The planning phase is one of the most important phases of the project. During this phase, the project manager works collaboratively with the project team and subject matter experts to develop a detailed project plan that incorporates plans for risk identification and mitigation and change management.
The project plan is a formal, living document that describes how the project will be managed. It outlines the deliverables, methods, related management plans (e.g., risk mitigation, change management), roles, responsibilities, timelines, accountabilities and a mechanism for monitoring the project as it progresses.1 The project plan is updated as needed throughout the various phases of the implementation to reflect any relevant changes. A well-designed project plan enables the project manager/lead to proactively control and complete the project deliverables in an efficient manner. 1
Risk Mitigation Plan
A risk is anything that has the potential to jeopardize the success of the project. Once a potential risk is identified a risk assessment should be completed to determine the probability of the risk occurring and the potential severity of the risk should it occur.2 Risk mitigation planning uses the information obtained from the risk assessment to develop appropriate strategies to manage, eliminate, or reduce the risk.2
Change Management Plan
A well-designed project management plan should include change management activities. Change management is the utilization of a systematic approach to support people and their organizations during the transition from their current state to their intended future state.3 In the context of eHealth implementations such as BPG Order SetsTM, project and change management plans work synergistically to increase the likelihood of a successful outcome. Project managers/leads are strongly encouraged to use formal change management methodology and a change management framework.4 Canada Heath Infoway’s integrated change management framework is recommended as it describes key elements to manage the people side of the change.3 These elements include plans for workflow integration, stakeholder management, communication management, staff education, monitoring and evaluation, and sustainability4
Future State Workflow Integration Plan
A future state workflow analysis is required to evaluate the current state workflow diagram(s) developed during the previous project phase. The goal of this analysis is to identify the most effective way(s) to integrate the BPG Order Sets within the existing workflow processes of each stakeholder (individual or group).3 Organizations are also encouraged to critically appraise the current state workflow diagrams to identify opportunities to streamline these processes, optimize resource utilization and eliminate inefficiencies. The output of this analysis is a future state workflow integration plan that incorporates future state workflow diagrams for each stakeholder (individual or group). This plan should be reviewed by the project steering committee and sign-off obtained prior to moving forward with the implementation phase.
Stakeholder Management Plan
Stakeholder management is required to fully engage all stakeholders and optimize the outcomes of the BPG Order Set implementation.3 Stakeholder management is an iterative process that uses a strategic plan to engage and communicate with all stakeholders.4 An effective stakeholder management plan describes all stakeholders, their degree of power and influence, and key strategies to increase their support while decreasing any potential negative impacts. A communication management plan is required to implement the stakeholder management plan. The effectiveness of the stakeholder management plan should be evaluated on an ongoing basis.4
Communication management is the “transmission of data between sources in and around the organization, as well as identification of the forms of transmission data to be communicated and reproduced” (p. 140).5 An effective communication management strategy controls the “delivery of planned, consistent, targeted, timely communication to the right groups, at the right times, using the most effective medium with built-in means for two-way communication” (p. 99).6 To increase the likelihood of a successful implementation, the project manager/lead must develop an effective communication plan to manage expectations, create a forum for constructive feedback, and positively influence attitudes towards the BPG Order Set.4
Project teams need to develop a comprehensive education and training plan that addresses both individual and organizational learning needs and results in end-user adoption. 4 Education increases awareness of the BPG Order Sets while training helps stakeholders to gain proficiency with the order set(s) and associated workflows and effectively integrate them into their daily routine. 4 Training should incorporate realistic scenarios and hands-on practice and be facilitated by nurses and super-users/champions who understand the stakeholders’ workflows and can help to tailor the content to reflect their practice environment.4
Monitoring & Evaluation Plan
Monitoring and evaluating is an important phase of the BPG Order Set implementation. Monitoring is an ongoing process that measures specific indicators to determine the extent to which the guideline implementation (facilitated by the BPG Order Set) achieved its planned or intended results.7 Evaluation focuses on the implementation more broadly to identify what worked, what didn’t work, and why.7
It is important to consider monitoring and evaluation early in the planning phase to ensure that lessons learned from previous eHealth implementation projects are incorporated into subsequent plans to increase the likelihood of success. Planning for monitoring and evaluation at this stage also ensures that the right people are engaged early to begin planning for data collection and extraction to support reporting requirements and evaluation metrics.
Ongoing utilization of the BPG Order Sets beyond the initial post-implementation phase is a critical success indicator.4 Health care organizations require a post-implementation sustainability plan that supports ongoing optimization and maintenance of the BPG Order Sets and associated workflows.4 RNAO’s Toolkit: Implementation of Best Practice Guidelines, Second Edition provides more detailed information on the steps involved in sustainability planning.
- University of Waterloo. (2017). Project management plan.
- MITRE. (2017). Risk Mitigation Planning, Implementation, and Progress Monitoring.
- Canada Health Infoway. (2013). A framework and toolkit for managing eHealth change: People and processes.
- Registered Nurses’ Association of Ontario. (2017). Adopting eHealth Solutions: Implementation strategies. Toronto, ON: Author.
- Hunt, E. C., Sproat, S. B., & Kitzmiller, R. R. (2010). The nursing informatics implementation guide. New York, NY: Springer.
- McCarthy, D. B., et al. (2014). Learning from health information exchange technical architecture and implementation in seven beacon communities. eGems (Generating Evidence & Methods to Improve Patient Outcomes), 2(1), 1060.
- International Labour Organization. (2015). Development cooperation manual. [Public Version]. Geneva, CH: Author.