Validating Knowledge through Skill Labs

Nashville, TN May 14 - 15, 2013

Validating Knowledge through Skill Labs

Lyn Ketelsen, RN, MBA

Studer Group Coach

Copyright © Studer Group. Please do not quote, cite, or disseminate without Studer Group authorization.

Objectives

Demonstrate the value of skill labs as a tool for

training a skill and validating a skill

Demonstrate how to conduct a training skill lab

Demonstrate effective coaching skills


Driving Performance

Diagnose

Assess

Treatment

Actions

Systems

Tools

Techniques

Processes

Teach

Skill Development

Skill Labs

Validate

Rounding

Direct Observation

Skill Labs

Coach Reward


Why Skill Labs

They create a safe learning environment without

the distraction of the routine work pressures and

interruptions

We can get more training or validation done more

efficiently and more effectively

We can provide more thorough feedback with

leaders more engaged

Staff internalize the behavior faster when they

have the opportunity to get direct, meaningful

feedback


Health Texas Care Provider Composite All Facilities %tile Rank

47 43

54

46

60 59 57 60

42 46

32 38

44 50

41 37

44 44 44

33 30 30

75 75

82

69

82 82 84

73

57

68

77

0

10

20

30

40

50

60

70

80

90

100

%ti

le R

an

k

2Q12

3Q12

4Q12

*AIDET® Skills Labs done 09/2012


CAHPS Inpatient – 2 East

Good Samaritan Hospital (The)

Displayed by Discharged Date

CAHPS Jul '11 - Sep '11

Oct '11 - Dec '11

Jan '12 - Mar '12

Apr '12 - Jun '12

Apr '12 - Jun '12

Top Box Top Box Top Box Top Box %ile

Rate hospital 0-10 56.1 ▼ 52.7 ▼ 61.5 ▲ 70.6 ▲ 57th

Recommend the hospital 57.7 ▼ 56.4 ▼ 64.2 ▲ 71.4 ▲ 50th

Cleanliness of hospital environment

72.5 ▼ 79.6 ▲ 82.4 ▲ 82.9 ▲ 88th

Quietness of hospital environment

39.5 ▼ 47.3 ▲ 37.4 ▼ 37.1 ▼ 2nd

Comm w/ Nurses 68.6 ▼ 71.5 ▲ 76.1 ▲ 87.6 ▲ 97th

Response of Hosp Staff 51.8 ▼ 55.8 ▲ 66.1 ▲ 84.0 ▲ 98th

Comm w/ Doctors 69.7 ▼ 71.4 ▲ 73.1 ▲ 73.3 ▲ 8th

Hospital Environment 56.0 ▼ 63.5 ▲ 59.9 ▼ 60.0 ▲ 27th

Pain Management 66.6 ▼ 57.4 ▼ 73.5 ▲ 90.1 ▲ 99th

Comm About Medicines 50.8 ▼ 57.9 ▲ 57.0 ▼ 61.6 ▲ 45th

Discharge Information 75.5 ▲ 71.7 ▼ 83.6 ▲ 80.4 ▼ 22nd


What is a skill lab?

Skill labs can be used for training a skill or

validation of a skill.

You have to know the difference because the feedback

is framed differently, as are the resources. Ex.

Rounding, Hourly Rounding®, AIDET®, Medication

Administration, Leader Coaching, etc.

In Training skill labs, educators, content experts

and others can be used to give feedback.

In Validation skill labs, leaders are present to give

feedback and competency is checked.

Typical topics for validation include AIDET® and Hourly

Rounding® but can include other technical skills


Sample Communication to attendees

Dear Nursing Leaders,

Thanks to each of you for your continued commitment to our journey to excellence. Your leadership and care for our

patients is key as we strive to provide excellent patient care to every patient….100% of the time…every day.

We are committed and invested in developing the skills you need to lead this journey. With that in mind, on <date>,

<names> from Studer Group will be joining us to be part of a Skill lab to focus on leader rounding on the patient. This skill

lab format allows us to learn and have fun at the same time. Nurse leader rounding validates the consistency and quality of

the care we are providing to the patients. We will practice rounding in a real patient setting to improve our patient care and

processes. We can build our skills for this tactic in a safe environment.

Mark your calendars and plan to attend this time of learning. 100% participation and attendance is expected. To prepare,

please note the following:

Schedule/Agenda: We will be meeting as a nursing leader group from 8:00am-9:30am in Stroud Hall to learn the skill

together. We will then break and you will come back at a scheduled time to the patient room/lab to role-play, practice,

ask questions and validate rounding skill. Check the attached schedule to find the time we have scheduled for you to

attend.

Skill Validation Form: Attached you will find a Skill Competency Assessment which outlines the rounding competencies

we will be validating. We will use this form to validate rounding skill and use this for further coaching and skill

development.

Current HCAHPS Results: Please bring your latest HCAHPS report to the morning session as well as to the skill lab to

help us review your highest priority items to include in your rounding.

I am looking forward to this skills lab as our next step to drive consistency in our patient rounds. It is going to be an

interactive and fun learning day for us all. Please call or email if you have any questions!

Have a great day!

<Executive Name>


Be Prepared – checklist Review Team CNO, Champion, Coach

Component Description Owner Notes, Feedback and Improvement Needed

Completed? Yes or No

Date Confirm date

Pre call to establish schedule

Participants

Nursing CNO / VP Nursing Directors

Nursing Managers Charge nurses COO Directors

Managers

Supervisors

Other senior leaders

Room Set Up

Reserve Patient Room

Reserve Teaching rm -nurse leader mtg

Trash on floor

Side rails down

Call light not by bed

Patient in a gown / family member

White board not filled out

IV pole, bag, tubing and tape

Three - Four chairs for validators

Tools

Skill Competency Individual Assessment form copied for each attendee

Skill Competency Assessment Summary (1 copy made and updated with attendee names)

HCAHPS data by unit: Each unit to bring current results

Rounding logs and weekly reports (copy provided for each attendee)

Sample rounding questions (copy provided for each attendee)

Scenarios – verified and copies made for role plays

Treat/Prizes to make it fun

Communication

Invite sent to participants with blocked time based on title

Process for documenting in file

Process for annual validation

Process for action plans

Notes

Additional Resources


Date: ________________ Name: ________________________________ Role: ________________

STRENGTHS IDENTIFIED/RATING

ESSENTIAL SKILLS (Each section equals 9 points for a total of 90 points)

NEED TO FOCUS ON IMPROVEMENT

ACKNOWLEDGE

Acknowledged entering the room (knock, hello, etc.)

Acknowledged using customer name as appropriate

INTRODUCE

Introduced self and role

Managed up experience/training/skill set, etc.

Managed up others (co-workers/other depts./organization, etc.)

DURATION

Gave time expectation of how long will take, how long expected to wait

Verbalized next step

EXPLANATION

Explained what would be taking place, why you are doing this, what will happen, and what they should expect. Addressed pain management

Used language that the customer understands

THANK YOU

Thanked the customer and showed appreciation (i.e., thank you for trust, for asking your question, for the opportunity to work together; ask if there’s anything you can do before leaving, etc.)

STRENGTHS IDENTIFIED/RATING OTHER (Each item equals 1 point for a total of 10 points) NEED TO FOCUS ON

IMPROVEMENT

Enga

gem

ent A

ttrib

utes

Active listening Non-multi-tasking Eye contact Tone of voice Appropriate speed of speech Appropriate use of touch Appropriate use of humor/emotion

Physical positioning – mirror customer’s position, sit without table or desk between if possible, etc.

Energy mirrors the needs of the customer

Washed hands entering room and as leaving the room if patient care area

>90 pts = Competent EVALUATION SUMMARY: Total: (100 pts)

Expert at AIDET® Evaluator Comments: Repeat Skills

Assessment Would be a good mentor to others

Evaluator: ___________________________________________________ Date: _____________________


When to do skill labs

When you need 100% of the staff to know,

understand and demonstrate competency in a

particular skill, technique or behavior

If for training – as quickly after introduction of the

didactic training on the why, what, when, where, who of

the skill

If for validation – approximately 60-90 days after

implementing the new skill; long enough to have some

practice, but not so long that bad habits are developed.

Ongoing annual competency can be done in the context

of the usual competency evaluation process

Video technology to assist with self assessment can

enhance learning


Now let’s try one!

We are going to simulate a training skill lab

Focused on skill development – Improving

Leaders skill in coaching and giving one-on-one

feedback when doing validation observations


What Does Great Coaching Look Like?

Let’s watch


Leaders need skill development and validation, too!

Reasons we don’t give immediate performance

feedback and coaching of staff:

Time

It will make staff feel uncomfortable

It will make them think we don’t trust them

The leader thinks the staff already do the skill well

enough

Patients report in rounds the staff are doing it


Coaching

It’s not about pulling the

weeds…

It’s about

fertilizing the

Garden…


How to give feedback

Don’t be too general

Teach to the test – this isn’t about “gotcha”. Your

feedback is a gift!

Have a vision of what success looks like and

coach to that vision

Identifying what’s wrong without a suggestion on

how to improve is auditing not coaching

Be positioned to be an observer/auditor

Have a plan/tool/form to outline the process and

behaviors expected


How to give feedback

Provide feedback on every step of the process and

every behavior – this also serves as a mini in-

service to refresh the process steps

Summarize with what is the one thing to focus on

for improvement

Ensure your feedback is aligned with the

performance of the person being observed. A-B-C

Position feedback positively – “I heard you say

your name; that’s a good start. Best practice says

we should also state your role and manage up”

Improve your observation assessment skills with

practice, practice, practice!


Ongoing Validation

Skill labs offer a great framework to enhance

skills or validate them but they do not replace

ongoing dynamic observation and coaching on a

daily basis by leaders.

Two-a-days…


HCAHPS focuses on a

measure of frequency.

Skill labs helps drive

consistency.

Every Patient,

Every Day

Getting a Gold Medal in

patient care requires the

same focus and attention of

an athlete.

Nashville, TN May 14 - 15, 2013

Thank you

Lyn Ketelsen RN, MBA 850-934-1099

[email protected]

www.studergroup.com

mailto:[email protected]

Documents

Validating Knowledge through Skill Labs