HealthSMART Clinical Systems Portfolio

HealthSMART Victoria’s Whole-of-Health ICT Strategy The Royal Children’s Hospital Clinical Systems Project Governance Model October 2004 Prepared by and dated Heather Maddern, RCH, 25/10/04 Endorsed by Version Amendment History V. 1 2 3 4 5 Date Created 10/09/04 29/09/04 05/10/04 19/10/04 25/10/04 Sections Changed Draft 5.1 5.1 5.1 5.1 Created/Amended by Heather Maddern Heather Maddern Colin Feekery Heather Maddern Steering Committee EMM Governance Model v5 rch.doc HealthSMART Victoria’s Whole-of-Health ICT Strategy Contents Clinical Systems Project Governance Model ......................................................................... 1 1.0 Introduction ................................................................................................................... 2 2.0 Clinical Systems Implementation Approach ................................................................... 2 3.0 Lead Agency Organisation.............................................................................................. 3 4.0 RCH Governance Structure Overview ............................................................................. 3 5.0 RCH Governance Structure Groups and Committees....................................................... 4 5.1 5.2 5.3 5.4 5.5 5.6 5.7 Electronic Medications Management Steering Committee ................................................. 4 Clinical Reference Group ............................................................................................. 7 Infrastructure/Technical Work Group ............................................................................ 9 Communications Group ..............................................................................................10 Health Information Group...........................................................................................11 Data Quality Group ...................................................................................................12 Training Group .........................................................................................................13 6.0 Appendix – RCH Clinical Systems Governance Structure .............................................. 14 EMM Governance Model v5 rch.doc HealthSMART Victoria’s Whole-of-Health ICT Strategy 1.0 Introduction For the HealthSMART program to succeed, projects must be supported by an effective organisation and committee structure. This organisation and committee structure will engage with the stakeholders spanning the executive, management and operational levels. The purpose of this document is to provide a template for the Agency’s to present details of their own governance structures/groups. 2.0 Clinical Systems Implementation Approach The implementation of new clinical applications will rely on the collaborative participation of Clinical Systems Lead Agencies, Shared Services Centres, vendors and the OHIS to deliver the sought after outcomes. Implementing the initiatives of the Clinical Systems Portfolio is a major program of activity that will take significant time and commitment from all involved. The proposed approach is tailored to reduce risk, provide flexibility and promote progress through multiple project streams. Key elements of the proposed approach include: Functionality is introduced in clinically logical groups of manageable size and increasing complexity; User skills, confidence and proficiency are developed as functionality is delivered; Health Agency governance structures and project experience grow with each project; A replicable implementation model increases project efficiency and promotes consistency of results; Health Agency capacity for change is increased incrementally with each project; Flexibility allows Health Agencies who prove themselves capable in the initial phase options in subsequent phases; Phasing of delivery enables earlier start of Health Agency implementation and demonstrable Portfolio results; With increasing experience roll-out timeframes may be able to be shortened; In addition to being a key step in the selection process, proof-of-concept trials provide an essential learning and preparatory opportunity for implementation; Adoption of a common base system across the enterprise pools resources for maximum gain, encourages idea sharing, reduces Agency implementation effort and begins the transition to common systems; and The generic implementation model can be applied if multiple products are selected for Clinical Systems panel availability. EMM Governance Model v5 rch.doc Page 2 HealthSMART Victoria’s Whole-of-Health ICT Strategy 3.0 Lead Agency Organisation The Royal Children's Hospital is a specialist paediatric hospital and provides a full range of clinical services, tertiary care and health promotion and prevention programs for children and adolescents. Patients are referred to the Royal Children's Hospital from all over Australia and the Asia-Pacific rim countries. As the major paediatric hospital in Victoria, the Royal Children's Hospital provides clinical, academic and advocacy services for children and young people throughout the state. It is internationally recognised as a leading centre for research and education. In its role as a leading paediatric teaching centre, the hospital has affiliations with the University of Melbourne and La Trobe University and links with other universities in post graduate studies. The hospital has 310 beds, and treats approximately 33,000 in-patients each year. A total of 280,000 children are treated by the hospital annually. 4.0 RCH Governance Structure Overview The Electronic Medications Management Steering Committee at RCH, chaired by Dr Colin Feekery, the Project Sponsor is the principal governance body of the electronic medications management project (as part of the DHS HealthSMART Clinical Systems strategy). Its role is to lead, direct and monitor all phases of the electronic medications management project. The Steering Committee primary reports are to the hospital Chief Executive Officer and to the Board of Health Information Systems. There are a number of Working Groups (Appendix – RCH Clinical Systems Governance Structure Organisational Chart) that will be established as the project progresses and matures: • Clinical Reference • Infrastructure/Technical • Communications • Health Information • Data Quality • Training These groups will inform, advise, report and provide practical input on their areas of expertise to the Steering Committee, via the RCH Clinical Systems Project Manager. The membership of the Steering Committee and Working Groups has/will be selected to be representative of all stakeholders. EMM Governance Model v5 rch.doc Page 3 HealthSMART Victoria’s Whole-of-Health ICT Strategy 5.0 RCH Governance Structure Groups and Committees 5.1 Electronic Medications Management Steering Committee Role statement • The role of the Electronic Medications Management Steering Committee (EMMC) is to lead, direct and monitor the implementation of the electronic medication management project (as part of the DHS HealthSMART Clinical Systems strategy) at the RCH. Name/Member Dr Colin Feekery (Chair) Mr Brian Lilley (Deputy Chair) Dr Simon Young Ms Jodie Palmington Mr Steve Firman Dr Noel Cranswick Mr Paul Longridge Dr Peter Simm Mr Cameron Barnes Mr Ian Little Ms Heather Maddern Ms Brenda White Dr Anna Moon Position Deputy Director, CSS & Medico-Legal Officer Director of Pharmacy Director, Emergency Department Director, Division of Surgery Operations Manager Director of Clinical Pharmacology Nurse Unit Manager RMO Representative Health Information Services Manager ICT Director RCH Clinical Systems Project Manager Director, Division of Laboratory Services Acting Director, Medical Imaging Services The composition of the Steering Committee is designed to represent the various interests of all key stakeholders: RCH executive, medical, nursing, pharmacy and other service provider representatives, the Information & Communications Technology (ICT) Department and the Office of Health Information Systems. When the Clinical Systems application has been selected and the project is at the Implementation Planning Study stage, representatives from the Office of Health Information Systems will participate in the Steering Committee. For example, the Clinical Systems Portfolio Manager may become a member and the Clinical Systems Project Manager a regular invitee to report on project progress in collaboration with the RCH Clinical Systems Project Manager. An executive representative from the Vendor (Vendor Relationship Manager) will be included as an invitee when the vendor is known. Terms of Reference Responsibilities • • Provide leadership, direction, decision-making and oversight to all initiatives undertaken within the Clinical Systems project, including any pre-implementation business. Endorse the scope of work to be undertaken in the project, including trial size, application Page 4 EMM Governance Model v5 rch.doc HealthSMART Victoria’s Whole-of-Health ICT Strategy functionality and the extent of decision support to be implemented. • • • • • Keep the project on track to a successful outcome, as measured by adherence to time, budget and performance (scope and quality). Monitor project budget against expenditure. Establish appropriate functional (business) working groups to implement the project, including approving and reviewing project implementation plans and the project budget. Receive and consider recommendations from working groups about issues related to the project. Monitor the business benefits post implementation, for example, medication error reduction. Reporting • Regular reports on progress of the initiatives will be made to: The HealthSMART Clinical Systems Steering Committee and the Office of Health Information Systems; The RCH CEO as 3 monthly briefings by the Chair and the RCH Clinical Systems Project Manager; The Divisional Directors Group (via Director, Division of Surgery); The RCH ICT Steering Committee (via the ICT Director); And any other significant stakeholder group as dictated by the progress of the project. Terms of Reference Review • • The Terms of Reference will be reviewed annually throughout the project term. The first review will take place in March 2005. Committee members who have not attended at least 75% of meetings will be asked to evaluate whether they have the time required to be part of the decision making committee or whether someone else should be nominated. Frequency of Meetings • The Steering Committee will meet monthly. The frequency of meetings may be reviewed at any time and additional meetings called to meet the demands of the project. Meetings may be cancelled at the discretion of the Chair if there is insufficient business. A forward schedule of meetings will be distributed at the beginning of each year and distributed to Steering Committee members, by the Clinical Systems Project Manager. • Appointment of Proxies • Proxies will not be allowed. Decision Making • Decisions will be made at meetings by a majority vote in the presence of the Chair or the Deputy Chair. Exercise of powers out of session • When an issue arises that in the opinion of the Chair of the Steering Committee, requires a decision and resolution before the next scheduled meeting of the Committee, the Chair may either call an extraordinary meeting of the Steering Committee, or proceed to seek an outof-session resolution. A resolution can be achieved and may be acted upon when the Chair/Deputy Chair and two • EMM Governance Model v5 rch.doc Page 5 HealthSMART Victoria’s Whole-of-Health ICT Strategy other members agree on a course of action. The decision will then be tabled at the next Steering Committee meeting. EMM Governance Model v5 rch.doc Page 6 HealthSMART Victoria’s Whole-of-Health ICT Strategy 5.2 Clinical Reference Group Role statement • Responsible for providing clinical content expertise, subject matter input and work practice information for all clinically related matters. It will advise both the EMMC and the other Working Groups to ensure that clinical issues are addressed in the appropriate manner. Name/Member To be appointed To be appointed To be appointed To be appointed To be appointed Mr Brian Lilley To be appointed Ms Bernie Beyer To be appointed Ms Heather Maddern Position Medical Divisional Director Senior Consultant 1 Senior Consultant 2 Chief Resident RMO representative Pharmacy Director Nursing Divisional Director Nurse Unit Manager Nursing Representative Clinical Systems Project Manager Terms of Reference Responsibilities • Set project key success factors: Achievement of Clinical System usage targets by clinicians (shared with EMMC). Identification and resolution of key clinical issues facing success of the project Ensure buy in of clinical community and provide a communication channel, in collaboration with Communications Group. • • • • • • • • Create a climate of sustained organisational commitment within the clinical community to the project. Assume the role of an ambassador or champion of the project. Act as a liaison to clinicians and executives in communicating key messages and information. Drive business change and improvement through the project. Provide linkage to clinicians and external clinical organisations. Provide guidance on clinical matters to other Work Groups and the EMMC. Direct policy relevant to the project to ensure it takes account of clinical expertise. Confirmation of clinical issues relating to the roll-out approach. Term of Membership • For the duration of the project. EMM Governance Model v5 rch.doc Page 7 HealthSMART Victoria’s Whole-of-Health ICT Strategy Frequency of Meetings • The Clinical Reference Group will meet monthly. The frequency of meetings may be reviewed at any time and additional meetings called to meet the demands of the project. Meetings will be cancelled if there is insufficient business. EMM Governance Model v5 rch.doc Page 8 HealthSMART Victoria’s Whole-of-Health ICT Strategy 5.3 Infrastructure/Technical Work Group Role statement • The Infrastructure Work Group is charged with current environment assessment, planning and addressing all requirements related to ensuring the infrastructure necessary for the program is in place and managing issues as they arise. It is the Group’s role to identify, plan and oversee all local technology needs including subgroups related to Infrastructure. Specific responsibilities will include WAN connectivity, LAN requirements, local servers (e.g. authentication) and access point placement and deployment. • Name/Member Mr Philip Moss To be appointed Ms Bernie Beyer Ms Heather Maddern To be appointed Position ICT Infrastructure Manager Desktop Services Manager Nurse Unit Manager Clinical Systems Project Manager Engineering/Building Manager Terms of Reference Responsibilities • Provide local counterpart of OHIS Technical Services Unit. • • • • Assess and document Health Service/Agency infrastructure state as appropriate for Clinical Systems implementation. Identify, plan and perform all necessary work space revision required for access point device deployment. Determine access point device needs, in collaboration with the clinical areas representatives and OHIS Project Manager. Identify, plan and perform (may include contracting) all LAN and electrical services upgrades needed to support access point device deployment for implementation of clinical systems Provide Technical Services resources needed to establish local service environments needed for clinical systems implementation (e.g. authentication). Prepare access device deployment including standard operating environment (SOE) configuration. • • Term of Membership • For the duration of the project Frequency of Meetings • The Infrastructure/Technical Work Group will meet monthly. The frequency of meetings may be reviewed at any time and additional meetings called to meet the demands of the project. Meetings will be cancelled if there is insufficient business. EMM Governance Model v5 rch.doc Page 9 HealthSMART Victoria’s Whole-of-Health ICT Strategy 5.4 Communications Group Role statement • The Communications Group will ensure that stakeholders receive consistent, timely, and positive messages, in addition to maintaining coordination between project activities and fostering project cohesiveness. It performs the role of dissemination of information to ensure that all necessary individuals and groups have a clear view of the project direction across RCH. Name/Member Mr Steve Firman To be appointed Ms Jodie Palmington Ms Julie Webber Ms Heather Maddern Dr Anthea Greenway Position Operations Manager Medical Divisional Director Nursing Divisional Director Public Affairs Manager Clinical Systems Project Manager Chief Resident Terms of Reference Responsibilities • Ensure critical stakeholders are apprised of current project activities and issues. • • • • • • • • Ensure the organisation is aware of current activities relating to Clinical Systems project. Ensure RCH patients/clients are aware of current activities relating to Clinical Systems project and how this may impact them Communicate key successes and milestones to the organisation. Develop a communications strategy for the Clinical Systems project being undertaken at RCH. Identify target audiences and stakeholders for communications. Determine the type and detail of information required for each stakeholder group. Determine the most appropriate method(s) of communication for each stakeholder group. Determine an overall schedule of communications for the project. Term of Membership • For the duration of the project. Frequency of Meetings • The Communications Group will meet monthly. The frequency of meetings may be reviewed at any time and additional meetings called to meet the demands of the project. Meetings will be cancelled if there is insufficient business. EMM Governance Model v5 rch.doc Page 10 HealthSMART Victoria’s Whole-of-Health ICT Strategy 5.5 Health Information Group Role statement • To ensure that health information management principles, policies and procedures are established within the context of the electronic medications management (clinical systems) implementation. Name/Member Mr Cameron Barnes To be appointed To be appointed To be appointed To be appointed Ms Heather Maddern Position Health Information Services Manager Clinical Audit/Practice Representative ICT Director delegate Medical Divisional Director Nursing Divisional Director Clinical Systems Project Manager Terms of Reference Responsibilities • • • • Provide advice on issues relating to electronic record content, storage and usage. Develop policies and procedures regarding storage of information contained within the electronic medications management system. Advise ethics and review committees on requests for extracts of information from the electronic medications management system for research purposes. Ensure health information and privacy principles are applied and adhered to in the context of the clinical system implementation. Term of Membership • For the duration of the project. Frequency of Meetings • The Health Information Group will meet monthly. The frequency of meetings may be reviewed at any time and additional meetings called to meet the demands of the project. Meetings will be cancelled if there is insufficient business. EMM Governance Model v5 rch.doc Page 11 HealthSMART Victoria’s Whole-of-Health ICT Strategy 5.6 Data Quality Group Role statement • The Data Quality Group is responsible for data quality issues related to the Electronic Medications Management project. The main role of the group is to ensure that the business units and service providers at RCH will agree to collect, store, and transmit data according to the standards agreed with DHS in consultation with stakeholders. Name/Member To be appointed Mr Brian Lilley To be appointed To be appointed Mr Mike Parow Ms Heather Maddern Position ICT Director representative Pharmacy Director Laboratory Services/Medical Imaging Director representatives Health Information Manager ICT Corporate Applications Manager Clinical Systems Project Manager Terms of Reference Responsibilities • Establish a firm and unambiguous statement of scope for the Data Quality Work Group • • • • • Facilitate processes and communication channels to promote data quality across the electronic medications management system. Identification and realisation of enterprise data quality approaches and benchmarks Ensure that Data Quality issues, such as interfaces between systems are adequately addressed throughout the project Support policy development relevant to data quality e.g. communication channels, processes, etc. Create a climate of sustained commitment to Data Quality through the electronic medications management project. Term of Membership • For the duration of the project Frequency of Meetings • The Data Quality Group will meet monthly. The frequency of meetings may be reviewed at any time and additional meetings called to meet the demands of the project. Meetings will be cancelled if there is insufficient business. EMM Governance Model v5 rch.doc Page 12 HealthSMART Victoria’s Whole-of-Health ICT Strategy 5.7 Training Group Role statement • The Training Group will ensure that pre and post- implementation of the Clinical Systems, all necessary individuals and groups attain appropriate training to be able to proficiently use the EMM system. Name/Member To be appointed Ms Marta Marek To be appointed Transient appointment (Ms Bernie Beyer initially) Transient appointment To be appointed To be appointed Ms Heather Maddern Position ICT Operations Manager ICT Training Officer RMO representative Nurse Unit Manager, Current Implementation Ward Nurse Facilitator, Current Implementation Ward Nurse Educator, MacKinnon School of Nursing Medical Training Officer Clinical Systems Project Manager Terms of Reference Responsibilities • Conduct training needs analysis and assess existing level of capability clinical area by clinical area (may be a ward, emergency department, outpatients, etc) within RCH, as the implementation rolls out. Assess existing training facilities and when and if necessary establish new training facilities. Plan, roster and deliver training. Obtain evaluation/feedback of training and modify training delivery methods accordingly. Conduct user satisfaction surveys post-implementation. • • • • Term of Membership • For the duration of the project Frequency of Meetings • The Training Group will meet monthly. The frequency of meetings may be reviewed at any time and additional meetings called to meet the demands of the project. Meetings will be cancelled if there is insufficient business. EMM Governance Model v5 rch.doc Page 13 HealthSMART Victoria’s Whole-of-Health ICT Strategy •Deputy Director, Clinical Support Services •Director of Pharmacy •Director, Emergency Department •Director, Division of Surgery •Director, Division of Laboratory Services •Medical Imaging Services representative R C H E le c tr o n ic M e d ic a t io n s M a n a g e m e n t S te e r in g C o m m itte e 6.0 Appendix – RCH Clinical Systems Governance Structure •Operations Manager •Director of Clinical Pharmacology •Nurse Unit Manager •RMO Representative •Health Information Services Manager •ICT Director •RCH Clinical Systems Project Manager C lin ic a l R e f e r e n c e In fra s tru c tu re / T e c h n ic a l C o m m u n ic a tio n s T r a in in g D a t a Q u a lit y H e a lt h I n f o r m a t io n • Medical Divisional Director • Senior Consultant X 2 • Chief Resident • RMO representative • Pharmacy Director • Nursing Divisional Director • Nurse Unit Manager • Nursing Representative • CS Project Manager • ICT Infrastructure Manager • Desktop Services Manager • Nurse Unit Manager • Engineering/Building Manager • CS Project Manager • Operations Manager • Medical Divisional Director • Nursing Divisional Director • Public Affairs Manager • CS Project Manager • ICT Operations Manager • ICT Training Officer • RMO representative • Nurse Unit Manager • Nurse Facilitator • Nurse Educator • Medical Training Officer • CS Project Manager • ICT Director representative • Pharmacy Director • Other service dept reps • Health Information Manager • ICT Corporate Applications Manager • CS Project Manager • Health Information Services Manager • Clinical Audit/Practice Representative • ICT Director delegate • Medical Divisional Director • Nursing Divisional Director • CS Project Manager EMM Governance Model v5 rch.doc Page 14