Trying to juggle work, attempts at a social life, staying physically active, and keeping up with adult tasks (i.e., oil changes and doctor’s appointments), something is bound to be forgotten. For example, when I first started at Haskell, I forgot to go to the dentist for close to two years. It wasn’t until someone mentioned they were going to the dentist that I realized this important task had slipped my mind. Now I have a biannual reminder set up to remind me, but without an outside party mentioning what I had forgotten who knows when I would have remembered. Most likely, it would have been when I finally got a toothache and there would only have been limited and painful treatment options available.
The same is true for activation readiness. Having someone remind you of a forgotten task as it pertains to a hospital opening can help allow you to get ahead of possible bottlenecks before there is a delay or discontinuity in the delivery of patient care.
Activation readiness focuses on either core operational tasks that are changing based on the new landscape or location, persons responsible, or order of tasks that are changed due to space layout with no actual change to the workflow. To successfully implement these changes, activation readiness relies on many different stakeholders coming together to ensure successful Day 1 operations, including staffing, education, policies and procedures, 5S activities, IT, communications and marketing, equipment, and supply locations. Not to mention, all of these factors need to be considered on a department, hospital, and system level.
For example, if the registration process changes in the oncology unit from bedside registration on the unit (a process the patients and staff are expecting) to pre-registration and brief check-in at the front desk (a new process change due to the streamlined entry points of the new tower), this process must be properly implemented. The information not only has to be approved and communicated to the staff working in the oncology department but also needs to be shared to all physicians’ offices that will be sending patients to the unit. At a minimum, team members from marketing, communication, oncology, physician groups, nursing education, registration, and guest services are required to come to a consensus on the new process and share information among their teams.
Forgetting one aspect of this coordination will result in significant delays and massive confusion on Day 1 operations. Not to mention, lack of coordination can hurt patient satisfaction when a patient hears different information from different staff members. Keep in mind this is just one department; depending on the number of departments moving, there are infinite processes that need to be developed, approved, and communicated.
How does all this activity stay streamlined and effective? To reduce the number of forgotten items, activation work is a vital step when dealing with any size hospital move. Having multiple eyes and perspectives on the rapid changes that can happen in a short period of time allows for the best chance of aligned operations, patient safety, and patient satisfaction. Coordinating and communicating necessary changes requires comprehensive and expert oversight. Implementing these changes requires the time and energy of possibly hundreds of staff members, which can become expensive but is necessary.
Activation in Action
A recent large-scale project, for which Haskell led activation efforts, involved 23 activation teams across both clinical and support areas that met biweekly for 11 months. In each meeting, the teams discussed their specific process changes as well as how those changes might affect other workgroups. They also covered communication, emergency and risk management, education, and change management needs. Each bi-week also included a “War Room” meeting in which the leaders of each workgroup came together to discuss issues, brainstorm possible fixes, and identify additional resources and timetables required to resolve problems. The group setting allowed vast amounts of information to be shared and heard at the same time.
The work of these teams culminated in tabletops and walkthroughs of practice patients who were cared for across multiple departments (for example, a patient started a journey to the ED, then was sent to surgery and recovery, then was admitted, and finally was discharged). This testing allowed staff to pressure test their new processes, paths of travel, hand-offs, and equipment in the new space. Any problems we encountered during the exercises were triaged and prioritized for resolution in the weeks leading up to the building opening. Any building code or life safety issues had to be addressed immediately; other issues were either important to address before the opening or could wait until after the opening.
While none of these details were individually difficult to address, management of the sheer number of details would overwhelm a team of hospital employees who already had their own jobs to do. They needed the outside perspective of a team experienced in project management of multidisciplinary implementation projects.
Understanding the importance of looping in risk management, regulatory, education, marketing, security, facilities, construction, change management, and move consultants at the appropriate time is a time saver in the long run to eliminate bottlenecks and red-tape at opening. Having someone remind you of forgotten tasks, whether it’s going to the dentist or looping in the regulatory team for a large-scale hospital move, can help reduce the chances of needing a root canal or, even worse, a patient safety event at the opening of a new patient tower.
