The Cleveland Clinic Health System’s East Region (CCHS-East) is comprised of Hillcrest, Euclid, Huron and South Pointe hospitals, all of which are located within Cuyahoga County in northeastern Ohio. These four hospitals have more than 1,000 beds and offer a full spectrum of health care services. The CCHS-East hospitals were part of a group before becoming part of the Cleveland Clinic Health System, in contrast to the rest of the hospitals, which were not a network prior to the establishment of CCHS. “That meant we were already sharing many processes and services across the region,” said Carole Hackett, chief learning officer at Hillcrest Hospital.
“We provide great value for our system because of our efficiency, and we do provide similar services across multiple hospitals, instead of having independent working functions that might be duplicating efforts at individual hospitals,” added Tom Vernon, manager of human resource development technology at CCHS-East. “A lot of times when you talk about functions such as ours, a lot of the focus is on activity-based metrics for training in the education department. We are truly based on performance outcomes and improving organizational performance, and training is one of the products that we deliver to help meet those goals.”
Health care regulations are a key driver of not only the development and delivery of educational content for the CCHS-East workforce, but also for verification of employees’ comprehension of their duties, Hackett said. “In health care, all the regulatory agencies like the Joint Commission of Hospital Accreditation and the government are requiring more and more proof that we have a competent staff. We are getting more and more mandates externally to prove our staff has the ability to perform in order to meet these standards. Of course, our goal is to have the highest quality standards.”
Training and development programs at CCHS-East are built according to a performance-based consulting model, which means organizational learning leaders confer with strategic business partners on initiatives. “We don’t just react at that point in time and develop a training solution,” Vernon said. “Just because someone’s requesting training, it doesn’t mean that’s the most appropriate solution for whatever they need training for. We would only develop training to begin with if we thought there was a learning deficit – if there was another environmental factor or a lack of feedback. We have a pretty good idea of what the actual skills are to meet the business needs on the job. We want to make sure we identify clearly what those behaviors are, so that by the time we develop the educational curriculum and track the people who go through those offerings, we know that the content is tied to a specific business need.”
CCHS-East uses collaboration to deliver some of its learning offerings, Hackett said. “The collaboration that occurs with continuous sharing of knowledge and learning comes from a very highly active team environment, so that our culture is one of interdisciplinary teams that have worked together collaboratively to help us meet our business goals. At any one point in East Region, we can have 30 to 50 teams, depending on the business goals of each individual (hospital). We also have inter-hospital teams – in other words, system teams that cross all hospitals.”
One initiative where collaboration has been particularly effective is CCHS-East’s graduate nurse internship program, which helps acclimate new nurses to the organization. “We found there was a high turnover rate within the first year of hire for graduate nurses,” Vernon said. “That’s actually a nationwide issue. Carole helped facilitate a team where we helped develop a graduate nurse internship program. Part of that was they had some classroom instruction, but then they came back and had support-group sessions structured periodically over a 12-week period, where they would come back and share experiences.”
“The average turnover rate in 2002 and 2003 was 25 percent for that group,” Hackett said of the state prior to those sessions. “Our turnover after the first six months (of the program) was 5 percent, and our turnover rate after one year was 12 percent, which is incredible.”
The company also utilized a learning management system offered by Pathlore to help CCHS-East employees squeeze mandatory training into their tight schedules, Vernon said. “As of 2004, 14 percent of our educational products were delivered through blended learning. We delivered 8 percent through e-learning. We currently have 66 active titles that range from compliance-type topics to professional development to smoking cessation. Last year, we provided 99,000 hours of training to our staff in the region. We have a lot of paper-based self-directed processes and paper-based processes that people need to do before they go to a classroom setting. We’re taking a baby step into the e-learning and automation arena, but it’s giving us a big bang for our buck in terms of efficiencies.
“We’ve been able to calculate that it saves us – and this is a conservative estimate – 17 minutes for every self-instructional learning packet (SILP) that we process through the LMS versus the ones we process by paper. We’re projecting that we will have about 5,400 completed this year. If we calculate that out by the 17 minutes per SILP, we come up with a savings of approximately 600 hours.”
“If we pull them out to put them in a classroom setting, we take them away from patient care,” Hackett said. “That is not where we want to go. We want to be able to find solutions that can be done more or less at a point in time where they need it, and not remove them from their job, which is taking care of their patients.”
Brian Summerfield, firstname.lastname@example.orgFiled under: Learning Delivery, Measurement, Technology