Posted on behalf of Terry LaPointe, VP, Client Services

downtime-plan-healthcare-itFrom a Client Services perspective, we come across many organizations who have done a great job implementing an electronic downtime process to handle scheduled or unscheduled downtime of the HCIS or Network.
However, while many have addressed the major components of a downtime plan – downtime procedures established and downtime application in place – there are a few small details that could have a big impact to how smoothly the downtime experience is for your organization.
Let’s put a few of these small, but impactful details into a few discussion buckets; Physical, Procedural and Educational impact points.

Physical Impact

Power Please!
Chances are, if you have a downtime solution deployed, there are one or more physical “downtime client(s)” on the floor at key locations receiving encrypted downtime reports on a regular basis. BUT, have you reviewed with your Hospital Plant Operations/Maintenance Team if those physical downtime clients are plugged into an emergency power outlet that is on a generator or UPS?  Downtimes come in many flavors, maybe it is just the HCIS down for maintenance, but what if you lose power and the pc is dead in the water?
Dotty about Downtime!
It may seem silly, but something as simple as a red dot sticker on a pc can send a calming reminder to the end user: Downtime reports here! Using a simple sticker system, coupled with end user education, the red dot can lead the user to the designated downtime workstation(s) and remind them to keep them online to receive refreshed reports.  Some clients use a colored keyboard, some a sign on the wall or use a sticker over the power button, reminding users not to turn this workstation off!

Procedural Impact

No Network? No Problem!
If your downtime solution utilizes Active Directory (AD) for end user authentication and stores the downtime reports on distributed downtime machines on the floor, we recommend an authentication contingency plan outlined in the event of a network outage. If the network/AD is down, and if cached AD credentials are not an option, no need to panic if the downtime solution has the ability to use local, non-AD emergency “Break the Glass” user(s) to get to the downtime reports.  Don’t stop with the creation of the emergency accounts; put a procedure in place to have those in need of the credentials to put a call a specific Help Desk number, or as an extra contingency, log them with the unit Supervisor.  After the downtime, reset the emergency user passwords for the next use.

Educational Impact

Fire Drill!
The best procedures in the world aren’t any good if folks don’t know about them or how to use the downtime solution.
Ok, so admittedly, this isn’t a small detail per se’, but put your downtime procedures to a test by scheduling a mock downtime.
A mock downtime will help shed light on gaps that need attention. The considerations below are by no means a comprehensive list of all items to address in a downtime procedure, but are items of concern for a lot of the clients we service at Summit Healthcare.

  • Are the downtime procedures available in a quick reference guide, integrated with my downtime solution?  Consider storing instructions and blank downtime forms IN the downtime reporting system!
  • Can I audit who has looked at downtime reports containing PHI and what patients the user(s) were looking at?
  • Do the users know where to find the downtime reports quickly?
  • Can the users get to the downtime reports when the power is out?
  • Do the downtime reports capture all the clinically relevant data needed in order to continue care?  How about Ambulatory or Financial?
  • Is the downtime procedure sustainable for 2 hours, 2 days, or 2 weeks?
    • Do I know who has a scheduled procedure and will be showing up if my HCIS is down?
    • How about patients needing special diets?
  • Do I need printers attached to the downtime stations, so that I can print out forms for documentation (used for re-entry)?  Remember, a network printer will not work if the network is down, so local printers on emergency power are advised.

There is no better time than hurricane season to ensure you have all the “i’s dotted and t’s crossed” in your downtime plan.
Remember, don’t forget the small details, and if you haven’t yet embarked on a downtime drill, give it a go; it is time well spent.