Jane Dowd is chief learning officer of Evanston Northwestern Healthcare (ENH), an integrated, academic health care system made up of three hospitals and 65 offices and facilities based in Illinois. She has worked in both for-profit and nonprofit organizations. We spoke with Dowd to get her perspective on learning in health care, including her thoughts, as she puts it, on “hard-wiring” learning into an organization.
CLO: Given your experiences, do you see differences in strategizing, designing or executing learning programs at nonprofit versus for-profit organizations?
Dowd: Unlike many other industries, health care has regulations related to learning and development and staff/provider competency. Regulatory agencies want proof that our people are competent to do their jobs and provide high-quality care to our patients. We need to go well beyond ensuring that staff members attend training — we have to be able to demonstrate staff competence on every major responsibility in their role. As a result, we put in place development processes and significant resources to support their development and performance on the job.
Another industry attribute that’s certainly not unique to health care is the challenge of gaining access to a very precious resource: people’s time. Time is extremely valuable for the average caregiver, and there are replacement costs when clinical professionals need to leave the department to attend training. We can’t leave those jobs unfilled for the day, nor can we call in unqualified temps. Our team has to be very creative and careful about how we design learning resources so they are easy to use and make an immediate impact. We create a lot of easy-to-read, just-in-time support tools such as one-page reference guides and 15-minute online learning modules. Our classes are typically between one hour to three hours versus a full-day program.
Finally, as a health care provider, our top priority is patient care. At Evanston Northwestern Healthcare, our mission is “preserving and improving human life.” In my experience in working for a for-profit organization, there is a greater focus on maximizing shareholder investments. I have seen the learning function ride a big roller coaster at some for-profits — with new programs introduced in good years and cutbacks in lean years. I believe our learning investments are seen as an integral part of operations and business objectives. These investments need to be aligned with business goals and demonstrate they are practical and customized to the needs of the individual, team and organization.
CLO: Can you provide an example of how you have applied these industry attributes to a specific project?
Dowd: ENH was one of the first health care systems to launch a paperless electronic medical records system. These are enormous change management projects that change the way you care for patients. And for some physicians, the change can translate to a heavier workload, especially at first.
At ENH, we started by training our top physicians, the clinical chairmen. Several sleepless nights were spent making sure that these soon-to-be champions of the system had a great learning experience — they needed to be both impressed by the system, as well as by the training experience, including the design of the training, the opportunity for interaction, the location, the hardware, catering, etc. We had 7,886 people go through an average of two days of training, and of those, 1,300 were physicians. It was a huge endeavor, but getting these champions involved (in addition to involving almost 30 nurses as faculty) contributed to its unqualified success. These early champions played a critical role in going back to their departments and talking about the importance of the new system and the training.
We also held the same standards on competency assessment for the technology training that we do for clinical care. All learners had to complete a “demonstrated” competency assessment following the training to show they not only understood the new system but also how to apply what they learned to their own roles. They couldn’t have a password to the new electronic medical record until they passed our demonstrated competency exam with a score of 85 percent or higher. This meant they couldn’t take care of patients until they passed.
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