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EE--CLIPS Training Project: CLIPS Training Project: The Good, The Bad, The Good, The Bad,
The Great!The Great!January 19, 2007January 19, 2007
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MHS and Our Training StoryMHS and Our Training StoryAgenda and PresentersAgenda 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
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OBJECTIVESOBJECTIVESLearn:• 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
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Patients First…More Patients, More Choices
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Memorial Hospital CentralMemorial Hospital Central
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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
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Memorial Hospital Central AdditionMemorial Hospital Central Addition
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Memorial Hospital NorthMemorial Hospital North
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The EThe E--CLIPS ProgramCLIPS ProgramElectronic 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.
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How we got there: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.
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End-User TrainingDesign Process
Post-Conversion Assessment
ProjectPlanning
Super User Training
End User Training
End User Training
DataCollection
ProcessDesign
WindowsAssessment
TrainersEducation
WBTDevelopment
Pre-DesignAssessment
May 2005 July 2005 July 2005 Oct 2005Sept 2005 Jan 2006 Feb 2006 Mar 2006
Feb - March 2006
April-May 2005Mar-May 05
E-CLIPS Project Phase 1 Implementation
March, 2005 March, 2006
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EE--CLIPS Training Logistics 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
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EE--CLIPS Training Logistics CLIPS Training Logistics
• Windows assessment for staff• Windows 2000 basic skills review on our
intranet• Windows 2000 test and classes
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EE--CLIPS Training Logistics CLIPS Training Logistics
Determined classes needed and number of “seat hours” for all employees from a spreadsheet designed by Cerner.
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EE--CLIPS Training Logistics CLIPS Training Logistics
• Created multiple class schedules• Created registration portal on our intranet
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EE--CLIPS Training Logistics CLIPS Training Logistics and Coordinationand Coordination
E-CLIPS Introduction CBT (computer-based training) to be taken before attending class.
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EE--CLIPS Training Logistics 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.
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EE--CLIPS Training Logistics 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.
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Role of Training CoordinatorRole of Training Coordinator
ClassRegistration
TrainerSchedule
ClassSchedule
Communication
ClassRosters
TrainingMaterials
Class Attendance & Evaluation
ClassCoverage
Auditing Classes, Feedback, Meetings, Reports, Updates, …
RecognitionLuncheon
Victoria del Valle
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Training MethodologyTraining Methodology
1. Teach Functions2. Cascade Learning
ASC Nurses/Therapists
Trainers
End Users
Super Users
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Selection of Nurse Trainers andSelection of Nurse Trainers andSuper UsersSuper Users
• Gap Analysis• Selection Criteria• Actual Numbers• Educational Consulting Firm
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Curriculum Development Curriculum Development Customized Training ToolsCustomized Training Tools
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Train the TrainersTrain the Trainers
• December 2005• 1-week Classroom Hands-on Training• Practice Time• Testing• Train Domain (environment)• Training Consistency
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MHS EMHS E--CLIPS TrainersCLIPS Trainers
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Super User TrainingSuper User Training
• January 2006• 2-day Classroom Functional Hands-on Training• Unit-specific Super User Training/Practice• System/Process Update Dissemination• Quick Reference Guides
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End User Training, Support, & End User Training, Support, & CompetenceCompetence
• 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
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A NurseA Nurse’’s Perspectives Perspective
Shanna Bock
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A NurseA Nurse’’s Perspectives 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
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A NurseA Nurse’’s Perspectives Perspective
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A NurseA Nurse’’s Perspectives 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)
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A NurseA Nurse’’s Perspectives 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.”
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A NurseA Nurse’’s Perspectives Perspective
Anger• Numbness and shock!• “Why are they doing this to me?”• “They can’t make me change the way I
document!”
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A NurseA Nurse’’s Perspectives 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.”
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A NurseA Nurse’’s Perspectives 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!”
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A NurseA Nurse’’s Perspectives 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!”
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A NurseA Nurse’’s Perspectives Perspective
• “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!”
More Acceptance
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Gearing up for GoGearing up for Go--Live: what Live: what happenedhappened……
• Feelings of anxiety • Observing the excitement of other staff
members. • Seeing the equipment being placed on the units.
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PracticePractice……PracticePractice……PracticePractice
• 8 hours of practice time allotted • Practice labs • Completing required homework and
practicing…
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• 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
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• 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
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Post GoPost Go--Live AssessmentLive 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
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BENEFITSBENEFITS• 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
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Looking forwardLooking forward
Communication tools broadened Continue to involve nurse trainers / super usersStandard training for new employees, additional
applicationsErgonomic assessmentsPowerForms redesign groups BPOC and CPOE later this year (07)
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The hardest part is over...