‘Go live’ may sound like a bad public health campaign, but it is a common term used in digital system roll-outs.
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In the digital world, it is the high-risk period of time before final implementation – when an IT system is tested and problems are identified.
Leadership is obviously needed when a new IT system is being tested. The executive team must set a ’go live’ date in advance and involve the interprofessional team in the planning.
It is vital that any ’go live’ phase of clinical IT systems has a clearly defined beginning and end with everyone signed up to it. Staying in this phase indefinitely is like being on constant alert and it is exhausting. It can also lead to staff questioning the future of the system, so tight time frames are essential.
The transition to a new IT system cannot be one person’s crusade and it needs to be a multidisciplinary approach. For example, many organisations working on electronic documentation establish an e-documentation group to standardise paperwork before a digital roll–out.
“You need to ensure you have champions”
This group can help by updating staff on the progress of the project and how it will affect clinical areas. They can also help make any necessary tweaks to the system to ensure patient safety and care.
It is important – if possible – to pick a quiet time to go live. Having a rota of staff who have skills in using the system and can provide support is also essential. This is not an issue of hierarchy or level but about system knowledge. You need to ensure you have champions.
The ’go live’ stage of a project should be exciting and using methods such as placing a countdown clock in staff areas or even on the front page of your intranet can help to generate enthusiasm for a change in practice.
You may want to adopt a “big-bang” approach to implementation, for example, when implementing an e-documentation you may choose to withdraw all the paper patient notes during the test period, or you could decide run two systems alongside each other, keeping both paper notes and the new digital records.
The approach has to be an organisation’s decision based on risk and the type of patients the trust is caring for
Open events outlining the cost, perceived benefits and the pace of change with timeframes can help allay staff and patients concerns about new IT.
Regular contact with executive teams, super-users and champions is also great for staff as it emphasises the governance and the executive team’s support for the system.
“Nurses are crucial to any safe digital roll-out”
Training and education is vital in the ‘go live’ phase. Clinical areas may have bank or agency staff or team members returning from sick or maternity leave. They should not have to jump unprepared into an entirely new digital clinical environment. Training has to be flexible and involve as much simulation as possible.
Nurses are crucial to any safe digital roll-out, and there are many roles that can help organisations during the transition, such as practice educators and senior and clinical nurse specialists to name just a few.
It is better to be pro-active and not reactive when introducing a digital system into healthcare. Being prepared for roll-out is a vital part of the process.
Lesley Jones is nurse fellow (digital) at NHS Improvement.
This series of blogs has been co-produced with help from trust staff looking at and introducing systems: Arran Rogers, Royal Berkshire NHS FT; Jane Benfield Gloucestershire Hospitals NHS Trust; Sam Neville, Basildon and Thurrock NHS Trust; and Dr Natasha Phillips, University College London.
What does 'go live' mean?