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E-Clips Physician training
 

E-Clips Physician training

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    E-Clips Physician training E-Clips Physician training Presentation Transcript

    • E-CLIPS Training Project: The Good, The Bad, The Great! January 19, 2007 1
    • MHS and Our Training Story Agenda and Presenters Introduction MaryLee Newman, RN, MS Logistics Arnie Park, MA Implementation Victoria del Valle, RNC, MSN The Nurse Perspective Shanna Bock, RN Conclusion MaryLee Newman, RN, MS Questions Panel 2
    • OBJECTIVES Learn: • About Memorial Health System • The basic structure of a clinical system project plan • A successful approach to effect an enterprise training plan for nursing • A Nursing Perspective • Benefits of the electronic system for nurses MaryLee Newman 3
    • Patients First… More Patients, More Choices 4
    • Memorial Hospital Central 5
    • Major Services to Meet the Community’s Needs •Emergency/trauma •Maternity/delivery •Infant and child care •Cancer treatment •Heart care •Orthopedic surgery •Rehabilitation •Outpatient services 6
    • Memorial Hospital Central Addition 7
    • Memorial Hospital North 8
    • The E-CLIPS Program Electronic Clinical Information Processing System (E-CLIPS) Mission: To be able to capture all patient care information at the point of care, with immediate access anywhere, using multiple devices, and in a secure manner. 9
    • How we got there: • Vendor selection process…close call: many years in the making. • Cerner ASC approach – Why? The Cerner Accelerated Solutions Center (ASC), located in Kansas City, MO specializes in the fast delivery of standard Cerner Millennium™ solutions using the following methodology: Design– Build–Test–Train–Convert . • PIT teams: Project Implementation teams; Clinical and non-clinical; managers and staff working together for a common goal. Included Pharmacy, Lab, Clin Doc, Med Admin, Training and Ed, ED, Medical Records, IS • Kansas City – Memorial Hospital staff participants made 5 trips to the ASC in Kansas City over 6 months to work with Cerner's staff to prepare for an initial April, 2006 implementation of the basic automated medical record. 10
    • E-CLIPS Project Phase 1 Implementation March, 2005 March, 2006 Project Pre-Design Data Process Windows WBT Trainers Super User End User End User Post- Planning Assessment Collection Design Assessment Development Education Training Training Training Conversion Assessment Mar-May 05 April-May 2005 May 2005 July 2005 July 2005 Sept 2005 Oct 2005 Jan 2006 Feb 2006 Mar 2006 End-User Training Design Process Feb - March 2006 11
    • E-CLIPS Training Logistics GOAL: Train 3000 users with many different job positions on many different applications in a 10 week period before go live. Arnie Park 12
    • E-CLIPS Training Logistics • Windows assessment for staff • Windows 2000 basic skills review on our intranet • Windows 2000 test and classes 13
    • E-CLIPS Training Logistics Determined classes needed and number of “seat hours” for all employees from a spreadsheet designed by Cerner. 14
    • E-CLIPS Training Logistics • Created multiple class schedules • Created registration portal on our intranet 15
    • E-CLIPS Training Logistics and Coordination E-CLIPS Introduction CBT (computer-based training) to be taken before attending class. 16
    • E-CLIPS Training Logistics End-user training for approximately 3000 employees taking multiple sequential classes. 4 training rooms running 8 am to 10 pm, 6 days a week for 10 weeks. 17
    • E-CLIPS Training Logistics • Physician training for 500 physicians included CBT, classroom, one-on-one scheduled and drop-in training in Physician Lounge. April 2006 • Go live 4/4/06 • Implemented post go-live training. 18
    • Role of Training Coordinator Trainer Communication Schedule Class Class Registration Coverage Class Auditing Classes, Schedule Feedback, Meetings, Reports, Updates, … Class Class Attendance Recognition Rosters Training & Evaluation Luncheon Materials 19 Victoria del Valle
    • Training Methodology 1. Teach Functions 2. Cascade Learning ASC Nurses/Therapists Trainers Super Users End Users 20
    • Selection of Nurse Trainers and Super Users • Gap Analysis • Selection Criteria • Actual Numbers • Educational Consulting Firm 21
    • Curriculum Development Customized Training Tools 22
    • Train the Trainers • December 2005 • 1-week Classroom Hands-on Training • Practice Time • Testing • Train Domain (environment) • Training Consistency 23
    • MHS E-CLIPS Trainers 24
    • Super User Training • January 2006 • 2-day Classroom Functional Hands-on Training • Unit-specific Super User Training/Practice • System/Process Update Dissemination • Quick Reference Guides 25
    • End User Training, Support, & Competence • 1/31/06 – 3/31/06 • 2, 4, and/or 5 hr Classroom Hands-on Instruction • Practice Lab (up to 8-hr paid time) • Clinical unit poster board for tracking staff training completion • Homework • Unit-Specific Workflow Process 26
    • A Nurse’s Perspective Shanna Bock 27
    • A Nurse’s Perspective What nurses were projecting: • Never used a computer or a clinical documentation program • Intimidation of the technology • Learning a new language (computer talk) • Anxiety of the conversion 28
    • A Nurse’s Perspective 29
    • A Nurse’s Perspective Kubler-Ross Grieving Stages 1. Denial (this isn't happening to me!) 2. Anger (why is this happening to me?) 3. Bargaining (I promise I'll be a better person if...) 4. Depression (I don't care anymore) 5. Acceptance (I'm ready for whatever comes) 30
    • A Nurse’s Perspective Denial • “This isn’t going to happen!” • “Memorial won’t invest in something like this.” • “I have heard of them doing this before and it never went through.” 31
    • A Nurse’s Perspective Anger • Numbness and shock! • “Why are they doing this to me?” • “They can’t make me change the way I document!” 32
    • A Nurse’s Perspective Bargaining • “If you stop this, I will do my charting better.” • “I might have to find another job if they go through with this.” 33
    • A Nurse’s Perspective Depression • “My career is over as I know it!” • “I don’t know how to use a computer!” • “They are going to fire me!” 34
    • A Nurse’s Perspective Acceptance • “I really like this computerized charting!” • “It is easy to find the information in the chart!” • “I don’t have to wait or go looking for a chart now!” 35
    • A Nurse’s Perspective More Acceptance • “It is easy working within this program!” • “The support was great!” • “All the information is only a click away!” • “Going back to paper is not an option!” 36
    • Gearing up for Go-Live: what happened… • Feelings of anxiety • Observing the excitement of other staff members. • Seeing the equipment being placed on the units. 37
    • Practice…Practice…Practice • 8 hours of practice time allotted • Practice labs • Completing required homework and practicing… 38
    • • Nurse Responsibilities – Mandatory use of system – Assisting other care givers with documentation or to locate information • Super users roamed units helping end users with tasks and documentation. • Nursing staff / patient ratio reduced on most units 39
    • • Trainers rounded hospital units wearing yellow vests assisting with training issues. • Cerner team wore red vests. • Hospital was decorated with our mascot, ‘sun guy’, to make Go Live activities fun. • Food, souvenirs 40
    • Post Go-Live Assessment • Transition was relatively smooth. • Total support from management • Dedicated and flexible staff. • Clinical managers involved in decision-making. • Needed more age-specific practice scenarios • Needed more practice with / testing devices MaryLee Newman 41
    • BENEFITS • Staff well-prepared for Go-Live • Staff positive about system • Nurses don’t have to stand in line waiting for a chart • No more department silos • Patient care can be reviewed prior to transfer / admit • Capturing more statistics • Greater staff retention • A number of nurses have returned to school 42
    • Looking forward Communication tools broadened Continue to involve nurse trainers / super users Standard training for new employees, additional applications Ergonomic assessments PowerForms redesign groups BPOC and CPOE later this year (07) 43
    • The hardest part is over... 44