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E M R S
2. Dedicate sufficient fulltime staff to work on implementation.
3. Name an informatics RN system administrator.
4. Ensure IT participates during implementation to avoid delays in interfacing or going live. But don't let IT drive implementation or else the end result will be what meets their needs, not your clinical needs.
5. Appoint a project manager that isn't the director of the surgical services department. It's hard to do both jobs well.
6. Choose a system with flexibility that allows you some autonomy to make changes. When we discovered the system preparations list had nurses prepping patients before positioning (we do it the other way around), we were able to change the list to match our actual workflow.
7. Training, training, training for all users. Training continues all along the way.
8. Be upbeat, because many people are intimidated by technology. I'm proud that we didn't lose a single staff person because of technophobia. Also, the EMR core staff needs to get all the encouragement and praise you can muster because the process can be discouraging at times. Get out the pom-poms!
9. Buy the system you want. Don't let price dissuade you — know that you can always purchase additional capabilities later. When we purchased our system, we had to give up some things that weren't essential to achieving our goals, but they were the "wow" things we'd love to have. What we bought is doing exactly what we thought it would, if not more than we dreamed.
10. Negotiate, especially at the end of the fiscal year, when EMR vendors have sales quotas to meet.
Ms. Saylor (asaylor@gjhosp.org) is director of surgical services at Community Hospital in Grand Junction, Colo.
