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You have designed your process, piloted-tested your solution, and made any necessary enhancements. Now, you are ready for a full-scale implementation.
A. Forming your Implementation Team
Your implementation team may be exactly the same as your design team or it may include members that continue on with the project along with new members joining the group. Even though you'll have to bring new members "up-to-speed," there may be some advantages to the latter approach:
As you move into the implementation phase, you may want to consider developing an implementation charter to supplement your design charter. This will provide a framework for:
B. Developing your Implementation Strategy
1. Planning and Communication of Implementation Strategy
To successfully coordinate an implementation strategy, mandatory meetings, led by executive sponsors, should be held with stakeholders representing physicians (i.e., clinical program leaders, departmental chiefs, and chairs) and patient care (i.e., nursing directors, pharmacy director, and pharmacy managers). Below is a sample letter inviting stakeholders to a training and implementation planning meeting on medication reconciliation.
Sample Letter to Discipline-specific Leader (PDF format)
During this meeting, implementation plans and training curriculum can be presented. A multidisciplinary training approach (i.e., physicians, nurses and pharmacists attending training classes together), should be recommended and is encouraged. A number of dates and time periods can be determined based on the needs and availability of various disciplines. Classes can be offered early in the morning, during the day, in the evening and on weekends to accommodate a variety of schedules.
Below is a customizable memo to announce and promote training sessions and educational efforts to your staff. E-mail reminders and memos sent from discipline-specific leadership to staff may be an effective method to increase attendance and participation while highlighting leadership support for the process.
2. Roll-out Strategies
Just like pilot-testing, there are several different strategies to roll-out your process. Depending on the scope of your project, some implementation strategies may include:
You should establish an implementation timeline. This helps ensure a timely roll-out while maintaining flexibility if unanticipated issues arise. Below are three sample timeline templates, suitable for customization.
Sample Timelines for Roll-out of Medication Reconciliation (PPT format)
Staff should be well informed and given adequate notice regarding training dates and implementation strategies prior to roll-out. Staff communication may need to occur through a variety of channels such as e-mails, brief announcements at staff meetings, and memos posted in nursing units, report rooms, conference areas, etc. Below is a sample flyer template to announce the roll-out period for staff.
Sample Flyer to Announce Roll-out on Medication Reconciliation Process (PDF format)
It is critical to put in as much time planning your implementation as went into your design (maybe even more) to ensure successful adoption. Stakeholders need to be “on board” to support the effort throughout the roll-out. Your leadership group will play a key role addressing roadblocks and approving needed changes resulting from broader implementation. Other considerations for a successful implementation include:
It is easy to fall into the mind-set of “we designed a great process, the pilot was successful, therefore, everything else will follow suit.” Through our experience, we found that it’s not always that simple, especially when many staff perceived medication reconciliation would add extra work without added benefit.
