The idea began when the chief nursing officer asked for a blog to facilitate collaboration within the nursing department and with administration and physicians. She wanted to address collaboration and communication with her staff, who were scheduled 24 hours a day, seven days a week, and over several geographic locations.
SCVHHS leaders began with pilots in the internal medicine residency program, nursing administration, and the IT service desk. Each has a workspace administrator and an identified champion who defines project goals, links to organizational leadership, and assesses user readiness before launching. They started with 1500 licenses for the pilots, but ultimately all employees will be users.
The plan includes ongoing collaboration with the larger County Information Services, who supports the creation of a countywide social media policy; creating a project team, measurable goals and objectives, and plans for addressing risk factors and communications for the project; and clarifying the following benefits of the technology:
• Facilitates chief resident–housestaff and housestaff–housestaff communication by streamlining dissemination of important information and reducing redundant email communication
• Facilitates knowledge sharing about new or existing policies and procedures and ongoing projects and initiatives
• Creates a collaborative environment where housestaff will be encouraged to actively engage in hospital and residency program committees and their initiatives: quality improvement, ACGME work hours, compliance, leadership training, program evaluation and improvement, resident well-being, etc.
• Serves as a central repository for important documents including "survival guides" and those related to leadership training, the job search process, life after residency, the licensing process, how to dictate, using the scheduling system, etc., which would exist as wiki workspaces to encourage collaborative updating and error correction
• Shares and elicits feedback on program and hospital-wide changes
• Improves patient care by encouraging the sharing of novel and valuable sources (websites, books, articles, community resources) on patient care, disease management, and evidence-based medicine
The new technology took off most quickly in the internal medicine residency program by the housestaff and has streamlined communication, information workflows, and continuity from one class to the next related to forms and documents, policies and procedures, sharing successes and failures, and requests from hospital and medical staff. It has also reduced risks by bringing unmoderated conversations and groups on public sites into the hospital’s secured internal system. Housestaff are on the leading edge with the technology and are making it part of the fabric of the organization.
Nursing administration uses the technology to facilitate their governance conversations, and the IT service desk is applying it for intervention tracking.
The SCVHHS information services department also sees tremendous benefits. Project teams will need to rely less on shared network drives, which are difficult to maintain, and fewer documents will be sent via email. In addition, the secured system can be accessed remotely by employees who may need to carry on the business of the organization during a pandemic.
Public health is exploring the use of public social networking sites and other online collaboration tools for H1N1 planning, response, and communications. Microblogging will be tied to the public information officer to ensure that the right messages are going out.SCVHHS sees an organic evolution and a natural adoption process as people talk about their experiences using the technology and think of ways to apply it to their work. The growth will be driven by need and word-of-mouth promotion.
The wiki and other social networking components will also be rolled out to mental health department staff, who will use it as a project team communication tool to share information and updates regarding the technical components of the Mental Health Services Act and seven project proposals which have been submitted to the State of California. The most up-to-date versions of the various documents will be available to access, and document versions will be under control. 
