changing gears lessons learned implementing large projects in
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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