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  • 1.  Metropolitan area with same EHR Vendor for different hospitals systems…how do you address training?

    Posted 07-10-2018 13:50

    Metropolitan area with same EHR Vendor for different hospitals systems…how do you address training?

    More and more we are seeing single EHR vendors take over regions. The interoperability is wonderful, but how does the same vendor impact training. We are seeing bored new hires sitting through "My third version of Epic training".

    We are an "Epic House" same as the wide majority of the hospital systems in the Dallas Fort Worth area. The functionality of Epic is similar from one organization to another. Differences are in how each organization decides to customize according to policy, Epic versions and third party applications. Although differences might be slight, I believe every system is putting new hires though full classes regardless of previous experience.

    My question to the group is how others are addressing the issues of training staff who have used your EHR vendors previously. Has anyone developed a gap analysis between their neighboring hospital systems? Has anyone developed a skill validation? What other ways have you all looked at this issue?

    Thank you for any input,

    Heather Scroggins MSN, RN-BC

    Heather Scroggins RN
    Arlington TX

  • 2.  RE: Metropolitan area with same EHR Vendor for different hospitals systems…how do you address training?

    Posted 08-13-2018 15:52
    Hi, Heather!

    In the past, I have used similar to a "test-out" option. I have end-users complete a pre-test which consisted of basic computer knowledge and comfort levels as well as a list of previous EHRs used. If our EHR was listed, then the employee could choose to attend the annual "refresher" version of the orientation (which I held once per year and was all virtual) that focused on changes within the past year (updates, anticipated updates/changes within the next year, etc), feedback from staff regarding documentation and workflow, and a hands-on competency. The hands-on competency (or "test-out") just consisted of 3-4 patient scenarios with directed instructions on what to document within the record. I would validate that I found the appropriate documentation in the appropriate field. Depending on the results I found (or didn't find), I would either validate competency, assign specific modules of the EHR education (I had this divided into areas/functions of the EHR), or require staff attend the entire orientation.

    The background purpose of the required annual "refresher" and competency validation ended up having a dual purpose. It began as my attempt to determine if there were work-arounds being used by specific shifts/departments/provider levels and re-educate if needed. I have found that even the most proficient EHR user can develop work-arounds which they believe are benign improvements to their workflow - but are actually detrimental to some of our data reporting functions. I also learned that hiring new employees with extensive previous experience on an EHR and who have developed work-arounds can quickly spread those habits to existing staff. Using this method, I have also had the opposite effect - I have on two occasions adopted or developed better documentation within the system from ideas generated from new employee competencies where their previous employer simply "did it better". So, in the end, it validated competency of staff and reduced work-arounds as intended - but it also provided me a way to get a glimpse into different methods or functions used by other facilities with the same EHR.

    Worth noting - In my facility (at the time this started), I was all there was for implementation, changes within the EHR, reporting, statistics, building, etc. We did not have a department or team or even another person to tell me what to do, how to do it, or provide guidance. We went from all paper to EHR in a 30-day period, and I was "volun-told" for the project in 2013. As we grew and as we were acquired by a larger organization, we have just kept the same general concept in place within our facility.

    Hope this helps!

    Amy Skinner, MSN, RN-BC, RNC, CPHQ