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 monumental towards achieving this outcome. Yet,
many customers make the mistake of failing to properly prepare for training. Usually they
are not allowing enough time to prepare the user to use the Sunrise Clinical Manager™ (SCM)
or Ambulatory Care Manager™ (ACM) systems efficiently and with confidence.
Communication and planning is “Key”
When assembling the project team, including a training coordinator at the onset, not only to
orchestrate data gathering and workflow analysis but to participate in the planning and
decision making meetings is key. Consider assembling a task force or cross departmental team
of representatives from every department or unit that is activating. The task force led by
the training coordinator can provide invaluable support to the design team in the form of
gathering data, conducting workflow analysis, identification and resolution of issues,
revising policies and procedures, performing system testing, acting as super users and/or
trainers, and when training is nearly complete, they are more than prepared to provide
activation support. The highest hurdle is getting the representatives temporarily off their
units and dedicated to the project.
The better prepared you will be to develop training that speaks to the user’s workflow.
Typically, physicians respond better to a peer. Engaging a physician on your team as a
champion can be a tremendous help to gain physician buy in and acceptance. Physicians take
comfort in knowing their needs are being communicated to the team by ‘one of their own’.
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 the new system will provide and/or replace at your organization or enterprise. For
example Sunrise Emergency Care, Sunrise Clinical Manager’s Patient lists, Info data, and
Results Retrieval for all care providers in the Emergency department and Inpatient
units/departments.
What Impact will this Project Have on Patient Care Delivery?
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 HR
or payroll to provide you with a list of employees sorted by department and job class and
shift to assist you with this analysis.
Tip: The data collected from the workflow analysis usually identifies 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 make your request as early as
possible so the decisions needed to go forward don’t 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.
Managing Security
Security rights in the system drives what content is delivered to whom in training. It is
important to know who will be doing order entry and maintenance, and who can retrieve results
as early as possible. Developing a security grid that includes all user types identified
during the workflow analysis serves as an invaluable tool in this process.
List the users (job class) down the side and the functions of their current state that
will continue in Clinical Manager across the top. Add the rights associated with each
feature on the grid to assist security administrator to add the appropriate rights to the
user’s profile.
Determine the number of users to be trained in each category on the grid by department,
shift and job class. Breaking down the numbers in this way will help when planning the
number of classes needed in order to accommodate individual department needs such as those
operating 24/7, weekends only, or the night shift.
As the grid is prepared it will be evident that many of the users on the list will need
the same content and that some 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
Select the training methodology that will best serve 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 format can be challenging for the instructor to keep everyone at the
same place. Often this methodology requires an assistant to be in the room to assist
students who get lost or fall behind.
- Instructor-led - decentralized Content is delivered in conjunction with a
super user or someone that is given specialized training to that is responsible for
training the employees in their department.
- CBT (Computer-based training) with proctor this methodology 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.
Tip: Regardless of the methodology chosen, it is highly recommended that training
is offered on the user’s normal shift whenever possible. However, consideration should be
given to holding one class per week for 11am-7pm and another beginning at 7 pm to ease the
burden on trainers. There should also be at least two weekend classes offered for those
employees who only work weekends.
Evaluating Resources
Once the number of users who need to be trained is determined, and there is a general idea
of the content, and the methodology for delivery, the evaluation of resources can begin. If
it is planned to use a classroom setting, the design should minimally accommodates ix to ten
workstations, have an instructor’s desk, 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 step is to calculate when training needs to begin, the number of classes needed to
deliver to train all the users by the activation date, and the number of trainers will need
to be requisitioned. In a classroom setting, the ideal instructor to student ratio is two
instructors for ten students. While with CBT, the ratio can be reduced one::ten.
If the numbers are such that training must start three months ahead of activation
consider doing one of the following:
- 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 for success is the development of a “Training Plan”. After the analysis and initial
planning are completed, tasks that will take time are developing the schedules, researching
and developing training materials. However, the plan is developed do not forget to add any
and all tasks that are anticipated to take more than 30 minutes to complete. Most health
care enterprises make the mistake of not accounting for tasks 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.
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.