Going Live In Healthcare (the Four Function Command Centre)

The following is a very brief overview of how we support our project go-lives here at Island Health. This Command Centre model has grown up over the past 10 years into a fairly well oiled machine that improves every time we use it. Each of the four functions has a specific purpose in the model which compliment and reinforce each other.

Key Drivers in Supporting Project Implementations 

  • All staff impacted by the change must be supported at the front line (e.g.: Onsite Support) and have a way to report problems (hardware, system, education needs etc.) to the go-live support team.
  • To reduce delays in responding to problems, the go-live team must have a single way (e.g.: Central Support) to receive and report out on the volume/themes of incidents that staff are experiencing.
  • The go-live team must have a way to bring the appropriate resources to bear on urgent issues as they emerge (e.g.: Rapid Response) to ensure interruptions to front line staff are kept to a minimum.
  • To ensure the right decisions can be made by the right people in as short a time as possible, there must be clear escalation paths for operational leadership (e.g.: Situation Room) to address urgent incidents as they emerge.

Onsite Support

Made up of inter-disciplinary teams (typically a project/technical analyst and a nurse/medical informaticist) who round on the units, providing at the elbow support/education and addressing issues in the moment. They can also be dispatched by Central Support to address high priority items (e.g.: Physician is having trouble logging into the system) and finally, they act as the “eyes and ears” of the Command Centre on the ground.

Central Support

An inter-disciplinary team that staffs a 24×7 Call Centre which is in addition to our regular Service/Clinical Solution Desks. Central Support answers calls from both Onsite Support and front line staff, logs them in an incident tracking system and then triages/dispatches to the appropriate team (Onsite Support, Service Desk, IM/IT Operations, Biomedical Engineering, Facilities/Maintenance, Housekeeping etc.). The Central Support lead(s) produce twice daily (10AM and 2PM) reports (placemat dashboards) for the Situation Room showing all incidents, themes and escalation points.

Rapid Response

Inter-disciplinary teams brought together at the request of the Central Support leads to work particular problems and will co-locate to collaboratively work the issue through to completion. These teams follow the Information Technology Information Library (ITIL) Framework for systems incident/change/problem and release management to ensure the fix is not worse than the original problem.

Situation Room

Consists of an inter-disciplinary operational leadership team who provide overall direction, serve as the highest escalation point and can provide in the moment decision making when needed (e.g.: if a system downtime is required). They also review the twice daily reports (placemats) from Central Support and guide resolution for any emerging themes.