In its third week, Epic go-live continues to exceed expectations

Bryan Cofrin (left), Epic training supervisor, and Frank Esposito, Epic oncology principal trainer, worked with Michelle Harrison, PharmD, oncology informatics coordinator, Pharmacy Services, during one of their Smilow North Pavilion floor rounds to offer help to staff who might need support. They helped Harrison locate a report in Epic that captures infusion start and stop times to ensure efficiency in billing and reporting.
Bryan Cofrin (left), Epic training supervisor, and Frank Esposito, Epic oncology principal trainer, worked with Michelle Harrison, PharmD, oncology informatics coordinator, Pharmacy Services, during one of their Smilow North Pavilion floor rounds to offer help to staff who might need support. They helped Harrison locate a report in Epic that captures infusion start and stop times to ensure efficiency in billing and reporting.

Only 12 days into Yale-New Haven Hospital's Epic go-live on the York Street campus, more than 5,500 users were actively using Epic concurrently across all sites, including York Street, Northeast Medical Group, Yale Medical Group, Greenwich Hospital and community physicians.

"This is a remarkable benchmark," said Daniel Barchi, chief information officer, YNHHS and Yale School of Medicine. "This is the Epic Corporation's third largest implementation in its 20 years and our mastery of Epic will set expectations for other go-lives nationwide. On Day 10, we were where we hoped to be on Day 21 — a truly impressive achievement."

Lisa Stump, vice president, Epic Project, is equally impressed with the successful go-live. "Nurses are creating inpatient care plans entirely in Epic and bar code scanning was above 80 percent in the first week," she said. "These are significant milestones that reflect well on our staff and their preparation."

To help diffuse stress during go-live, Volunteer Services pulled out all the stops to provide employees with distractions — purple Epic stress balls; a serene space to relax — the Oasis on the top floor of Smilow; fortune cookies and lip balm; live music performances in Smilow's lobby; and, on Valentine's Day, chocolate hearts. To the delight of staff, Carol Cestaro, Service Excellence manager, and volunteer Gene Vacca, roll a cart brimming with snacks onto the Surgery/Trauma Unit.

During the two weeks of the Epic go-live, Volunteer Services designed and staffed the Epic Oasis on the 15th floor of Smilow Cancer Hospital. Almost 1,000 employees took advantage of the oasis where they were able to de-stress from the demands of implementation and receive a Reiki treatment or chair massage, or just sit and look out over Long Island Sound in the relaxing environment created by nearly 50 employees and volunteers. Here Michael Trulli, a licensed massage therapist of Therapeutic Sports and Techniques, discusses the benefits of massage with sonographers Danielle Mezzanotte (center) and Lindsay Moler, both of Diagnostic Radiology.

Transplant Unit super user Christine Salamida (right), RN, was pleased with the progress staff on her unit have made after only a week on Epic. Here she discussed end-of-shift intake and patient documentation with Brittany Senic (left), RN, and Katie Daniels, RN.

Another key indicator of Epic success is CPOE — computerized physician order entry — where doctors place medication and procedure orders for patients — and this marker was an impressive 90 percent at the end of the first week.

According to Barchi, the command center will be open through the end of the month. Purple-shirted Epic team members will continue to provide units with trouble-shooting and enhanced training for those who request it.

"We are hearing from units that they are largely self-sufficient and no longer need the at-the-elbow help we've sent them," said Daniel Barchi, chief information officer, YNHHS and Yale School of Medicine. "This is a great sign because it shows how proficient and confident staff are with documenting, order entry and bedside medication verification."

Stump noted the high level of leadership engagement in the initial days of golive that set the stage for Epic success. "Our senior leaders and physicians were everywhere, 24/7," said Stump, "and this was meaningful for staff. It helped with decision-making and problem-solving. With everyone's help, we didn't miss a beat and hospital operations continued without interruption."

Stump pointed to one solution that required collaboration to resolve. In the initial Epic build, only Perioperative Services staff would be able to see the schedule of patients and procedures on an electronic board that replaced the Navicare system of tracking patients. In Navicare, clinicians on patient care units could see the schedule and plan bed assignments according to when patients had left the OR and were in the post-anesthesia care unit. Without that information, units could not anticipate and plan for patient admissions.

Making the change that would allow patient care units to see the boards required agreement from both Greenwich Hospital, which had gone live in April, and Bridgeport Hospital, which will go live in September.

"Giving more staff access to this information impacts all three hospitals so we had to have agreement before we could make the change on York Street," explained Stump. "Everyone agreed because it makes sense for safe patient flow but it is an example where consensus was needed to change an agreed-to process."

Now that Epic implementation is well under control on the York Street campus, Barchi said that those working in the command center will turn their attention to the Saint Raphael Campus.

"We are impressed that at this point, 95 percent of employees on the SRC have registered for training — an excellent sign," said Barchi. "The Saint Raphael go-live is June 1 and it is going to be here before we know it!"