Introducing new information technology—software and hardware—to a long-term care operation can be a daunting prospect. This is never more so than when trying to bring staff up to speed on the new program. The extent of a facility's or organization's success at training staff can make or break the project. One long-term care manager who is particularly experienced at meeting this challenge is Sandra Mitchey, LNHA, RAC-C, who has been spearheading IT developments at Heritage Enterprises, a 32-facility Illinois-based chain, for the past 18 years. From multiple product introductions, Mitchey has noted that the bottom line is to keep staff feeling positive, and that is a goal that takes several steps to achieve. Connie Hoselton, Heritage's senior vice-president of human resources, joined with Mitchey in elaborating on this in a recent interview with Nursing Homes/Long Term Care Management Editor-in-Chief Richard L. Peck.
Peck:What have you found to be the greatest training need of long-term care staffs taking on a new IT system?
Mitchey:The greatest need is that staff across the board communicate with each other and work together.
Hoselton:It's vitally important that each department knows how its work and understanding of the system affect the other departments. They have to realize that they're really all in this together.
Peck:Once you've gotten staff's attention about this, what's the best way to get started?
Mitchey:Everything starts with a complete commitment to the project by upper management. It doesn't do to have staff hearing one thing and observing another. That's one way problems begin. Leadership also has to get across the idea that nobody “owns” anything, that the system is not just for the benefit of one group or another. All viewpoints and suggestions should be welcome from every quarter.
At Heritage we have a team of administration, department heads, finance, and other senior management, as well as managers of individual facilities involved in pilot projects, all discussing the needs, wants, and wishes of all members of the organization. In a smaller, single-facility approach, a team of department supervisors, the administrator, and the DON could collaborate in the same way. The vital thing is for the initial meetings to cut across departments and discuss everyone's concerns.
Peck:Once the time for training arrives, what's the best specific approach?
Mitchey:At Heritage we have a classroom with eight workstations. We can train 20 staff at a time, but prefer to train 8 at a time so that everyone has a workstation. We also do help desk–type phone training—that is, we are able to remotely control the individual's cursor at the other end of the phone line to guide the individual through the program. This has been very effective, so much so that, although I used to make the rounds of our facilities to conduct this sort of training, I don't have to do that so much anymore.
Peck:What about having people learn the system hands-on, on the job? Is that effective?
Mitchey:We prefer not to do it that way. People just get too frustrated and they end up not liking the software. We try to do anything to avoid that happening, and to make sure that they stay comfortable with the system and have a positive outlook.
Peck:What about the perennial problem of staff turnover, which can hamper even the best training programs? How do you accommodate that?
Mitchey:We're evaluating something that could be the answer to this—e-learning modules for individual training on demand. There are several available now, and we're looking for something we can locate in a quiet area, not too congested but not shut off from the world either, where the CNA can sit down, log on, and get easy access to training in a number of areas. We're looking at wall monitors and drop-down keyboards as another means of offering this. Other criteria for the e-learning modules would be that they're easy to understand, use audio and video, are multilingual, offer good posttesting, and automatically track usage and individual grades. Our idea right now is to give our CNAs 10 of their state-required 12 hours annually of training, with the other two hours in-service. And we can provide this training at any time that it's needed, and for anyone.
Peck:What about management, such as administrators and DONs—are they expected to have some degree of expertise or involvement with IT?
Mitchey:Expertise, no, but at Heritage we are looking at developing training in many areas using a software that enables us to write modules according to our own policies and procedures. The modules go into such areas as corporate compliance, employee relations, wage-hour administration, public health regulations, and facility safety, including fire codes.
Peck:It's interesting, the training model that you've adopted for a multifacility organization: You pilot things at one or two facilities, make needed improvements, and the training grows from there. Would you elaborate on this?
Mitchey:This is an approach that's been tested, tried and true. The key here is that every facility needs a champion for the IT system, someone who is willing and able to bring the system into the facility, train everyone, troubleshoot, and give support. We ask facility leadership for nominations of such individuals, then interview these people and train the trainers. It doesn't matter what level of facility staff they occupy, as long as they can fill this role. I know of one CNA who is a natural at this, in fact who is so good and supportive that she can train RNs without complaint because they see that she is positive in her approach and works well with staff.