Clinical & Systems Transformation (CST) is one of the largest and most complex healthcare projects in Canada. Behind all the complexity, however, one simple principle holds firm: it’s all about improving patient care.

The CST project was scheduled to transition from design into testing at the end of October 2014. Design has now been extended because more time is required to complete the design work, and because there is a need to further validate the design in the clinical information system. The validation checks are to ensure the system has been built to reflect the requirements that our design teams outlined and that it meets our collective needs.

“The design team members used data collection worksheets to inform how the system is built, based on the new workflows they designed,” explains Barb Trerise, CST Executive Sponsor, PHC. “It’s difficult to envision what the clinical information system will look like based on the contents of a spreadsheet. The validation process allows them to answer the question, ‘Is this the design I expected based on the requirements we outlined?'”

The main outputs of the design teams are called clinical playbooks. These serve as a key tool for testing and transformational learning teams. The first few playbooks have not been accepted as complete by our Health Organizations following comprehensive reviews. There are two reasons for this: some teams have outstanding design work to complete, and all teams need more time to validate what they have designed in the clinical information system. We are now working to understand the implications and to determine specifically what impact this will have on the project, including how much time is needed to complete this work and the best approach.

“It is important that the teams have the opportunity to review the work they have done to ensure they have confidence in what has been designed and built before testing begins. This work is still in progress,” says Susan Wannamaker, Vice President Professional Practice & Chief Clinical Information Officer, VCH. “The priority is to ensure that we have well-designed workflows and a well-designed system that meets our expectations of improving patient care.”

“This extension to the design sub-phase does not reflect badly on our design teams,” says Carla Gregor, CST Executive Sponsor and Vice President CST/Special Projects, PHSA. “The work they have completed to date is valuable, impressive and high quality – there is just more to do. It was always our intent to design iteratively, so our design teams could see their work being built, identify gaps and course correct as required. This process helps to ensure we are confident in our new workflows and the system we are creating. It is the responsible thing to do for our patients, staff, physicians and taxpayers. We want to acknowledge the hard work of those who have contributed their expertise.”

For more information

You can reach the project team via info@CSTproject.ca (use subject line: Design Extension) or by calling our confidential CST voicemail box: 604-675-2510 x 22454.

Alternatively, you can contact the CST Executive Sponsor or CST Executive Director/Transformation Lead for your organization.

• Paul Brownrigg, CST Executive Sponsor and Vice President CST/Special Projects, Paul.Brownrigg@vch.ca
• Susan Wannamaker, Vice President, Professional Practice and Chief Clinical Information Officer, Susan.Wannamaker@vch.ca
• Donna Stanton, CST Executive Director/Transformation Lead, Donna.Stanton@vch.ca

Background information

• CST is a joint initiative of VCH, PHSA and PHC, and one of the largest and most complex healthcare projects in Canada. It spans across several areas of the continuum of care including: acute care inpatient and outpatient units, ambulatory care and residential care. As well as creating consistent, leading practices, and a shared clinical information system, CST will deliver HIMSS Level 5 functionality.

• Clinical design teams, made up of hundreds of highly-skilled, multi-disciplinary professionals from across the three Health Organizations and Team IBM, started work on April 7, 2014. These teams are tasked with designing our future workflows, based on leading practices. In doing so, they are defining the requirements for our new clinical information system.