As long-term, post-acute care and senior living organizations progressively embrace electronic health records (EHRs), more facilities are seeking ways to make implementation pain free. For many, adopting technology represents a departure from current operations and processes, which are typically paper-based. In fact, if staff are unfamiliar with new technology, the initial transition can be especially challenging. Even worse, if implementation is difficult for staff, these organizations could see low long-term adoption, jeopardizing their technology investment.
However, long-term care (LTC) organizations can take steps to ensure EHR implementation goes smoothly. Two of our skilled nursing facilities, West Hartford Health & Rehabilitation Center and Avon Health Center, both in Connecticut, learned many lessons during its EHR implementation, inclding the importance of giving the staff early and multifaceted training.
A chief driver for successful implementation is the introduction of a multifaceted training effort providing clear information when and where staff need it most. For example, West Hartford Health & Rehabilitation Center and Avon Health Center recently partnered with SigmaCare, New York, N.Y., to develop and execute a robust training program to implement the EHR. Together, we launched a dynamic instructional program that ensured staff were well-prepared to use the software over the short term and the long term.
The following sections take a brief look at the different strategies we found useful for the training efforts at these two locations, and shed light on why each component was so instrumental in leading to success with our EHR implementation.
1. Develop a comprehensive plan
The key to effective training is a detailed, comprehensive plan. When developing such a roadmap, your EHR vendor can be a good place to start, since it has broad experience with installing the technology and can advise on best practices for educating staff.
“SigmaCare offered a thorough, hands-on training program that taught our staff to use the technology to its fullest potential,” says Theresa Sanderson, administrator at West Hartford Health & Rehabilitation Center/Avon Health Center. “Together, we collaborated to build and implement a plan customized for the unique needs of our staff.”
Not every training format works for everyone, adds Krishna Bala, PhD, senior vice president of operations, SigmaCare. “When formulating a training plan, consider using multiple venues for the training sessions, to help staff remain attentive and engaged while learning of the real-world implications of this training once it goes live. Venues can include classrooms for general education, real-world clinical spaces for practice opportunities and point-of-care workstations for supervised trial runs.”
During the training, SigmaCare proactively served as a resource or training leader, depending on our needs. We held classroom education programs centered on a roles-based curriculum, which helped staff get real-world practice with the new EHR. On-site staff for point-of-care assistance were also available after the EHR went live to ensure all questions about the system could be answered quickly.
2. Allot sufficient staff training time
To ensure staff are comfortable using the EHR, ample time should be allocated to get them up to speed on the technology. In order to maximize reception and avoid patient care disruption, we also suggest that training take place independent of regular shifts and employees be compensated accordingly. If staff try to train during their shifts, they may be distracted or frequently interrupted, causing them to rush through education exercises and potentially miss key information. This type of distraction could negatively impact patient care. Similarly, if staff are forced to train on their free time, they may become frustrated, leading to satisfaction and retention issues.
Instead, dedicate specific time for staff to receive training. Earmarking training time shows that the organization is committed to preparing staff to use the EHR. It also underscores the importance of the initiative and the value the organization places on staff preparedness.
“We realized this transition would be a considerable time commitment for our employees and therefore provided 40 hours of training to each staff member outside of his or her regular shift to ensure each staff member was receptive to the process and able to provide undivided attention to the task at hand,” says Russell Schwartz, director of operations at West Hartford Health & Rehabilitation Center/Avon Health Center. “To accommodate this, we increased overtime so nurses could cover one another during training windows.”
We also worked with SigmaCare to identify a training program specific to our needs, where staff progressed through the different modules in four-hour increments,” he adds. “During this period we received zero patient complaints during our go-live period. In fact, in many cases, the patients were not even aware of the training process.”
The right implementation process reflects well on the facility and keeps stress to a minimum, Sanderson adds. “Although organizations may hesitate on EHR implementation for fear of patient disruption or retention concerns, we certainly did not find that to be true. We proudly celebrates the fact that we did not lose a single nurse or file a single patient complaint in the process of implementation.”