

10. 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

11. Building the Right Team

  • Understanding skills required to tackle such a large implementation
      • Planning
      • Execution
      • Knowledge and Experience
  • Do not under estimate resources required in the planning stage
  • Construction 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

12. 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

13. Governance Model Program Manager Bell Aliant Vendor/PartnerInvolvement Joint Program Steering Committee Bell Aliant Steering Committee plusCapital Health Steering CommitteeProgram Sponsor CDHA Director Solutions Architect Solution Developer, CSE, Engineers User Migrations Project Manager DAY 2 Operations Hospital Implementations Project Manager Emergency Room Implementation Project Manager Program Manager Capital Health 14. RecommendedImplementation 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)

15. 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

16. Contingency Operations

  • You simply cant 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)

17. Business Change

  • Its not enough to execute smoothly on technology
  • changes & implementations people need to know
  • who, what, when, where why Changes are being
  • introduced.
  • Advanced Communications
  • Site Prime meetings, negotiations and clarifications
  • Reinforce 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