Collaboration key to building CST confidence

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Vancouver General Hospital implemented the CST Cerner clinical information system on November 5, 2022. This was the largest phase in a project that will see all Vancouver Coastal Health sites plus the Provincial Health Services Authority and Providence Health Care sharing the same electronic health management system. It was also one of the largest Cerner deployments in North America to date.

VPSA’s CST Task Group worked closely with the VGH CST team to support a successful rollout.

“Our mandate was to develop and deliver engagement activities, including opportunities for hands-on experience with the system prior to go live,” said the group’s chair, Dr. Raheem Kherani. “We worked with VCH to develop a communication strategy and work plan to build awareness among medical staff. An important aspect of our work was to ensure clear processes were established to identify and report issues, questions, and problems. We also raised unresolved problems to VCH leadership when necessary.”

Due to the COVID-19 pandemic, there was a long lead up to CST’s implementation at VGH. VPSA hosted its first CST townhall in January 2019, offering physicians an opportunity to see the system in action and try out workstations on wheels. That was followed by a workshop in October 2019. A CST page was added to VPSA’s website including resources and articles to prepare for the transition and CST was highlighted in each issue of the organization’s weekly Checkup newsletter. Shortly after CST’s introduction at Providence Health Care in November 2020, VCH’s Chief Information Officer Ron Quirk met with VPSA members to talk about the role technology plays in health care.

“Our work helping members prepare for CST ground to a halt with the onset of the pandemic and the decision to delay implementation,” recalled VPSA President Dr. Alison Harris. “That changed when the November 2022 go-live date was announced and we ramped up our activities.”

In February 2022, VPSA and VCH’s CST team partnered to offer system demonstrations. These were offered to different departments and divisions, with workflows tailored to match specific needs. Sessions were led by physicians already working with CST at other sites who could speak from personal knowledge about training, the initial weeks following go live, and working with CST. FESR optimization workshops were offered in April 2022 and these were followed by another townhall session in May 2022. VPSA also created an anonymous feedback form for members to raise concerns.

As the November 2022 go-live date approached, activities picked up. With more physicians taking part on the CST Task Group, VPSA applied for and received an additional $50,000 from Doctors of BC for CST preparation. Task group members began meeting regularly with Vancouver Acute’s CST Medical Leadership to discuss ways to support members and voice their concerns and feedback. VPSA provided coffee, tea, and snacks for in-person training sessions, visits were organized for physicians wishing to visit sites where Cerner had been implemented already, and workstations on wheels became a fixture at its monthly VGH lunches.

As the days to launch counted down, VPSA introduced weekly surveys to get a sense of members’ confidence levels and to see if these improved over time. To assist with the transition itself, lunches were offered weekly in the VMDAS Hub for Engagement and Wellness at VGH for the first month and snacks were available daily. An optimization session was offered in mid-November to assist those with specific requests.

“The survey showed increased confidence with Cerner over time,” said Dr. Kherani, “and members raised 30 specific concerns that we took to VCH’s CST leadership team for action.”

“Our partnership with VPSA was critical for the successful launch of CST at VGH,” said Associate Physician Engagement Lead, Vancouver Acute, Dr. Dave Wilton. “The engagement measures made a significant difference and allowed us to focus on training and implementation. The activities also provided insights into what issues our physicians were having, allowing us to quickly search for and/or create solutions unique to our site.”

VPSA is currently funding meals for department and division optimization sessions and continues to solicit and collect feedback and concerns. An updated survey was launched recently with the goal of assessing further ways of supporting VPSA members during this important transition. The new survey will be available for one month and we ask members to take it every week so we can measure progress. VPSA’s CST Task Group is continuing its work in order to provide ongoing opportunities for physicians to provide feedback to make improvements that optimize the system.

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