Scant communication, poor training, and missing guidance. Will Epic really roll out in the LHD this month?
Frontline health workers in the Hunter New England LHD say the rollout of the single digital patient record is not going well and may compromise patient care and safety.
HNELHD was scheduled to be the first go-live site of the Epic rollout in New South Wales in March, until the SDPR Implementation Authority delayed it to this month, while doing a limited rollout at the Justice Health Forensic Mental Health Network and the NSW Health Pathology John Hunter hospital lab late in March.
According to the SDPRIA’s website, this month remains the scheduled go-live for Hunter New England LHD, but in a letter to TMR, received from frontline workers over the weekend, that surely must be in doubt.
“As the first district to ‘go live’, there is considerable stress, uncertainty, and anxiety surrounding this major system change, with many staff feeling underprepared and unsupported as the rollout approaches,” read the letter.
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One staff member told TMR independently that the rollout was “a bin fire”.
Staff members outlined the following concerns.
Core processes
Frontline workers told TMR that not even the basics have been completed.
“There remains significant uncertainty around core admission processes,” they said.
“Admissions staff are still unclear on how patients will be admitted to the hospital within the new system, what pre-booked admissions transferred from the current system will look like once imported, and who will be responsible for registering and admitting newborn babies.
“At present, this is a clerical responsibility, yet there has been no clear guidance as to whether this process will remain with clerical staff or be transitioned to nursing staff.
“There are also significant practical concerns regarding whether the current physical and technical setup of our emergency department is conducive to the effective rollout of SDPR.”
Staff told HSD that existing ED workflow and layout did not align well with the demands of the new system with doctors already reporting difficulties with basic functions like printing documents.
“If these fundamental technical issues are not resolved prior to implementation, it is difficult to see how the system can operate safely and efficiently in a high-pressure emergency environment,” they said.
The onus had been placed on staff to request time to “play in the sandpit”.
That, wrote the staff, essentially meant “sitting at a computer and attempting to train themselves without knowing whether tasks are being completed correctly, efficiently, or in line with expected workflows”.
“Staff are left to create fake patient profiles and develop real-world scenarios on their own, such as how to process an unconscious patient presenting to ED without identification, with no guidance as to whether these tasks are being completed correctly or in accordance with expected workflows.
“This again highlights the lack of clear direction regarding workflow processes.”
Despite creating fake patient profiles, staff had yet to see what existing patient profiles imported from the current system would actually look like.
Online training
HNELHD workers told TMR that “the amount, and most importantly the quality, of online training has been extremely poor”.
“When training first commenced earlier this year, the program was still being built and adapted for NSW Health, with parts of the system changing from day to day.
“Most training sessions are conducted via Teams and are generally scheduled during standard working hours, making it extremely difficult for frontline staff to fully participate while managing their clinical and operational responsibilities.
“The chat function is turned off and microphones muted, preventing staff from asking questions in real time. As a result, many staff have been forced to use their own time, including days off, to review material and attempt to prepare themselves for SDPR implementation.
“The Q&A function has been enabled; however, the SDPR trainers are not frontline workers and often do not understand or know the answers to questions staff are asking that directly affect their ability to do their jobs.
“This raises serious concerns about patient safety, as well as potential reputational damage to the hospital and the LHD as a whole.”
Related
Communication
“Communication from management at a local level, as well as from SDPRIA ‘trainers’ … regarding expected local workflows and changes to job roles has been minimal, with many responses to emails and Teams Q&A chat threads simply being, ‘I will follow this up’,” said HNELHD workers.
“As healthcare professionals, we provide care and support to people during some of the most difficult times in their lives, and we take great pride in delivering high-quality care,” they wrote.
“Staff are already under significant pressure and are not adequately compensated for the demands of their roles under current conditions.
“Many are deeply concerned that the rollout of SDPR, without adequate preparation, support, and consultation, will place even greater strain on staff while potentially compromising patient care and safety.”
