Partnerships@Work: 5 strategies for introducing staff to an EHR

As long-term, post-acute care and senior living organizations progressively embrace electronic health records (EHRs), more facilities are seeking ways to make implementation pain free. For many, adopting technology represents a departure from current operations and processes, which are typically paper-based. In fact, if staff are unfamiliar with new technology, the initial transition can be especially challenging. Even worse, if implementation is difficult for staff, these organizations could see low long-term adoption, jeopardizing their technology investment.

However, long-term care (LTC) organizations can take steps to ensure EHR implementation goes smoothly. Two of our skilled nursing facilities, West Hartford Health & Rehabilitation Center and Avon Health Center, both in Connecticut, learned many lessons during its EHR implementation, inclding the importance of giving the staff early and multifaceted training.

A chief driver for successful implementation is the introduction of a multifaceted training effort providing clear information when and where staff need it most. For example, West Hartford Health & Rehabilitation Center and Avon Health Center recently partnered with SigmaCare, New York, N.Y., to develop and execute a robust training program to implement the EHR. Together, we launched a dynamic instructional program that ensured staff were well-prepared to use the software over the short term and the long term.

The following sections take a brief look at the different strategies we found useful for the training efforts at these two locations, and shed light on why each component was so instrumental in leading to success with our EHR implementation.

1. Develop a comprehensive plan

The key to effective training is a detailed, comprehensive plan. When developing such a roadmap, your EHR vendor can be a good place to start, since it has broad experience with installing the technology and can advise on best practices for educating staff.

“SigmaCare offered a thorough, hands-on training program that taught our staff to use the technology to its fullest potential,” says Theresa Sanderson, administrator at West Hartford Health & Rehabilitation Center/Avon Health Center. “Together, we collaborated to build and implement a plan customized for the unique needs of our staff.”

Not every training format works for everyone, adds Krishna Bala, PhD, senior vice president of operations, SigmaCare. “When formulating a training plan, consider using multiple venues for the training sessions, to help staff remain attentive and engaged while learning of the real-world implications of this training once it goes live. Venues can include classrooms for general education, real-world clinical spaces for practice opportunities and point-of-care workstations for supervised trial runs.”

During the training, SigmaCare proactively served as a resource or training leader, depending on our needs. We held classroom education programs centered on a roles-based curriculum, which helped staff get real-world practice with the new EHR. On-site staff for point-of-care assistance were also available after the EHR went live to ensure all questions about the system could be answered quickly.

2. Allot sufficient staff training time

To ensure staff are comfortable using the EHR, ample time should be allocated to get them up to speed on the technology. In order to maximize reception and avoid patient care disruption, we also suggest that training take place independent of regular shifts and employees be compensated accordingly. If staff try to train during their shifts, they may be distracted or frequently interrupted, causing them to rush through education exercises and potentially miss key information. This type of distraction could negatively impact patient care. Similarly, if staff are forced to train on their free time, they may become frustrated, leading to satisfaction and retention issues.

Instead, dedicate specific time for staff to receive training. Earmarking training time shows that the organization is committed to preparing staff to use the EHR. It also underscores the importance of the initiative and the value the organization places on staff preparedness.

“We realized this transition would be a considerable time commitment for our employees and therefore provided 40 hours of training to each staff member outside of his or her regular shift to ensure each staff member was receptive to the process and able to provide undivided attention to the task at hand,” says Russell Schwartz, ‎director of operations at West Hartford Health & Rehabilitation Center/Avon Health Center. “To accommodate this, we increased overtime so nurses could cover one another during training windows.”

We also worked with SigmaCare to identify a training program specific to our needs, where staff progressed through the different modules in four-hour increments,” he adds. “During this period we received zero patient complaints during our go-live period. In fact, in many cases, the patients were not even aware of the training process.”

The right implementation process reflects well on the facility and keeps stress to a minimum, Sanderson adds. “Although organizations may hesitate on EHR implementation for fear of patient disruption or retention concerns, we certainly did not find that to be true. We proudly celebrates the fact that we did not lose a single nurse or file a single patient complaint in the process of implementation.”

3. Provide enhanced classroom Wi-Fi

If an organization opts to provide classroom training, we recommend checking nearby Wi-Fi levels to ensure they can support the influx of individuals interacting with the system at the same time during classroom training. At West Hartford and Avon, we discovered we needed to augment our classroom Wi-Fi to guarantee that everyone was able to participate in training to the degree and at the speed they wished to.

4. Identify internal champions

Once initial training is complete, organizations should consider selecting high-performing staff to serve as champions—internal EHR experts who answer questions, mentor those who are struggling and encourage consistent solution use. If a question surpasses a champion’s skill set, he or she should be able to resolve the issue quickly. For this reason, it is helpful to partner with an EHR vendor that offers 24/7 support.

You can identify champions during training and even ask the person conducting the classroom training for input. “West Hartford and Avon designated a champion for each shift, working with SigmaCare’s implementation team to select ideal candidates,” Schwartz says. “We focused on those individuals who learned the solution quickly and appreciated its benefits. Interestingly enough, two of the nurses we were most concerned about in terms of their willingness and ability to embrace the EHR ended up being champions because they swiftly observed the solution’s advantages and embraced the system with ease.”

5. Offer continuous reinforcement

EHR training should not be a one-and-done exercise, but rather a continuous effort. When selecting an EHR, be sure your vendor partner will remain onsite for the first two weeks to spearhead questions and help overcome roadblocks. After these few weeks are complete, the organization should plan for continued training to help staff stay fresh on the solution and navigate new developments. Such follow-up may be internal, conducted by champions or department leadership. One way to keep things current is to incorporate educational tips into daily or weekly staff meetings. To further reinforce training, an organization may choose to bring the vendor back monthly, quarterly and/or annually.

“Once an organization sets out to implement an EHR, it is critical to choose a vendor that can provide hands-on training and support for a seamless transition and a high level of user proficiency,” said Steve Pacicco, SigmaCare CEO. “We are devoted to cultivating a strong partnership with our facilities and provide onsite training and 24/7 support to assist them in achieving the financial and clinical outcomes they expect in order to maximize their investment in the SigmaCare technology.”

The benefits of a concerted approach

Being intentional about EHR training can benefit an organization in several ways. At West Hartford and Avon, we found that this approach allowed us to be able to increase education efficiency and timeliness while ensuring staff felt comfortable with the process. Like many other organizations, before we started, we harbored concerns about staff engagement and adoption hesitancy. But, we found that staff appreciated the focused, hands-on education approach and the attention called to allocated time and funding for such training.

“It’s critical to establish a strong foundation and a solid plan from which to build your EHR process,” SigmaCare’s Pacicco says. “We’ve found that creating a teamwork mentality between our staff and the organization adopting our solutions sets the stage for success, yields improved workflows and ultimately increases quality of care.”

There is no question that getting an EHR up and running takes work, and a solid training effort is key to successful adoption and long-term use. Organizations that commit to a program that includes both classroom and real-world experiences can ensure their staff are ready and able to fully leverage an EHR, setting themselves up for success across the increasingly interoperable landscape of the healthcare industry.

Russell Schwartz is the Director of Operations and Theresa Sanderson is the Administrator at West Hartford Health & Rehabilitation Center/Avon Health Center. They can both be reached at 860-521-8700.

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