Loretta Gallagher on Setting Up and Maximizing EMR Training
For hospitals implementing a new Electronic Medical Record (EMR) system, (aka Electronic Health Records or EHR), training all the end users on the new system is vital to success.
All hospitals realize the training endeavor, but manpower and expenses required can be a surprise. Loretta Gallagher, owner of Gallagher Associates based in Wayne, New Jersey, runs a firm that specializes in EMR implementation. They work closely with the EMR vendor in implementing and setting up systems for hospitals, which gives us amazing insight to EMR training. According to Gallagher, three important factors to consider are classroom space, employees not at work because they are in training, and the number of trainers needed for the process.
Ideally you do not want to start your training too soon; this can be a use it or lose it skill. Loretta Gallagher mentions that training staff too far in advance of them using the system can lead to frustration at go-live. Gallagher recommends a training cycle of 4–6 weeks prior to your go-live. She has seen success with an 8-week roll out model, providing you keep the end-user engaged and practicing. The EMRs being implemented today are robust, comprehensive and sophisticated; nursing often needs 16–24 hours to complete a training class for a single role. If you have nursing that float between different roles i.e. Emergency room and Inpatient, they will need two complete classes.
Gallagher notes that a 4-week training cycle means that 25% of your staff will be in class every day for four (4) weeks. That has the potential to create large backfill expenses. Nursing is traditionally the most difficult position to lose large numbers of staff to training, which affects continuity of patient care.
According to Gallagher Associates, nursing shortages has also created an issue in which a large number of agency staff is brought on board to backfill, often at a large price tag.
Loretta Gallagher and her team at Gallagher Associates say that determining the number of weeks end-user training will use is the first step to planning. Once you pick the number of weeks, a determination of how many classrooms will be needed. A 4-week training cycle will need double the classrooms of an 8-week cycle. Space is a precious commodity in hospitals says Gallagher. Where an 8-week cycle might need 15 classrooms (all equipped with computers, projectors, and infrastructure), a 4-week cycle would need 30 classrooms fully equipped.
Training staff will be the next consideration says Gallagher. You will need staff to work with your build teams to design the classroom materials early in the implementation process. You will also need to bring on large numbers of staff to complete the actual training. Much of this actual training staff can be short term; once the large push of training for go-live is complete, you will need to retain staff for new hire training, upgrades, and add-ons. The number of trainers needed will likely go down considerably post go-live.
Loretta Gallagher: Successful Training Models
Loretta Gallagher has seen several successful models for this influx of short-term training staff and lists them below:
1. Use your best and brightest from their current roles and make them full-time trainers for 4–6 months. They will need to come out of their current role completely. These staff members can be a huge asset for you. They know your past systems, key players, culture and current state workflows. Note that we mentioned 4–6 months, but above, we talked about 4–8 weeks of training. Do not underestimate how long it will take to make this staff become trainers, to learn the material, understand the exercises, and learn to present. A 6-week “train the trainer” type program is a minimum requirement.
2. Hire experienced consultant trainers. This is often a road hospitals take, as they are backfilling so many roles during training. Losing more staff to become trainers is sometimes too much to handle. Consultant trainers will come in knowing vendor functionality, but they will not know your culture and workflows. This means that these consultant trainers will still need a 6–8 week “train the trainer” program.
3. Hybrid of option one (1) and two (2); probably the most common method.
This is high-level guide only scratches the surface of what to expect when planning for hospital training. Keep in mind there is so much more planning required in scheduling rooms, staff, trainers and environments. Track your training and utilize your LMS. Loretta Gallagher of Gallagher Associates is a knowledgeable and intelligent professional who is heavily involved in making hospitals and nurses succeed in all paths of professional development and work processes.