TRUE MEASURE OF THE DESIGN TEAM'S SUCCESS IS USER ACCEPTANCE AND COMPETENCY
By Judy Jarrett
The ability to design and configure a system to the specifications of an organization can be an overwhelming
experience for the entire team. The goal of a project of this magnitude may be ten-fold, but ultimately the
intent is to improve financial viability, patient safety, and patient satisfaction. The true measure of the
team's success lies in user acceptance and competency. A successful training program is vital to achieving this
outcome. Yet, many customers make the mistake of failing to properly prepare for training. The most common
problem is not allowing enough time to cover the content in systems you are activating such as Sunrise Clinical
Manager™ (SCM) and/or Ambulatory Care Manager™ (ACM) in order to use the system efficiently and with confidence.
Communication and planning is “Key”
When assembling the project team, include a training coordinator at the onset, not only to participate in
planning meetings and decision making, but to assemble a task force to facilitate communication between
information technology and the departments impacted by the project. The task force, led by the coordinator, can
perform integrated and functional testing, assist with policy revisions and, ultimately, become super users and
trainers. When training is complete, these individuals are more than capable of performing activation support.
The greatest hurdle is getting these representatives temporarily off their units and dedicated to the project.
Also, if at all possible, bring a physician on board to act as a champion. Physicians take comfort in knowing
their needs are being communicated by one of their own, so having a physician in this role can be invaluable in
gaining physician buy-in and acceptance.
Suggestions for communicating with other organizations are:
- Seeking the assistance of a VCS consultant for “lessons learned” from other
customers.
- Starting a Blog to read posts about “Best Practices”
- Join a Listserv to read the posts of other Eclipsys customers
Determining the Scope
Determine whether the project scope will involve a pilot unit, a group of units, a facility, or the entire
enterprise.
Once you know the departments involved in the project, the next step is to identify the features to be used
within these departments and the impact on patient care.
To adequately determine the impact on patient care, it is important to perform an extensive workflow analysis
of all licensed and unlicensed personnel working in each affected department, e.g., Unit clerk/Receptionist,
RNs, LPNs, Technicians, Respiratory Therapist, PT/OT/Speech Therapist, Nursing Assistants, Dietician, Dietary
assistants, Case Managers, Discharge Planners, Nurse Practitioners, Physician Assistants. If it is a teaching
hospital, don't forget residents, medical students, student nurses, and agency staff. Ask Human Resources or
payroll to provide you with a list of employees that are sorted by department, job class, and shift to assist
you with this analysis.
The data collected from the workflow analysis usually identifies the issues that need to be directed to the
steering committee as well as the design team. Getting on the steering committee's agenda may require advance
notice so it is important to make your request early so the decisions you need made do not negatively impact
the project's timeline. Refer to the Training Implementation manual supplied by your Eclipsys Project Manager
for more issues that typically need to go to the organization's steering committee.
Security Drives Training Content
The content that you need to include for each user is dependent upon their assigned security rights. It is
important to delineate which users can perform order entry, order maintenance, and results retrieval as soon as
possible.
It is helpful to create a security grid that includes all the user types you identified during the workflow
analysis and the key functions to include in training. The users are listed down the left side by job class and
the key functions you are implementing across the top. Add the rights associated with each function on the grid.
The results will help you to determine the number of classes you will need to create based on the number of
users who need the same content. This grid can also assist the security administrator to add the appropriate
rights to the user's profile.
Although the grid lets you see which users can be grouped in the same class or enrolled together in the same
course, a word of caution here, users may need the same content, but their learning style and workflow may be
vastly different. Avoid combining nurses and physicians in the same class! Generally, nurses need the big
picture, but they also need the detail to fully understand the process. While physicians and emergency staff
need only enough to get started, and then they prefer to try to figure the rest out on their own. It is proven
that holding separate sessions will pay off for your implementation.
Training Methodology
The methodology that you select for delivering training should be one that best serves the needs of your
end-users. The steering committee may need to make the final decision but here are some suggestions to help with
making recommendations.
- Instructor led - (Centralized) classroom Content is delivered in conjunction with a demonstration
and the students follow along with the instructor. Students learn best by doing, however, if you have users
in the class with a varying level of skills and background, this methodology can be challenging for the
instructor to keep everyone at the same place. This methodology also needs a second trainer in the room to
assist students who come in late, get lost or fall behind.
- Instructor-led - (Decentralized) Content is delivered in conjunction with a super user or someone
that is given specialized training who is responsible for training the employees in their department.
- CBT (Computer-based training) with proctor this methodology often costs more to develop but,
there is an opportunity to recoup those costs over time so the ROI is considerably better than the cost of
instructor-led delivery. There are many articles published to support that CBT reduces the number of
training hours by 40%
Given that labor costs are the greatest expense, reducing training time for activation and beyond can greatly
reduce the overall training budget. Students appreciate being able to interact with the system and to do so
at their own pace. Since all learning styles are covered, retention is improved by 30%. There is also the
assurance that the content is delivered consistently for everyone.
- WBT (web-based training) delivered via a secure Intranet or Internet connection - provides an
option for those who are unable to leave their work site and come to a central location. The advantages are
the same as CBT with the exception of not having a “live” instructor available to answer questions.
Regardless of the methodology chosen, it is highly recommended that training be offered on the user's normal
shift whenever possible and directed toward their workflow. However, consideration should be given to holding
one class per week for 11am-7pm staff and another beginning at 7 pm. There should also be at least two classes
offered on the weekend if you have employees who only work the weekend shift.
Evaluating Resources
Once you have determined the number of users to train, and you have a methodology for delivering the content,
the calculation of resources can begin. If you plan to use a classroom setting, the design should minimally
accommodate nine to ten workstations, an instructor's desk, and access to the internet, a printer, and a supply
cabinet. If there is a plan to incorporate practice exercises into the curricula by specialty (recommended), a
standup three-ring notebook works very well to separate exercises accordingly. However cost of the notebooks
should be allocated in the budget along with printing supplies.
Class Schedules
The next steps are to calculate the number of classes needed to train all the users by the activation date and
when training will need to begin. In a classroom setting, the ideal instructor to student ratio is two
instructors for ten students. While with CBT, the ratio can be reduced to a ration of 1:10.
If the numbers are such that training must start three months ahead of activation consider doing one of the
following so training is not more than six weeks.
- Allocate more classrooms, computers and trainers so training can be carried out no more than six weeks
ahead of activation. If space is an issue, consider renting space offsite at a location convenient to the
majority of the users.
- Develop CBT as a training methodology, or as a supplement to training. CBT is an excellent solution to
train remote employees, physicians, or just for review. It also makes for an excellent make-up solution.
- Deliver a pre-test to see if some users could teach you!
- Make the training database available in departments and on nursing units so the user's can review and
practice when they have down time.
Remember schedules on nursing units are usually finalized six to eight weeks in advance, so send the
completed schedules to the nursing administrators ASAP.
Tip: Your VCS Consultant can provide you with the tools you need to calculate this information with
confidence.
Develop a Training Plan
Critical to your success is the development of a “training plan”. Tasks that are anticipated to take more than
30 minutes to complete should be added to the plan. Most health care enterprises make the mistake of not
accounting for tasks that are deemed negligible, when in fact negligible tasks added together require many hours
of your time. Include the hours it will take to research the content with a subject matter expert (non-writing
time) as well as the time to actually develop the training adjuncts, resource manuals and quick reference guides
and make revisions to printed materials. Recognize a project of this scope will undergo many changes until
activation and beyond.
Be sure to add sufficient time to plan and develop the training database. Even though the database itself may
be a copy of the test environment, patients will need to be added as well as orders, results, and documents to
accommodate the scenarios included in the content as well as practice scenarios. And be sure to remove all
identifying information if real patient data is used.
Evaluation
Plan for the evaluation of training immediately after the student completes it. Be open to conducting another
evaluation two or three weeks after training to determine if training actually accomplished your goal of
preparing the user to safely use the system.
Call or email VCS’ Corporate Headquarters at (610) 444 1233 or
vcs@getvitalized.com for more information and
training tips for successful implementations.