The "big bang" implementation: not for the faint of heart.

Replacing a hospital's obsolete mainframe computer system with a modern integrated clinical and administrative information system presents multiple challenges. When the new system is activated in one weekend, in "big bang" fashion, the challenges are magnified. Careful planning is essential to ensure that all hospital staff are fully prepared for this transition, knowing this conversion will involve system downtime, procedural changes, and the resulting stress that naturally accompanies change. Implementation concerns include staff preparation and training, process changes, continuity of patient care, and technical and administrative support. This article outlines how the University of Missouri Health Care addressed these operational concerns during this dramatic information system conversion.