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Epic preparation is epic, as employees ramp up for go-live

With only one week left before Epic goes live on Yale-New Haven's York Street campus, the pace of preparation has ramped up exponentially.

Employees who are involved in the implementation are everywhere and many are wearing Epic's signature purple shirt. Last week, the project's command center opened in an enormous space on the first floor of 55 Park Street and is now home to 200 computer terminals, 200 phone jacks, 20 printers, five 80" monitors and enough wire to wrap around the hospital many times over.

The monitors will display workflow issues and progress as soon as the go-live starts to roll out on Thursday, January 31. Employees in the command center will assess and report progress in their own areas and the monitors will capture the "big picture" for staff.

During the week of January 7, staff on inpatient and outpatient units conducted dress rehearsals that replicated the admitting, diagnostic, documentation and discharge workflows that they will use in Epic on February 1. Shoreline Medical Center and Temple Medical Center also conducted dress rehearsals, some of which included transferring patients to Yale-New Haven for treatment.

As go-live draws nearer, Epic staff are increasingly working from the command center at 55 Park Street so they can better support employees. Members of the Epic team fielded questions and addressed issues during two days of dress rehearsals that yielded valuable information. Shown (l-r) are: Lauren Gosselin, application specialist; Lois Freeman, RN; and Heidi Krieg, RN, Epic nurse application specialist.

Proud of their accomplishments on Day 2 of conversion weekend, some PFAS outpatient staff and an Epic trainer gave a thumbs up for their work on pre-registering more than 7,000 outpatients already scheduled for a YNHH visit. Seated are (l-r): Kerry Rhone, EPIC trainer; Mary Arduini, access representative; and referral representatives Kristi DiTolla and Julie Winnik. Standing (l-r) are: Linda Tracy, supervisor, Smilow Care Centers; Emilia Valentin, referral representative; Lisa Muscillo, access representative; and Kathleen D'Adio, referral representative, and Kim Sawyer, supervisor, both of Smilow Care Centers.

Intense concentration marked the dress rehearsal in the Pediatric Emergency Department as staff worked quickly to admit an 8-year-old "patient" who had been in a terrible car accident. Bleeding in the brain was suspected and time was of the essence. Shown (l-r) are: Cheryl Brophy, RN, Epic nurse application specialist; William Kean, RN; Karen Santucci, MD, section chief, Pediatric Emergency Medicine; Liz Ryan, RN; and Amanda Worcester, ED technical associate.

For more Epic photos, check out the gallery.

"We tried to develop scenarios that would involve as many departments as possible so our trials would be comprehensive," said Lois Freeman, RN, coordinator, Epic clinical documentation team. "The exercises were very productive because they surfaced issues that we have been able to address in advance of go-live."

Freeman, a veteran of Bridgeport Hospital, gained experience working on the Greenwich go-live but notes that "Yale-New Haven is a more complex institution with more than 1,000 beds, an active Emergency Department, Shoreline Medical and Temple Medical centers and the Smilow Cancer Hospital and Transplant Unit," explained Freeman.

"Our scenarios involved as many of these sites as possible so we could authenticate hand-offs and workflow."

While dress rehearsals progressed, smaller groups around YNHH — including discharge, code and rapid response teams — performed simulations with Epic teams. They also worked through scenarios so they would be more proficient at go-live. In addition to Epic team members — many of whom are working full-time on the York Street campus — YNHH Super Users are finalizing their training so they can assist employees "at-the-elbow."

Jill Spatafore, RN, Care Coordination, who had worked as an analyst on the Epic Project for two years on the clinical documentation team, is a Super User for the Care Coordination department.

"I've been reviewing care coordination workflow in Epic with my colleagues in staff meetings and minisessions," said Spatafore. "I want them to be comfortable with Epic prior to go-live and encourage them to use the ‘playground' as often as possible. This kind of practice will help us on Day One when we have to document ‘real' patients in Epic."

On Saturday and Sunday, January 12 and 13, the Epic command center surged with activity when almost 200 inpatient and outpatient registrars and schedulers worked each day on pre-registering and scheduling patients. They entered patients who were scheduled to come in for dates of service February 1-14, throughout the York Street campus and all YNHH satellites.

Another 100 staff from the Epic Project, Epic headquarters, hospital managers and Super Users also contributed to the conversion's success.

"Pre-registering more than 6,000 patients over two days got us proficient and confident with the system," said Tamrah Riley, RN, director, PFAS Access and Clinical Bed Management.

"When we go live, our efforts will save patients time because so many have been pre-registered. This was an important investment in both patient and employee satisfaction," said Riley, who led fast-paced dance sessions to help employees keep loose during the conversion weekend.

"In two days, we were able to complete 7,000 registrations for outpatient visits," said Sandy Elkin-Randi, director, Outpatient Access. "This conversion allowed our staff to become more confident with the system without patients standing in front of them."

In addition, Diagnostic Radiology employees manually scheduled and validated 3,000 of the 12,000 appointments that were directly converted into Epic, giving staff the opportunity to work within the Epic system. Grace Limosani, clinical referral specialist in the Breast Center, was pleased with her progress over the two days.

"I got much better — I am not as panic-stricken," said Limosani. "The conversion helped me get faster and more comfortable scheduling imaging procedures. My advice for other employees is to get into the playground and practice because it does make a difference."

"Our conversion to Epic is complex and right around the corner but I am extremely pleased with our progress to date," said Lisa Stump, vice president, Epic Project. "The dress rehearsals have gone well, our small-scale conversions have been successful and our weekend pre-registration effort set the stage for success on Day One. At this point, my advice to employees continues to be: practice, practice, practice because it does make a huge difference." Stump noted that Saint Raphael Campus staff are registering for training that will prepare them for Epic go-live on their campus on Saturday, June 1.

Yale-New Haven Hospital news release

Yale-New Haven Hospital is a nationally recognized, 1,541-bed, not-for-profit hospital serving as the primary teaching hospital for the Yale School of Medicine. Yale-New Haven was founded as the fourth voluntary hospital in the U.S. in 1826. Today, the hospital's two New Haven-based inpatient campuses include Yale-New Haven Children's Hospital, Yale-New Haven Psychiatric Hospital and Smilow Cancer Hospital. YNHH has a combined medical staff of about 4,500 university and community physicians practicing in more than 100 specialties. YNHH's York Street campus and associated ambulatory sites are Magnet-designated by the American Nurses Credentialing Center.

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