Creating an Effective Onboard Team for EMR Implementation

This report presents a strategic proposal for creating an effective onboard team for the implementation of Electronic Health Records (EHRs) in the healthcare sector. It covers topics such as team creation, team building strategies, potential challenges, conflict resolution techniques, and engagement plans to promote motivation and cohesiveness. The aim is to provide guidance to the board of directors of Thomason Health System (THS) in Australia.

Introduction
Teamwork is an essential component in healthcare sector. The team should be motivated,
cohesive, communicative and goal oriented to get successful (Khatri & Gupta, 2016). The
Thomason Health System in Australia is one of the largest healthcare delivery units which is
aiming to implement a new ITS in the form of Electronic Health Records (EHRs). The recently
appointed CEO of the company along with the board of directors has asked to establish an
onboard team for the facilitation of an effective technology transition. The aim of this report is
the present a strategic proposal regarding the same to the board of directors of THS.
Part I: Team Creation
Onboarding Team Members and Rationale
The integrated healthcare system is one of the major solutions towards the challenges in
healthcare. The electronic health records system is having several benefits towards healthcare
services due to its unique property in enhancing patient’s care, patient’s centeredness, safety,
communication, equity, timeliness, and education. The EHRs also act as a strong source for the
healthcare providers to provide better healthcare. In addition to this, it is always encouraged to
have a healthier lifestyle within the population by appropriate nutrition, physical activities, wider
use of preventive care and avoiding risky behaviors (Garaigordobil & Martínez-Valderrey,
2015). The EHRs and its ability to share information regarding healthcare helped to facilitate
high quality care and will create a tangible enhancement for the healthcare organization (Hsu,
Wang, Chen, & Hsiao, 2016).
Using the Thomason Health System Bios, the selection of the onboard team was performed. The
team will be consisting of Virginia Pavini MD, Marco Tortello, Ph.D., Todd Ramos, RN,
Cristina Trevor MD, and Jennifer Kline. Dr. Marco is having a background of information
technology that focuses on patient-centered technologies. Because of his expertise in IT and
healthcare, it makes him ideal for the position of a thought leader in this core team. His
leadership will ensure that the onboarding team must meet the entire requirement associated with
the project. Dr. Virginia is quite experienced and has given service to THS for a long time. Her
role is to be a staff chief and has played a major role in THS success. The employee idealizes her
and always listens to her recommendations. She has the mindset to involve staffs in each process

that makes the transition process quite easier because the staff feels to be a part of the project
from the beginning. Dr. Cristina is experienced in implementing EHRs at other places and knows
the vitality of the technology. She is also experienced in streamlining the health records and
enhances the timing of doctor’s visits to the patient. The registered nurse Ramos is the
administrator of the nursing staff, and the responsibility he has is to get in touch with all the staff
at each level. Todd is highly concerned about the work involved in the EMR transition will
stretch the staff quite thinner. Jennifer is quite excited to meet the staff, and the ability to interact
with the staff throughout will provide a positive outlook on the benefits of the EHR and makes
her an excellent inclusion in the team (Kaneko, Onozuka, Shibuta, & Hagihara, 2018).
Part II: Team Building
Team STEPPS
The team STEPPS is nothing but the combination of the plans that offers tools, techniques, and
strategies that can help the professional in the healthcare field optimize and develops their
knowledge and team performance in healthcare settings. STEPPS team is derivative of five
important principles. These principles include communication, team structure, leadership, mutual
support and monitoring of situation (Team Stepps, 2014). Firstly, the level of skills of each team
member will be vital to know for the newly appointed chief operating officer. The support from
each of them will play a vital role as some of the members may be weaker in some area and may
be stronger in others. The members are also required to understand and support each other and
encourage team building. It will also discuss the care plan, staff, and availability of healthcare
providers throughout the shifts, available resources, and workload on the staffs. After the
discussion, there will be a debriefing of everything to evaluate the accomplished objectives and
decide if there was a success (Dyer, 2015).
A shared mental model will be implemented where each member of the team will be accountable
for their workload. Each member must be on the same page in terms of issues or goals that
required to be solved. It will help in maintaining a significant awareness about a member of the
team and their workload to achieve mutual support. It will also provide a safety net within the
team that will ensure the mistakes and oversights get caught easily and swiftly. The team

members will be responsible for assisting with the request as it will develop a climate of active
collaboration and mutual benefits (Rock et al., 2015).
Potential Challenges
Various challenges may come while creating an effective team for EMR implementation.
Precautions can be actively taken to avoid hardship among the team members. To alleviate such
challenges, where the member fails to achieve a similar vision, it is important to ensure the
mission and vision of EMR must be understood clearly and accepted by everyone. The roles and
responsibilities of work must be shared equally, and the balance must be achieved. If it is not
done, the workload will be not equally distributed, and they will start feeling overworked and
unappreciated. Significant issues can also be created with improper communication as it is a vital
part of the team members to work cohesively and able to express themselves in a group. Trust
issues among the peer can also be a critical part in a team as it may lead to giving a feeling of
unconfident on other’s abilities, communication, and work ethics. Therefore, it becomes very
important to understand the weakness and strength of each other and provide support and
encouragement whenever required (Kaneko, Onozuka, Shibuta, & Hagihara, 2018).
Techniques to Resolve Conflicts
There are five techniques that are very important to negotiate, identify and resolving the
conflicts among the team members. These techniques are hitting the conflict head-on, defining
the acceptable behavior, viewing conflicts as opportunities and the factor of importance.
Developing a framework that will help in decision making will be the key aspect of defining
acceptable behavior. Defining the position clearly will help people to know that has been
expected from each of them (Hsu, Wang, Chen, & Hsiao, 2016). When some conflicts are
inevitable, the team members must be responsible for solving the issues as soon as the seed of
conflict is sown. Intervening in the conflict proactively will help in preventing the issue from
arising. Knowing when to pick your battles is essential for any organization. It helps with time
management and with learning whether the battle or conflict is worth the time required to resolve
it. Moreover, viewing conflict as an opportunity is a great teaching experience. It helps with

personal growth and development which later down the line will help in alleviating potential
conflicts or hardships (Newell & Bain, 2017).
Engagement Plan to Promote Motivation and Cohesiveness
As the Chief Operating Officer, leading by example helps inspire team members to stay
motivated and ambitious to continuously try to complete tasks at hand. Offering incentives are
always a motivation for team members to stay positive and focus on the goals that need to be
completed. Creating opportunities for employees to develop themselves and their skills is always
encouraging. It shows that their well-being matters and that they are appreciated. Additionally,
focusing on culture and atmosphere helps make the work environment more pleasurable and
improves efficiency as well as cohesiveness between team members.
Part III: Engaging the Organization
Applying Principles to Engage THS Staff
THS needs to encourage staff to embrace the adoption of the new EMR system. Being
that some staff is less than enthusiastic about the implementation of the EMR; THS needs to
change the culture of the organization while the staff adjusts to accepting the new system. To do
this effectively, THS must consider the principles of interpersonal and group dynamics. The
onboarding team must communicate the benefits of adopting the new EMR, such as a decrease in
the cost of healthcare, a decrease in clinical errors, and improved care coordination for the
patient. “By developing secure and private electronic health records for most Americans and
making health information available electronically when and where it is needed, health IT can
improve the quality of care, even as it makes health care more cost-effective”. The onboarding
team also must point out the benefits that employees will see, such as a reduction in workloads as
physicians can easily view vital signs, lab results, imaging, discharge summaries and type their
note electronically while they are completing their patient encounter. THS leadership should use
the benefits of adopting the EMR to create a positive view of the new technology and reiterate
that the change aides in patient care and staff workflow (Hsu, Wang, Chen, & Hsiao, 2016).
Strategies to Reduce Resistance

One appropriate strategy the onboarding team should use to reduce the resistance of the
EMR is group decision making. “Research confirms that groups produce more and better
solutions to problems than do average individuals working alone, and the choices groups make
will be more accurate and creative”. Leadership needs to involve a diverse selection of
employees that are affected by the newly implemented technology. EMRs affect staff in different
ways so having people with different backgrounds collaborate will make the outcome better as it
will have addressed a variety of questions and concerns (Penny, 2017).
A second strategy is one that has two parts: create effective training for employees so
they are supported throughout the change process and have designated super users (or informal
leaders) that employees can go to for additional one to one training and guidance (Wallensteen,
2018). A handful of employees should be selected as informal leaders of the implantation of the
EMR and be available to assist those that need extra help or hands-on training. “Team members
often address concerns and issues with informal leaders that are not shared with managers”
(Borkowski, 2017). If staff members know they have different layers of assistance to help them
adjust to the new technology, they will be less likely to be resistant to it, and a culture of change
can successfully be implemented (Wallenstein, 2018).
Plan to Assess Effectiveness of Onboarding Team
Three months:
Objective: To evaluate team EMR comprehension
Plan: Make sure staff completed all necessary training and understand how to use all necessary
functions. Get feedback on training provided. Did everyone feel supported in the transition?
Six months:
Objective: How has the EMR been working, any technical issues or concerns? Any new
questions?
Plan: Collect feedback on staff experiences using the EMR so far and make sure it is working as
planned and that it is a positive experience so far.
One year:

Objective: To evaluate the EMR implementation outcome and provide suggestions
Plan: Obtain staff insight into the rollout of the EMR and how it has improved their workflow.
Review any limitation concerns and collect recommendations for the future. “This critical
inquiry is essential to learning from the experience.” (Borkowski, 2017).
Assessment Plan for THS Staff's Engagement of EMRs
Three months:
Objective: To evaluate team EMR use compliance
Plan: Obtain staff feedback on the EMR application itself and check for staff compliance in
using the new technology.
Six months:
Objective: How does the team feel about the EMR now that it has been in use for six months?
Plan: Get feedback on if the EMR is improving workflows, if benefits discussed during
onboarding are being realized and if they are happy with the system. Keeping employees happy
is crucial to maintaining a productive workforce. “It requires regular monitoring the satisfaction
of the workforce and being prepared to execute swift action plans if needed.”
One year:
Objective: Review any limitations in engagement and recommend how to improve.
Plan: Collect employee experiences and concerns on the limitations of the new EMR.
Recommend how to improve in the future through upgrades.
References-
Khatri, N., & Gupta, V. (2016). Effective implementation of health information technologies in
US hospitals. Health care management review, 41(1), 11-21.

Hsu, C. N., Wang, Y. C., Chen, I. L., & Hsiao, S. C. (2016). Isqua16-2073 implementing
external electronic medication records to promote effective hospital medication
reconciliation. International Journal for Quality in Health Care, 28(suppl_1), 12-12.
Kaneko, K., Onozuka, D., Shibuta, H., & Hagihara, A. (2018). Impact of electronic medical
records (EMRs) on hospital productivity in Japan. International journal of medical
informatics, 118, 36-43.
Rock, C., Mizusawa, M., Small, B., Hsu, Y. J., Kauffman, C., Trivedi, J., ... & Maragakis, L. L.
(2017, October). Implementation of Electronic Medical Record Hard Stop Alerts for
Inappropriate Clostridium difficile Tests in Academic and Community Hospital Setting;
Impact on Testing Rates and Clinical Outcomes. In Open forum infectious diseases (Vol.
4, No. suppl_1, pp. S608-S608). US: Oxford University Press.
Dyer Jr, W. G. (2015). Team building. Wiley Encyclopedia of Management, 1-2.
Penny, D. J. (2017). Landmark lecture on cardiology: the quest for the ultimate team in health
care–what we can learn from musicians about leadership, innovation, and
teambuilding?. Cardiology in the Young, 27(10), 1947-1953.
Newell, C., & Bain, A. (2018). Building shared mental models. In Team-Based Collaboration in
Higher Education Learning and Teaching (pp. 43-49). Springer, Singapore.
Garaigordobil, M., & Martínez-Valderrey, V. (2015). The effectiveness of Cyberprogram 2.0 on
conflict resolution strategies and self-esteem. Journal of Adolescent Health, 57(2), 229-
234.
Wallensteen, P. (2018). Understanding conflict resolution. SAGE Publications Limited.
Borkowski, N. (2016) Organizational behavior, theory, and design in health care (2nd ed.).
Burlington, MA: Jones and Bartlett.