HIM 685 Module 7 Final Project Milestone Two Example

Final Project Milestone Two: Week by Week. The Change Management and Implementation Plan for Exchange Integration at Longleaf Regional

[Student Name]

Southern New Hampshire University

HIM 685: Advanced Topics in HIM II

Final Project Milestone Two

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[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

Final Project Milestone Two: Week by Week. The Change Management and Implementation Plan for Exchange Integration at Longleaf Regional

Milestone One set four goals for Longleaf Regional Medical Center's integration with the statewide exchange: clean patient identity before the first feed, timely admission and discharge notices, discharge summaries available within 48 hours and a growing share of record requests answered through the exchange without cutting release-of-information positions. The Module Six paper chose Kotter's sequence of steps, checked against Weiner's questions about readiness, as the approach to change. This milestone turns both into a plan for the composite 180-bed hospital in Hattiesburg, Mississippi: who does what, when, how people will hear about it, how they will learn the new work, how the hospital will know it is ready to move on and how the change will be made to last.

Workstreams and Owners

The work is divided into five workstreams, each with one owner. Patient identity, owned by the HIM director with the registration manager, links the two clinic identifiers, merges duplicate records and trains registration staff on identity checks. Interfaces and infrastructure, owned by the IT manager, builds the notice, lab and document feeds and upgrades the document server for round-the-clock queries. Documents, owned by the chief medical officer's office with HIM, makes discharge summaries complete and signed within 48 hours. Release-of-information transition, owned by the HIM director, retrains the team and redesigns its work. Patient notice and choice, owned by the privacy officer, publishes notices and runs the opt-out process. A steering group of the five owners meets every two weeks.

Timeline

Table 1 sets out the timeline. Identity work comes first because every feed depends on it, and the release team's transition runs throughout rather than at the end.

Table 1. Twelve-Month Implementation Timeline

Note. Months run from the steering group's first meeting.

Communication Plan

Communication follows the advice of Kotter (1995), who found that leaders tend to undercommunicate a vision badly and must repeat it in every channel available. The message for every audience is the same at its core: patients and clinicians across the state will be able to see Longleaf's records in minutes, and the hospital is investing in the people who make that possible. The details differ by audience. Physicians hear about faster access to outside records and what is expected of their signatures, through the two physician champions at department meetings. Registration staff hear why identity checks matter, through short huddles. The release-of-information team hears first and most often: a meeting with the director in week one, a weekly update from the guiding group and an open question box whose answers are posted. Patients see a plain-language notice in clinics, on the website and in admission packets.

Training

Training is role-based. Registration staff complete a thirty-minute module on identity verification and the cost of duplicates. Physicians receive a single page on signing summaries and on what outside clinicians will see. The release-of-information team receives the most: two specialists train first with the exchange's support staff on match review and query monitoring, then teach the rest of the team in pairs over six weeks, with practice on real but de-identified cases. Each team member finishes with a short skills check, and anyone who needs more time gets it without penalty.

Readiness Checkpoints

Readiness rests on two shared conditions, wanting the change and believing the group can deliver it (Weiner, 2009). Before each phase begins, the steering group will check both for the people most affected. For the release team, an anonymous survey asks two questions: whether the change will be good for patients and the team, and whether the team can learn the new work. The plan does not move to the next phase until most answers are positive; if they are not, the group spends two more weeks addressing the concerns raised. Similar checks with registration staff and physician champions precede the identity and document go-lives.

Measures

Progress is tracked monthly against the four goals: the duplicate record rate, the share of notices sent within fifteen minutes, the share of summaries signed and available within 48 hours and the share of provider requests answered through the exchange. Two people measures are added: release-team readiness scores and team turnover. Vest and Gamm (2010) observed that exchange efforts often stall on organizational problems, and these measures are designed to show such problems early.

Each measure has an owner who reports it at the steering meeting, and any measure that misses its monthly target two months running triggers a short review of causes rather than a push to work harder. Results are shared with the release team at their weekly update, so the people doing the new work see the same numbers leaders see.

Making It Last

Lewin (1947) emphasized that new patterns must be stabilized or groups drift back to old ones. Three steps anchor the change. The release team's new roles will be written into job descriptions with updated titles and, where justified, pay grades. The mail and fax workflow will be retired formally after three consecutive months in which the exchange handles its target share, with exceptions documented. And exchange measures will be added to the department's standing monthly report so that attention does not fade after go-live.

Conclusion

The plan gives every workstream an owner and a timeline, tells each audience what it needs to hear, trains people according to how much their work changes and pauses when people are not ready. The final project will combine it with the strategic analysis into one integration and change plan.

References

Kotter, J. P. (1995). Leading change: Why transformation efforts fail. Harvard Business Review, 73(2), 59-67.

Lewin, K. (1947). Frontiers in group dynamics: Concept, method and reality in social science; social equilibria and social change. Human Relations, 1(1), 5-41. https://doi.org/10.1177/001872674700100103

Vest, J. R., & Gamm, L. D. (2010). Health information exchange: Persistent challenges and new strategies. Journal of the American Medical Informatics Association, 17(3), 288-294. https://doi.org/10.1136/jamia.2010.003673

Weiner, B. J. (2009). A theory of organizational readiness for change. Implementation Science, 4, Article 67. https://doi.org/10.1186/1748-5908-4-67