Leadership, Implementation, and Change Management
Leadership, implementation, and change management tests how informatics projects are governed, delivered, adopted, and sustained. Expect questions on charters, stakeholders, change models, go-live readiness, and benefits realization.
Governance and planning
- A project charter states scope, sponsor, goals, success measures, and constraints. A steering committee resolves priorities and risks.
- Stakeholder analysis maps influence and interest. A RACI matrix clarifies who is responsible, accountable, consulted, and informed.
- The project plan includes risk register, communication plan, workflow validation, integration and regression testing, training, and cutover.
Change and adoption
- Kotter's eight steps move from urgency to anchoring change. ADKAR focuses on awareness, desire, knowledge, ability, and reinforcement.
- Rogers's diffusion curve describes innovators, early adopters, early majority, late majority, and laggards; tailor engagement accordingly.
- Go-live requires a command center, super-users, at-the-elbow support, downtime procedures, and escalation paths. Optimization continues afterward.
Worked example
A CPOE go-live has 70% of physicians trained one week out. Reasoning: readiness criteria include validated workflows, approved order sets, device availability, and training thresholds. The team delays the go-live by two weeks, targets high-volume prescribers, and adds at-the-elbow support. It tracks adoption and order-entry safety events daily.
Traps
Treating go-live as the finish line; skipping stakeholder analysis; ignoring resisters; over-customizing; no benefits tracking.