“Start Listening”: Two Leaders on How Their Teams Overcame “Horror Stories” and Improved Outcomes

The numbers don’t quite add up. For the past several years, technology has played an increasingly significant role in both operations and care delivery; and yet, adoption and EHR satisfaction rates remain low.

Clearly there’s a divide. The question is, how much of it can be attributed to people and processes — rather than just technology, and what can be done to bridge the divide? The answer is by having leaders share their stories, which was the case at a CHIME23 Fall Forum panel, moderated by Bobby Zarr (VP, Healthcare, uPerform). But rather just talking about what they did right, Terri Couts (SVP and CDO, The Guthrie Clinic) and CT Lin, MD (CMIO, UCHealth) took a different approach by revealing some horror stories from their pasts — and how they sought to flip the script.

Guthrie’s Story: Technology Unplugged

When Guthrie Clinic — a five-hospital system with a large geographic footprint across Pennsylvania and upstate New York — announced plans to update Epic’s MyChart Bedside, expectations were high. “We were going to engage with our patients, increase our scores, and take some work away from nurses,” said Couts. And so, when early findings showed that not a single account had been activated, it was clear there was a problem.

The root cause? The devices had been placed at the foot of the beds — near the electrical outlets. And while that made sense from a charging standpoint, it failed in terms of usability. “The technology was awesome,” but without involvement and input from users, the implementation was dead on arrival, forcing leadership to start from scratch.

Fortunately, they also started with a new recipe, according to Couts, who was brought in to help turn the tide. The first priority was to “start listening to the why,” she said. “IT was doing things to them. They had no input and no understanding as to the ‘why.’”

It became clear that more effective training was needed. And so, Guthrie created a concierge rounding service in which individuals utilized data to identify problems and provide on-the-spot education. The key, Couts said, was to figure out what users need to be successful.

One thing that proved quite important is transparency. “Sometimes it’s just understanding what’s coming down the road and making sure they’re aware of it ahead of time,” she said.

In fact, one of the biggest wins was realizing the importance of communication and making sure clinicians felt heard, which in turn helped build trust. “Once they started seeing that we could give them little tips and tricks and make it personalized, we became partners,” Couts added.

A critical component of that is in connecting the IT team and trainers to the mission of the organization, which is very difficult if they’re viewed as a barrier rather than an enabler. By adopting a customer experience approach to the training process, IT was better able to reach clinicians. “They felt heard and engaged, and our team was happier because they were able to provide support.”

And, as a byproduct of that, “they felt connected to the care that was being provided.”

UCHealth’s Story: Classroom Deconstructed

CT Lin’s idea of a horror story is one in which EHR training takes place during 8-hour classroom sessions. Not just because attention spans are limited, and people learn at different paces — both of which are very legitimate concerns. But also because UCHealth has onboarded nearly a thousand new faculty and staff members, spread out across hundreds of miles, in the past year.

And so, his team decided to blow up the classroom model. “We know from adult learning theory that people pay attention for one hour or maybe two on a good day,” which means the remaining six hours were being wasted. On the other hand, UCHealth’s “deconstructed training” model features “human learning” for about a half-hour with small groups that are asked to configure 4-5 items. From there, they advance to self-paced learning.

To supplement that — and make sure learners stay on track — UCHealth offers advanced training based on specialty, along with pothole training, which helps pinpoint areas that require more education. These methods enable users to learn at their own speed and ensure important pieces don’t slip through the cracks. According to the feedback they received, it’s been widely accepted, with the vast majority of clinicians reporting they are retaining more content and feel better prepared.

The ultimate endgame, Lin noted, is to break down the barriers that have long existed between clinicians and IT staff. By making education “a central part of the conversation,” organizations can move closer to that goal. “With training tools like this, we’re helping people to become more efficient,” Lin added. “We’re knowledge workers. We ought to be teaching our clinicians and our staff how to use information to be better teammates to raise the game for all of us. This is a way to get there.”