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Mandatory/Required Workgroup Workgroup members Cheryl Lovlien, NES Supervisor LeAnn M. Johnson, Nurse Administrator Lynn Alcock, NES Educational Technology Kathy Ferguson, NES Competency Program Karen Sell, HR Service Partner Heath Elenbaas, University of Minnesota, Graduate Student

Mandatory/Required Workgroup Workgroup members Cheryl Lovlien, NES Supervisor LeAnn M. Johnson, Nurse Administrator Lynn Alcock, NES Educational Technology

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Mandatory/Required Workgroup

Workgroup members Cheryl Lovlien, NES Supervisor LeAnn M. Johnson, Nurse Administrator Lynn Alcock, NES Educational Technology Kathy Ferguson, NES Competency Program Karen Sell, HR Service Partner Heath Elenbaas, University of Minnesota, Graduate Student

Identification of Issues

Charge from Nurse Executive Committee (NEC) to define “mandatory” “required” implications when requested by proponents of initiatives.

Implications: Compliance & tracking Burden in time and effort Outcomes

Identified Process

1. Preliminary review of issues

2. Focus Groups to collect data

3. Complete data collection and develop themes to represent Focus Group conversations.

4. Review of literature

5. Benchmark

6. Develop recommendations

7. Present project and recommendations to NEC

8. Develop plan based on support of Nursing Leadership

9. Communicate

Review of issues

No clear definition of Mandatory/Required training No clear process of approval, review of cost/benefit or

related outcomes Concerns with amount of education and staff feeling of

continuous amounts of mandatory training No way to identify what training meets which criteria for

accrediting agencies (Joint Commission, Magnet, ANCC provider)

Event related to lack of tracking BLS/ACLS Magnet requests for data-difficult and time to collect

information Dissatisfaction from learners who do not feel required

training is appropriate for their role

Draft Definitions

Education: transmission of vocational/professional knowledge, skills and abilities to provide safe, competent care and/or ability to function within the employee’s role in the organization.

Information: Content specific to the employees ability to perform job functions: changes in policies, procedures, equipment, new and changed processes. Need to determine what information is “required” to perform job function

Communication: Content that is beneficial (would make work easier) but not “critical” to patient safety.

Draft Definitions Mandatory training: required by law or governing agency/legal

statute (ERTKA, OSHA, HIPAA). Implies tracking of compliance

Required training-education: Mayo Clinic or we as a division/department in the health care organization deem this information to be “required”. Implies tracking of compliance

Recommended: Does not require 100% individual interaction with education. Conceptually 60-70% spread of information can influence change. No tracking for compliance

Training: “to teach so as to make fit, qualified, or proficient” Merriam-Webster (m-w.com)

Focus Group

Requested time at unit meetings to hear from the “end user/customer” (unit councils, staff development, preceptor, practice, congress) Attended 43 different groups, > 347 nursing staff

participated

Request for centrally located Focus Groups to hear the voice of Leadership (Nurse Manager/Nurse Supervisor/CNS/NES) and concerns with current systems/processes. (4, one hour sessions across campus sites) 75 nurse leaders participated

Face to Face Education- Nursing Staff

When it makes sense: Hands on required (decubitus ulcer, insulin pen)-

connects information to action Important knowledge with rationale (sepsis-diabetes)

Difficult to attend PIE: Practice Initiatives Education – parking, can’t get

away during work hours to attend, staff don’t support

Allow staff input to Education Determining topics, determining assignments Disseminating education/information Superuser/Champion models

Online Learning-Content- Nursing Staff

Methodology: When it makes sense (fire, safety, code 45) Issues:

Too many-OVERWHELMING-“Death by Powerpoint” Need to know how many slides/how long The assignments need to fit my job responsibilities Allow me to test out if content repeats the same year to year Can’t receive immediate feedback

What would they like to see: Multiple options (face-face, online, interactive options, ability to test out)

Method fits the content If testing, do small content, then test, more content then test Provide with immediate feedback if answers wrong

Online Learning with Sound- Nursing Staff

Can’t do on unit computers (sound not active, too noisy in area, not available)

Culture: not supported, viewed as “goofing off” Can’t do during work time: “I’m here for my patients”

Liked RRT Video/sound functionality

Can’t bookmark Can’t move ahead

Online Learning-Navigation- Nursing Staff

Easy to use: “personal view”, “one stop shop” for all online training, automatically goes to transcript

Testing: give me rationale as to why I missed the answer (immediate feedback)

Navigation Buttons: Keep in the same place on all training

Auto bookmark: “instead of losing my place when I can’t get back to the screen before it shuts down-have to re-do all content”

Notifications: like them, but in just the right amount-enough to remind me without NAGGING

Retrieving Information later: right now when education is done there is no where to get it unless there is a guideline

Online Learning-Time- Nursing Staff

Control timing of assignments Too many--“You think you’re done and then another

note arrives” BATCH Quarterly (33 of 43 groups recommended)

Provide time (away from direct care)/coverage: Need uninterrupted time

Hard to concentrate, distracting on the unit with noises, alarms, patient/family requests, can’t remember content, not a good learning environment

Access from Home- Nursing Staff

Yes: 53% Rationale: quiet, can concentrate, can pay

attention, access to computers at work, would like option

No: 47% Rationale: want to keep work life balance,

don’t want to HAVE to do it at home Discuss info with colleagues in the moment

Competencies- Nursing Staff

Emergency Medical Response- Why the same every year Want a “bus stop” on unit to complete

No Paper Competencies Complete online “Who reads these?”

Centralize all our competencies: “one stop shop” and Decentralize bring it to me

Rationale: why are we doing the same thing year by year

Focus Group-Themes- Nursing Leadership

One stop shop Easy to find

Reports Should come to me (push vs pull) Alert me to staff who need to complete Should be available by topic Do I have to track compliance on all?

If staff are off for FMLA, doesn’t look like we have compliance.

Focus Group- Nursing Leadership

Leadership involvement in assignments Consistent process to assign “required”

Identify criteria and categories (Category I, II, III topics)

Who determines the topics? Do we have logic (rationale) behind these

decisions? “Just because of one event, one year, we keep doing yearly”.

Focus Group- Nursing Leadership

PIE: concern with ongoing access to content, ability for staff to access

Need time: but how does it get used, who tracks, what if they don’t need time?

Need multiple options to learn, find the best methodology

Competence assessment: what has to be done? What is required? Who determines the need for the topics and who does them, What is the best practice?

Access from Home- Nursing Leadership

Large Majority: NO Need to track time: which would be difficult

don’t have a mechanism, would require more time from Leadership/emulator

Mixed Message: “we’re telling them they shouldn’t be connecting to work from home and then we allow it”

Would not be Fair/Equitable: Some work to get it done as soon as possible, others take all the time given

Benchmarking

No definition: use Mandatory/Required interchangeably

Provision of time: ranges from 0-100 minutes/quarter.

LMS: all use some type of system

Access from Home: most do not due to FSLA, those that do provide for Contact Hour

Topics: determined usually by one person or a committee.

Allina Hospitals & Clinics, Cleveland Clinic, Johns Hopkins Hospital, Mayo Clinic in Florida, Shasta Healthcare

Next Steps

• Present project and recommendations to NEC• Next week- Nursing Informatics Technology Committee

(NITC) to discuss proposal for LMS• Develop plan based on support of Nursing Leadership

• Tiering Education Workgroup begun to look at approval process and methods for Mandatory/required education.

• EPD Technology Workgroup: reviewed Literature on how to select an LMS, created LMS requirements document.

• Communicate

Coordinate with other groups: • Night owl education workgroup

Questions/Suggestions