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When a healthcare organization is preparing to bring live an EHR system, the costs are high. From implementation and training, and through go-live, managing the budget is essential. A planned taper is a critical step.

To be both fiscally responsible and have a smooth staffing transition, it is critical to include a planned staffing taper throughout go-live. A gradual staffing reduction decreases staff anxiety as well as promotes staff autonomy. Staff reduction, also known as a taper, usually occurs after a full week of 100% staffing. Based on the total staffing, a target is agreed upon with your staffing firm and the organization. Data should be collected in areas that are in a position to have a reduction as well as those that may benefit from a delay in their reduction. The following steps are recommended:

  1. Meet with the stakeholders appointed to determine the taper sites and numbers. A goal is set to achieve the target reduction amount.
  2. Introduce findings as well as data into the discussion to determine the correct sites and numbers.
  3. Once all input from both sides is included, collectively decide which sites will have staffing reductions in the first taper. There are times when the target reduction cannot be reached due to slow adoption or other reasons. In these cases, an option of partially deferring the taper as needed is recommended with a correlating action plan. The difference can be made up in the subsequent tapers or not at all based on adoption and stability of build.

Once agreement on the taper numbers has been reached a seamless transition of support exiting should occur with minimal to no disruption of the client spaces.

Early communication of the tapering strategy is recommended throughout all of the readiness activities before go-live.  Optimum suggests that the client communicates the expectations to the internal staff to reduce the anxiety of the team. Subsequent tapers would progress based on objective feedback, the strength of internal super-users, and the progress of adoption.  Progressive tapers will result in the larger support team exiting by the close of the second week of activation with a “small smart” team remaining for weeks 3 – 4.

For staffing reduction, this is best practice. It has proven to be both staff and budget friendly. There are exceptions based on unique needs and circumstances.

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Victor Cornin

Director, EHR Delivery LinkedIn

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