Purpose
The purpose of the BPG Order SetTM Implementation Toolkit is to help health care organizations implement best practice guidelines developed by the Registered Nurses’ Association of Ontario (RNAO). RNAO’s BPG Order Sets serve as knowledge translation tools to simplify the process of integrating the guidelines within electronic health information systems. More detailed information on the benefits of using BPG Order Sets is available in the resource "What is an RNAO BPG Order Set?"
Based on the experiences of early adopters of the BPG Order Sets, this user-friendly Toolkit delineates key steps, tools and other resources to support organizations in this venture. It covers topics such as project management, change management, risk mitigation and sustainability planning—topics that are essential for a successful implementation, yet are often overlooked. Finally, there is vitally important information on the need for upfront data extraction planning to support post-implementation monitoring and evaluation and ongoing quality improvement.
Target Audience
This Toolkit will have relevance for all individuals involved in the implementation of BPG Order Sets including:
- frontline nurses and other health professionals (as appropriate, based on the guideline topic);
- nurses with expertise in computer systems or informatics;
- professional practice leaders, nurse educators, advanced practice nurses and clinical nurse specialists;
- information technology professionals; and
- decision support personnel.
About the Toolkit Development
The Toolkit was developed during the RNAO Nurse Peer Leader Network Project. The toolkit and the project were both funded by Canada Health Infoway (Infoway). A key goal of the Project was to promote evidence-based wound management across multiple sectors using RNAO’s BPG Order Sets. The Project included six nurse peer leaders working in four health care organizations across the care continuum: ambulatory care, acute care, home care and long-term care. It brought together nurses with informatics expertise and subject matters experts from the partner organizations to embed the BPG Order Sets within four electronic health information systems: Meditech®, Epic®, Procura® and PointClickCare®.
The Toolkit includes tools and resources used by the nurse peer leaders throughout the Project as well as other pertinent tools identified in the RNAO eHealth guideline: Adopting eHealth Solutions: Implementation Strategies.1
Toolkit Sections
The Toolkit contains five sections. The first section describes the purpose of the Toolkit, identifies the target audience and provides an overview of the contents. The other four sections are aligned with RNAO’s BPG Order Set Implementation Framework which delineates the four key phases of the implementation process: initiation and analysis; planning; implementation; and evaluation and sustainability. Each of these sections is described below.
[collapsed title="Initiation and Analysis"]
This section provides a variety of tools and resources to support key activities that are required at the outset of the BPG Order Set implementation project such as the: establishment of the governance structure; project team orientation; and analysis of the implementation context. Tools included in this section are:
- organizational readiness assessment;
- sector-specific governance structures;
- project team orientation presentation;
- gap analysis template; and
- examples of workflow analysis.
[/collapsed] [collapsed title="Planning"]
Tools to effectively plan each step of the BPG Order Set implementation are included in this section. These tools include:
- project charter;
- project plan templates;
- project and change management resources;
- data collection and extraction plans; and
- an evaluation framework.
[/collapsed] [collapsed title="Implementation"]
This section contains tools to guide and monitor the execution of the activities planned during the previous phase. Tools included in this section are:
- BPG Order Set implementation guides;
- weekly progress reports;
- implementation plan template;
- issues log template; and
- change request log.
[/collapsed] [collapsed title="Evaluation and Sustainability"]
This section provides tools that promote the sustainability of the intended benefits of the guideline implementation through BPG Order Sets. Tools provided in this section include:
- continuous quality improvement strategies;
- resources to sustain knowledge use; and
- strategies for system optimization.
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How to Use This Toolkit
Each section of the Toolkit builds upon the previous section to guide and support the process of implementing RNAO’s BPG Order Sets. Each section contains some or all of the following in their Tools & Resources sub-section:
- Implementation Guides: Each guide provides instructional material to walk users through the process of embedding the BPG Order Sets within a specific software application (i.e., Meditech®, Epic®, Procura® and PointClickCare®).
- Project and change management tools and resources: These include items such as frameworks, checklists, templates, forms, and worksheets.
- Presentations: Each slide deck can be viewed by individual users or presented to a group (e.g., project steering committee). Some slide decks are templates that are customizable while others are recorded presentations.
- Videos: Each video can be viewed by individual users or presented to a group during staff education sessions.
These tools and resources are freely accessible. Health care organizations are encouraged to leverage them as needed as they progress through each phase of the BPG Order Set implementation. Many of these tools can be tailored to meet the needs and context of individual health care organizations.
It is recommended that health care organizations use this Toolkit in conjunction with RNAO’s Toolkit: Implementation of Best Practice Guidelines, Second Edition.2
References:
- Registered Nurses’ Association of Ontario. (2017). Adopting eHealth solutions: Implementation Strategies. Toronto, ON: Author.
- Registered Nurses’ Association of Ontario. (2012). Toolkit: Implementation of best practice guidelines (2nd ed.). Toronto, ON: Registered Nurses’ Association of Ontario.
