Contributed by Charles Fred & Bob Bulow, The Breakaway Group

Rules dictate the way in which a game is played. In a work-related environment, the “rules” we use to operate and make decisions have evolved from an enduring system of incentives and rewards that reinforce how things get done.

Often these rules are so ingrained that they define the culture of an organization. Therefore, if the rules are developed to drive the people of an organization toward its mission, then the leaders have created a rich environment for success. But, if the rules are incongruent with the purpose of the organization, frustration and anxiety among those attempting to deliver on the mission prevail.

Frustration is an understatement for many clinical leaders attempting to support the introduction of any new IT application. The rules they live with daily are centered on the quality of care provided to the patient. The accord created with the rules of patient care is often challenged by an unfamiliar set of rules introduced with a new IT application.   

The reality is that the introduction and adoption of new IT applications – especially clinical applications – can be disruptive, inefficient and slow. Of course, that reality means excessive time spent away from the primary task of providing patient care. The foreign rules that take the providers away from the patient are born in a veritable clash of objectives between installation and end-user adoption. Rules around installation drive behaviors toward managing an event, and are measured in terms of project-related milestones with the purpose of all activity is the go-live. The end-user’s ability to use the new application, given the drive toward installation, is viewed as a task in the overall plan – not as the primary objective. With installation rules driving most decisions, the actual adoption of the new workflow by the care provider is overlooked as the reality of thoroughly training end-users during the frenetic go-live sequence is untenable. This conundrum is made even more complex when traditional methods of instruction for IT and workflow related skill development not only take healthcare providers offline, but are focused on the features and functionality of the application without regard to roles and tasks necessary to get the job done. End users are often left to their own devices for figuring out how to incorporate the technology into the nuances of their daily workflow.  

Consider a new set of rules for the introduction of IT applications in healthcare – rules that are created to support the rapid adoption of the application by those treating patients and rules and that ultimately safeguard the promise of the expected ROI to the healthcare organization. End-user adoption as the primary objective versus installation will fundamentally reposition the effort to focus on the outcome of the application via the skill of its users. The short and long-term results of this repositioning are significant and healthcare leaders who are using these new rules are realizing actual benefits that are often out of reach for those who continue to view IT applications as installation projects. To realize end-user adoption, leaders must change their approach and the rules they use to judge success.

First, healthcare administrators must focus on leading change. When integrating new technology, significant emphasis should be placed on planning and execution. Engaging the workforce at the outset, promoting the need for change and creating an environment that calls for action are key factors for success. End-users need to be included in the process, especially when it involves workflow re-engineering. Decision-makers must realize that end-user adoption is primarily a change leadership challenge, not a technology project.

Second, the education of healthcare providers must be meaningful and relevant to the roles and tasks that they perform. One of the biggest and most common mistakes made in the design of training is overwhelming learners with features and functions that they don’t necessarily use on a daily basis. Instead, for each end-user role, define the primary tasks to be completed with the new technology and employ learning tools that include scenario-based simulations to make the learning process relevant. Once end-users gain confidence in using the application to perform their routine duties, they will naturally explore and expand their knowledge of the full potential of the new technology.  

Third, healthcare organizations must provide continuous support of knowledge transfer throughout the useful life of the technology solution. Job aids and refresher training are among the tools used to sustain the gains. High turnover rates in today’s healthcare organizations demand robust strategies for a continual effort to educate the workforce.  

Lastly, what gets measured gets done. The rules and metrics that leaders apply to significant IT investments must be consistent with the overall mission of the organization. End-user adoption must move to the top of the leadership agenda for organizations striving for both high-quality care and fiduciary responsibility.

Charles Fred is chief executive officer for The Breakaway Group, a Denver-based company that helps healthcare professionals spend less time learning technology and more time treating patients. He can be reached at (303) 483-4300 or cfred@thebreakawaygroup.com. Bob Bulow, chief financial officer for The Breakaway Group, can be reached at (303) 483-4300 or bbulow@thebreakawaygroup.com.