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Randy Graff
Sara Henning
Problem     Background       Goals




Challenges
                Overview

 Timeline     Training    Lessons Learned
Problems

    300 new housestaff from all
    over the world


    Start July 2 – safe to see
    patients
Encounters with
Patients
Underground work
New Service Provider
Great Opportunity
Transform Educational Process




Training              Planned
  Blitz              Education
Training Services
   Office        Faculty              Everything
                             Epic
Productivity   Development               Else


                                       PeopleSoft



                                       SharePoint



                                     GME Milestones
Training Services
   Office          Faculty                  Everything
Productivity     Development        Epic       Else

6 Physician Support/Trainers                 PeopleSoft
2 Training Environment Builders
Physician Subject Matter Expert (ARNP)       SharePoint
Video Talent (Medical Student)
Web Development & Online Content           GME Milestones


         Community Manager – The Magic Bullet
UF&Shands

    Clinical Leadership                   IT Leadership


GME Office         Credentialing Office    Identity Management


Epic Resident
 Champions


  Program
  Directors                   New Innovations

  Program
Coordinators
Problem     Background       Goals




Challenges
                 Overview

 Timeline      Training   Lessons Learned
Gainesville, FL
1,688 Beds
929,000 Outpatient visits
12,000
Employees
1,500 Faculty Physicians
6 Colleges

6 Centers and Institutes
6,000 Students
6,000 Students and Housestaff
19 Core Programs
              45 Sub Specialties
220 New Housestaff
680 Total
Epic Modules
• ADT
• ASAP
• Cadence
• EpiCare Ambulatory
• EpiCare Inpatient (ClinDoc)
• HIM                            Anesthesia
• HOD                            Beacon
• MyChart                        Radiant
                                 Resolute HB
• OpTime
• Prelude
• Resolute PB
• Stork
• Willow
2011

   Email



 3 Websites



HealthStream
               •   Register Housestaff
 Classroom     •   Identify Epic Champion
               •   4 HR “Coaching” session
               •
   Sakai
                   Take assessment in HeathScream
Spreadsheets   •   Work through first rotation
               •   Gain access to production
Problem     Background       Goal




Challenges
                Overview

 Timeline     Training    Lessons Learned
Goal



       Train new housestaff
       before July 2
Problem    Background        Goal




Challenges
                Overview

  Timeline    Training    Lessons Learned
Challenges


Training Materials




          Epic Environment
Challenges


Switching Specialties




            Training Method
Challenges


Coordination




          LMS Tools
Challenges


Email Addresses




          Internationals
Challenges




June 30 – July 2
Do fellows have to take this
         training too?


Can we have our training right
           here?


     Do I have to do this?
   I’m retiring next year…


  I have been using Epic for five years. I am a Super
             User. Do I have to do this?
Problem     Background        Goal




Challenges
                Overview

Timeline      Training    Lessons Learned
Process




Trainers met with Epic Resident Champions (ERC)
      [What do you do?]
Trainers created an outline
Vetted with ERC
Process




Trainers drafted training
Training Services Instructionally Designed
Training Services tested
Process




Trainers & ERC tested
Trainers Cross-Checked Specialties
FEB       MAR          APR          MAY            JUN        JUL

  Training Begins - Email all Incoming Housestaff
  (6/1)
                             UF IDs Created Sent to Sony (4/6)
  Assessments Due (5/4) In-Person Training Complete (7/3)
               Resident Match Complete (3/15)
  Develop Milestones (2/1)
  In Class Training Handouts Due (6/8)
                             UF data sent to Shands Identity Mgmt
  Peer Review of Modules (5/11) of Process – Nurses (7/5 -
                        Evaluation
               Resident Demographic in New
                             (4/6)
  Chief Resident Meeting (2/10)
  In Person Training Begins – OB (6/15)
                        7/13)
               Innovations (3/22)
  Program Coordinators Receive Shands
  Program Coordinator MeetingResident Website & Form Updated
  Credentials (5/18)
  Online Training Complete (6/22)
                        New Housestaff Training Complete
  (2/28)                     (4/13)
                        (7/13)
  Housestaff Orientation/Training (6/25)
                             Education Modules Due (4/26)
  Email Incompletes to Prog. Coordinators (6/29)
External Communication
Internal Communication
Problem     Background        Goal




Challenges
                Overview

 Timeline    Training     Lessons Learned
Online Training – ELearning in Sakai
Online Training – Medicine Learning Map
Each Learning Map
contains:
• Playground
   Instructions
• Assigned Patient
   Information
• Inpatient & Outpatient
   Scenarios
• Proficiency
   Assessment
• Course Feedback
Psychiatry & Anesthesia
Learning Map
Online Training – Scenario Example
Each Scenario contains:
• Learning Objectives
• Patient Situation
• Actions based on Workflow
• Screenshots & Video Clips
• Handouts for Review
• Check Your Work
• Important Notes


Each Scenario also:
• Included Collaboration of
   Epic Champions
In-Person Help – Epic Study Halls
Online Help – Resources
                          Citrix
                          & Epic




      Sakai
Online Assessments




• 80% or better to pass.
  May use Epic Playground during Assessment
• Maximum of 2 attempts to successfully complete this assessment
• Failed assessments - required to meet one-on-one with an Epic trainer
• Not able to meet with patients until online and in-person training complete
Course Feedback
In-Person Training – Classroom
June 15 – 29th
                                 OB & GYN           Neuro Surg

                                                         Ortho




Psychiatry                   Open House                           Peds Res
                 Radiology                     Surgery
Emergency                    Internal Med                        Family Med


July 2nd & 3rd

                                  Anesthesia      Peds Fellow

                                    Ophtha
In-Person Training – Outline
Inpatient Training (2 Hours)
   • Configuration in Production
      • Login & P-Sync
      • Resources
      • Order Sets & Smart Text
   • Demo/Training
      • Charts & Results Review
      • Patient Summary
      • Graphing
In-Person Training – Outline
Ambulatory Training (2 Hours)
  • Overview of the Schedule (Care Teams, Change
    Provider)
  • Overview of the Visit Navigator
  • Order Entry (medication, lab, radiology, POCT,
    referral, preference list)
  • Progress Note (smartphrases, Notewriter)
  • Completing office visit encounter
  • Overview of the telephone encounter
  • Other encounters (orders only, documentation
    only)
Problem     Background        Goal




Challenges
                Overview

 Timeline     Training    Lessons Learned
Lessons Learned
Credentialing Office       GME Office    Identity Management


 Doctor Numbers




                             New Innovations
Add More Sub Specialties
Epic Training




In Patient               Out Patient
Epic Training




Clear Workflows
 Rich Scenarios
More Customized Videos
Test Out
Test Out
Proctored Tests
Thank You!

Sara Henning
sara@ufl.edu



               Questions?




                              Randy Graff
                            rgraff@ufl.edu

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Expediting a sustainable_approach_for_new_resident_emr_ver_9

  • 2. Problem Background Goals Challenges Overview Timeline Training Lessons Learned
  • 3. Problems 300 new housestaff from all over the world Start July 2 – safe to see patients
  • 4.
  • 5.
  • 9. Great Opportunity Transform Educational Process Training Planned Blitz Education
  • 10. Training Services Office Faculty Everything Epic Productivity Development Else PeopleSoft SharePoint GME Milestones
  • 11. Training Services Office Faculty Everything Productivity Development Epic Else 6 Physician Support/Trainers PeopleSoft 2 Training Environment Builders Physician Subject Matter Expert (ARNP) SharePoint Video Talent (Medical Student) Web Development & Online Content GME Milestones Community Manager – The Magic Bullet
  • 12. UF&Shands Clinical Leadership IT Leadership GME Office Credentialing Office Identity Management Epic Resident Champions Program Directors New Innovations Program Coordinators
  • 13. Problem Background Goals Challenges Overview Timeline Training Lessons Learned
  • 14.
  • 20. 6 Colleges 6 Centers and Institutes
  • 22. 6,000 Students and Housestaff
  • 23. 19 Core Programs 45 Sub Specialties
  • 25. Epic Modules • ADT • ASAP • Cadence • EpiCare Ambulatory • EpiCare Inpatient (ClinDoc) • HIM Anesthesia • HOD Beacon • MyChart Radiant Resolute HB • OpTime • Prelude • Resolute PB • Stork • Willow
  • 26. 2011 Email 3 Websites HealthStream • Register Housestaff Classroom • Identify Epic Champion • 4 HR “Coaching” session • Sakai Take assessment in HeathScream Spreadsheets • Work through first rotation • Gain access to production
  • 27. Problem Background Goal Challenges Overview Timeline Training Lessons Learned
  • 28. Goal Train new housestaff before July 2
  • 29. Problem Background Goal Challenges Overview Timeline Training Lessons Learned
  • 30. Challenges Training Materials Epic Environment
  • 33. Challenges Email Addresses Internationals
  • 35. Do fellows have to take this training too? Can we have our training right here? Do I have to do this? I’m retiring next year… I have been using Epic for five years. I am a Super User. Do I have to do this?
  • 36. Problem Background Goal Challenges Overview Timeline Training Lessons Learned
  • 37. Process Trainers met with Epic Resident Champions (ERC) [What do you do?] Trainers created an outline Vetted with ERC
  • 38. Process Trainers drafted training Training Services Instructionally Designed Training Services tested
  • 39. Process Trainers & ERC tested Trainers Cross-Checked Specialties
  • 40. FEB MAR APR MAY JUN JUL Training Begins - Email all Incoming Housestaff (6/1) UF IDs Created Sent to Sony (4/6) Assessments Due (5/4) In-Person Training Complete (7/3) Resident Match Complete (3/15) Develop Milestones (2/1) In Class Training Handouts Due (6/8) UF data sent to Shands Identity Mgmt Peer Review of Modules (5/11) of Process – Nurses (7/5 - Evaluation Resident Demographic in New (4/6) Chief Resident Meeting (2/10) In Person Training Begins – OB (6/15) 7/13) Innovations (3/22) Program Coordinators Receive Shands Program Coordinator MeetingResident Website & Form Updated Credentials (5/18) Online Training Complete (6/22) New Housestaff Training Complete (2/28) (4/13) (7/13) Housestaff Orientation/Training (6/25) Education Modules Due (4/26) Email Incompletes to Prog. Coordinators (6/29)
  • 43. Problem Background Goal Challenges Overview Timeline Training Lessons Learned
  • 44. Online Training – ELearning in Sakai
  • 45. Online Training – Medicine Learning Map Each Learning Map contains: • Playground Instructions • Assigned Patient Information • Inpatient & Outpatient Scenarios • Proficiency Assessment • Course Feedback
  • 47. Online Training – Scenario Example Each Scenario contains: • Learning Objectives • Patient Situation • Actions based on Workflow • Screenshots & Video Clips • Handouts for Review • Check Your Work • Important Notes Each Scenario also: • Included Collaboration of Epic Champions
  • 48. In-Person Help – Epic Study Halls
  • 49. Online Help – Resources Citrix & Epic Sakai
  • 50. Online Assessments • 80% or better to pass. May use Epic Playground during Assessment • Maximum of 2 attempts to successfully complete this assessment • Failed assessments - required to meet one-on-one with an Epic trainer • Not able to meet with patients until online and in-person training complete
  • 52. In-Person Training – Classroom June 15 – 29th OB & GYN Neuro Surg Ortho Psychiatry Open House Peds Res Radiology Surgery Emergency Internal Med Family Med July 2nd & 3rd Anesthesia Peds Fellow Ophtha
  • 53. In-Person Training – Outline Inpatient Training (2 Hours) • Configuration in Production • Login & P-Sync • Resources • Order Sets & Smart Text • Demo/Training • Charts & Results Review • Patient Summary • Graphing
  • 54. In-Person Training – Outline Ambulatory Training (2 Hours) • Overview of the Schedule (Care Teams, Change Provider) • Overview of the Visit Navigator • Order Entry (medication, lab, radiology, POCT, referral, preference list) • Progress Note (smartphrases, Notewriter) • Completing office visit encounter • Overview of the telephone encounter • Other encounters (orders only, documentation only)
  • 55. Problem Background Goal Challenges Overview Timeline Training Lessons Learned
  • 56. Lessons Learned Credentialing Office GME Office Identity Management Doctor Numbers New Innovations
  • 57. Add More Sub Specialties
  • 64. Thank You! Sara Henning sara@ufl.edu Questions? Randy Graff rgraff@ufl.edu

Editor's Notes

  1. Problem BackgroundGoalsChallengesTimelineExternal Communication Sharron’s Site Internal Communication SharePointTraining (online and in person)Delivery Method SakaiMaterials and assessmentsLessons Learned (doc numbers, sub specialties, IP OP split)
  2. Problem BackgroundGoalsChallengesTimelineExternal Communication Sharron’s Site Internal Communication SharePointTraining (online and in person)Delivery Method SakaiMaterials and assessmentsLessons Learned (doc numbers, sub specialties, IP OP split)
  3. Problem BackgroundGoalsChallengesTimelineExternal Communication Sharron’s Site Internal Communication SharePointTraining (online and in person)Delivery Method SakaiMaterials and assessmentsLessons Learned (doc numbers, sub specialties, IP OP split)
  4. Problem BackgroundGoalsChallengesTimelineExternal Communication Sharron’s Site Internal Communication SharePointTraining (online and in person)Delivery Method SakaiMaterials and assessmentsLessons Learned (doc numbers, sub specialties, IP OP split)
  5. Problem BackgroundGoalsChallengesTimelineExternal Communication Sharron’s Site Internal Communication SharePointTraining (online and in person)Delivery Method SakaiMaterials and assessmentsLessons Learned (doc numbers, sub specialties, IP OP split)
  6. Timeline graphic with pictures(Intermediate)To reproduce the picture effects on this slide, do the following:On the Home tab, in theSlides group, click Layout, and then click Blank.On the Insert tab, in the Images group, click Picture. In the Insert Picture dialog box, select a picture and then click Insert. Select the picture. Under Picture Tools, on the Format tab, in the Size group, click the Size and Position dialog box launcher.In the Format Picture dialog box, in the Crop tab, in the Crop position section, crop the picture to the following values:Width: 9”Height: 2.65”Left: .5”Top: .5”Adjust the values in the Picture position section to properly position the picture within the cropped image.Under Picture Tools, in the Format tab, in the Size group, click Crop, click Crop to Shape, and then under Rectangles click Round Same Side Corner Rectangle (eighth option from the left).Drag the top yellow diamond adjustment handle slightly to the right to decrease the amount of rounding on the corners. Under Picture Tools, in the Format tab, in the Picture Styles group, click Picture Effects, point to Shadow, and then under Inner click Inside Center (second row, second option from the left).To reproduce the timeline effects on this slide, do the following:On the Home tab, in the Drawing group, click Rectangle.On the slide, drag to draw a rectangle.In the bottom right corner of the Drawing group, click the Format Shape dialog box launcher.In the Format Shape dialog box, do the following:In the Size tab, set the Width of the rectangle to 9”, and then set the Height to .73”In the Line Color tab, select No line.In the Fill tab, select Solid fill, and then set the following values:Color: Black, Text 1, Lighter 35%Transparency: 20%In the Shadow tab, click the button next to Presets, and then under Inner click Inside Center (second row, second option from the left). Drag the rectangle onto the bottom of the picture. Press and hold SHIFT and select the rectangle and the picture. Under Drawing Tools, on the Format tab, in the Arrange group, and then do the following: Click Align and then click Align Selected Objects. Click Align and then click Align Center.Click Align and then click Align Bottom.Click Align and then click Align to Slide.Click Align and then click Align Center. To reproduce the month labels for the timeline, do the following:On the Insert tab, in the Text group, click Text Box, and then on the slide, drag to draw the text box.Type the text you want to appear in the text box (this example uses months of the year, so you might type “JAN”), and then select the text. Format the text in the textbox using the following steps:On the Home tab, in the Font group, choose the Gill Sans MT Condensedfont and a font size of18.Click the arrow next to Font Color, and then under Theme Colors click White, Background 1, Darker 35% (fifth row, first option from the left).In the Paragraph group, click Center.Select the text box. On the Home tab, in the Clipboard group, click the arrow under Copy, and then click Duplicate. Repeat the process until there is a total of six text boxes. On the slide, drag the text boxes onto the rectangle to form a row. Press and hold CTRL and select all six text boxes and the rectangle.Under Drawing Tools, on the Format tab, in the Arrange group, do the following:Click Align, and then click Align Selected Objects.Click Align, and then click Align Middle. Press and hold CTRL and cancel the selection of the rectangle, keeping the text boxes selected. Under Drawing Tools, on the Format tab, in the Arrange group, do the following:Click Align, and then click Align to Slide.Click Align, and then click Distribute Horizontally. To change the text in the duplicate text boxes, click in each text box and edit the text (this example uses months of the year).To change the color of a text box, select the text in the text box, and then on the Home tab, in the Font group, click the arrow next to Font Color, and then under Theme Colors click White, Background 1 (first row, first option from the left). To reproduce the vertical line with text effects on this slide, do the following:On the Home tab, in the Drawing group, click Line, and then, in the slide, draw a line.On the Home tab, in the drawing group, click the Format Shape dialog box launcher.In the Format Shape dialog box, in the Size tab, under Size and rotate, set the following values:Height: 1.2”Width: 0”Rotation: 0˚Also in the Format Shape dialog box, in the Line Style tab, set the Width to .75 pt and then, under Arrow settings, set the following values:Begin type: Oval Arrow (second row, third option from the left).Begin size: Arrow L Size 1 (first row, first option from the left).End type: Oval Arrow (second row, third option from the left).End size: Arrow R Size 1 (first row, first option from the left).Also in the Format Shape dialog box, in the Line Color tab, select Solid line, and then set the Color option to White, Background 1, Darker 25% (fourth row, first option from the left).Close the Format Shape dialog box.On the Home tab, in the Clipboard group, click the arrow under Copy, and then click Duplicate. Select the duplicate line. Under Drawing Tools, on the Format tab, in the Size group, in the Shape Height box, enter 2.6”.Press and hold SHIFT and select both lines. On the Format tab, in the Arrange group, do the following:Click Align, and then click Align Selected Objects.Click Align, and then click Align Center.Click Align, and then click Align Top.Drag both lines together on the slide to position them under one of the timeline month labels. Press and hold SHIFT and select both lines and the text box they are under. On the Format tab, in the Arrange group, do the following:Click Align, and then click Align Selected Objects.Click Align, and then click Align Center.Create the subtext boxes:On the Insert tab, in the Text group, click Text Box, and then on the slide, drag to draw the text box.Type the text you want to appear in the text box, and then select the text. Format the text in the textbox using the following steps:On the Home tab, in the Font group, choose the Gill Sans MT font and a font size of 20.Click the arrow next to Font Color, and then under Theme Colors click White, Background 1 (first row, first option from the left).In the Paragraph group, click Align Text Left.On the Home tab, in the Paragraph group, click Align Text Left to align the text left in the text box.On the slide, drag the text box to position it to the right of the vertical line. To reproduce the background on this slide, do the following:Right-click the slide background area, and then clickFormat Background.In the Format Background dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then set the following values:Type:LinearDirection:Linear Down (first row, second option from the left).Angle: 90˚Under Gradient stops, click Add or Remove until two stops appear on the slider.Also under Gradient stops, customize the gradient stops that you added as follows:Select the first stop, and then set the following values:Position: 50%Color: Black, Text 1(first row, second option from the left).Select the second stop, and then set the following values:Position: 99%.Color:Black, Text 1, Lighter 35% (third row, second option from the left).
  7. Problem BackgroundGoalsChallengesTimelineExternal Communication Sharron’s Site Internal Communication SharePointTraining (online and in person)Delivery Method SakaiMaterials and assessmentsLessons Learned (doc numbers, sub specialties, IP OP split)
  8. Problem BackgroundGoalsChallengesTimelineExternal Communication Sharron’s Site Internal Communication SharePointTraining (online and in person)Delivery Method SakaiMaterials and assessmentsLessons Learned (doc numbers, sub specialties, IP OP split)