“Positive Outliers”: Leaders Share Strategies for Keeping Users Trained in a Continuously Changing World

Given the amount of resources healthcare organizations devote to clinical applications — and the increasingly critical role those applications play in improving outcomes — it’s safe to say that proper training is paramount.

“Never underestimate the need for training and support,” said Lisa Stump, Chief Information and Digital Transformation Officer at Yale New Haven Health System. “Keeping your ability and acumen in those systems is as important as maintaining your clinical area of expertise. It always has to be top of mind,” she noted during a panel discussion, which also included Alistair Erskine, MD (CIO & Chief Digital Officer, Emory Healthcare and VP for Digital Health, Emory University) and Ryan Seratt (Director of Training & Development, 314e Corporation).

Failure to do so could be devastating, noted Erskine. “If you don’t train appropriately, you pay for it in spades.”

But it’s not enough simply to have a program in place. User training should be continuous, it should be offered in different formats, and it should be embedded into the workflow, according to Stump. “It is an absolute shared responsibility that starts with operational owners as subject matter experts to inform the expectations of the technology we’re putting into place, the utility of the technology, and the workflow in which it will be used,” she noted. She believes that “if we simply train people in the points and clicks of how the technology works, we’ve really not done our job.”

Getting it right means being willing to dig deeper. During the discussion, the panelists offered best practices on how to create and sustain an effective program for training users on clinical applications.

Leverage experts. At YNHH, Stump relies on IT leaders who are subject matter experts in technology to help advise training programs by identifying the core features and functions, as well as those that are “nice to know,” she said. “My responsibility is to ensure we have the right trainers who are able to deliver content and do it in a way that engages our users in a personalized way so that we’re creating not just content, but a program that meets the needs of our users and the organization.”

Take it outside the classroom. The problem with educating users in the classroom setting is that users retain just a small portion of the knowledge once they exit, according to Erskine. He believes training will continue to edge “closer and closer to the frontline,” as long as at-the-elbow support is offered. “If you have someone showing you how to change something, that ends up being a better strategy.”

Diversify. Another smart move, according to Seratt, is to have a diverse delivery strategy, rather than relying on one method. “It’s not one size fits all,” he noted. “You have to have different approaches for different situations.”

Start small. It’s also important not to pile on too much information too quickly, according to Stump. Her team starts with 100-level training, which covers the minimum required information users need to do their jobs safely and effectively. “We try not to overwhelm people before they have a basic understanding of what the technology can do,” she said. Erskine uses a similar approach; once users have cleared the first level, they learn about shortcuts and leveraging features to become more efficient. “The timing of that content delivery is very important,” he added.

Embedded education. The methodology is also critical, said Erskine, whose team has taken a page from EHR implementations and embedded 30-second videos reminding users how to complete certain tasks. Through “modular training,” they’re able to cut valuable snippets and paste them into different parts of the workflow. The key to making this type of training successful is to offer at-the-elbow support, whether it’s live or virtual, to those who may be struggling. “If we see folks are logging too much pajama time, we can create a personalized session to help them out,” he noted. Similarly, Stump offers virtual, instructor-led courses that guide users through processes, along with pre-recorded podcasts and 1-page descriptions. “We make sure to push those out through a variety of methods,” she added.

Space it out. It’s important to remember that even the brightest minds can only absorb so much information in one setting, said Erskine. “Once you reach that limit, anything else is lost. They have to be able to apply the knowledge to really internalize it.” Stump agreed, noting that training, like any learning process, must be ongoing to enable individuals to reach the next level of proficiency. To that end, YNHH uses regular checkpoints — 30, 60 and 90 days after the initial training — to continue to reinforce education. “We also layer in some of the additional pieces of functionality, usability, and utility in the system,” she said, emphasizing that the first session focuses solely on navigating the system. “We can’t begin to help you understand how to get data out until you’ve had an opportunity to use the system.” Search and reporting capabilities, for example, are gradually added into the training.

Find the outliers. What can get tricky is identifying those who need additional training. That, according to Erskine, is where data can play a key part. “Looking at the data is really important,” he said. “Everyone is going to be on the bell curve. There will be some champions, and some who struggle.” The former can become super users who receive additional training across subspecialties and can pass that knowledge along to others — while also providing feedback to leaders. “They’re so valuable,” Erskine added. Stump also leverages data to pinpoint “positive outliers” who are able to complete tasks quickly, and find out their secrets. “We want to make sure our training reflects those best practices.” Interestingly, they’ve found that feedback is much better received when it comes from peers, and is therefore more likely to result in improvements. “It’s been really helpful.”

Aim for ‘just enough’. While it may seem counterintuitive to healthcare leaders, training programs must avoid aiming too high, according to Seratt. “There’s more and more of an appetite for what we call ‘just-enough training. What skills can I teach someone to carry them forward? What do they need to know to do their job, and what can they reference at a later time? It’s important to categorize that,” he said. “Not all training is built the same.”

As organizations have realized this, formal training sessions have been slowly phased out and replaced by what Seratt termed ‘micro-learning’ tactics such as incorporating tipsheets into the workflow. “We’re seeing more of a need for that,” he said. And instead of training on every aspect of upgrades, he advised leaders to take a different approach. “The best practice I’ve seen is when people categorize something as ‘discoverable,’ such as a new option on a dropdown menu. People will see it and know exactly what it means. You don’t need to communicate that.” The focus, he noted, should be on “pairing everything down and teaching people survival skills,” and “letting discoverable things get discovered.”

Finally, as with any IT initiative, training can’t just be about checking boxes, said Stump, adding that leaders need to set clear expectations from the start. “We need to keep it centered on the value it delivers,” she noted. “It’s not training for the sake of training, the same way we say it’s never technology for the sake of technology. It always has to be top of mind to keep our users trained and capable in the systems.”

And it’s not just about strengthening the workforce; continuous training can also help ensure organizations are getting the most from IT systems, noted Seratt. “A lot of the value comes from supporting people through that learning experience as things continue to change,” because they will, he added. “We’ve got to help people through the journey.”

To view the archive of this webinar — Strategies for Keeping Users Trained Up on Ever-Changing Applications (Sponsored by 314e Corporation) — click here.