Ensuring that you have enough staff to cover day-to-day, new-hire, remedial, and monthly EHR update training is not an easy task. At the most recent Epic User Group Meetings and Spring Councils, sessions dedicated to building steady training teams were among the best attended. To be sure, Epic training is a hot topic in healthcare organizations—particularly as it relates to new hires. Here are some best-practice suggestions to help establish a long-term and successful Epic training program.
The Necessary Evils
Many organizations are opting for eLearning in lieu of classroom training to reach multiple groups. The difficulty with this approach is the inability to truly know if the participant grasped the material. Most participants can pass a quick post-exam without completely understanding or retaining the information.
Timing is also an issue. Even a two-day lapse between an eLearning session and practicing the learned material can pose the risk of an 80 percent information loss, requiring retraining or additional support during the first shift following training. That said, when used correctly, eLearning can be quite effective when used in conjunction with traditional classroom training and immediate practice.
For those familiar with Epic, an interactive eLearning session that speaks to the specifics of your organization can easily be implemented in lieu of classroom training. When using eLearning, make sure to follow adult learning principles. Keep courses short, interactive, and challenging to keep end users engaged. To help participants retain information, include built-in exercises to prevent advancing without completing an action.
In a preceptor-led training model, about four to eight hours of classroom training should be sufficient. Stick to the basics of navigation, terminology, and one or two main workflows to get comfortable working in the system.
For physicians, schedule a one-on-one follow-up with the trainer to set up preference lists and customizations within the same week. Avoid doing this day one or two, as the physician will need to be familiar with the existing orders and sets before customizing further.
Beyond the Classroom
Routine Training Integration
Standard training and orientation programs offer great opportunities to incorporate Epic-specific training elements where applicable. Nurses, for example, have a day or more of skill validation when starting a new position. For every skill they perform, an Epic training opportunity exists. Have participants find the order in Epic, perform the skill, then document the appropriate procedure and follow up. Collaborate with the education department and affected department leaders to add Epic workflows into routine training outlets.
Learning happens best when on the floor, in the department, or repeatedly completing a task. Assign new hires a preceptor who is well versed in Epic and department workflows. Have them log in and perform the work while the preceptor guides them through their duties. After two to three days of side-by-side work, your new employee should be off and running.
Draw preceptors from within the new employee’s department and remove them from their daily duties when onboarding new hires. Choose your preceptors wisely. Just because Jane Doe is the resident Epic expert on your floor doesn’t mean she’ll be the best preceptor. Look for someone who embodies your organization’s culture, is a cheerleader for Epic, and has the patience to answer the same question multiple times.
Materials must be well written, well organized, and—most important—accessible. Often, materials are outdated, in print form only, or not easily found by the end user. The use and regular maintenance of Learning Home Dashboards can ensure the latest materials are organized, intuitive, and available.
Consider turning tip sheets into two-minute-or-less video snippets. More often than not, watching and then repeating a process is preferable to deciphering a tip sheet and/or screen shots—especially for physicians and millennials looking for the quickest answer.
While new hires account for about 30-50 percent of a trainer’s time, some individuals or departments will always need a little extra help. For example, evaluating a workflow to offer a faster/easier process, retraining, or providing additional one-on-one time with the end user can account for another 20 percent of a trainer’s time.
Each month, a new set of Epic updates must be showcased to employees. This can be accomplished via monthly training or eLearning. In my experience, the time to coordinate and deliver monthly update training accounts for about 10 percent of the trainer’s time.
End users often struggle in silence. When my trainers are not actively training, or working on materials, they are rounding in the departments they support looking for opportunities to strengthen knowledge. In addition to rounding, trainers attend huddles and meetings, offer help, and bring vital intel about updated or ill-working workflows to the principal trainer’s attention.
Trainers will also spend a good deal of time working “tickets” to assist end users (and often analysts) in identifying and communicating problems and resolutions.
Learning Management System (LMS) Administration
Hundreds of small details go into ensuring that Epic training is meeting the needs of an organization. Who is expected in training? When and where can training be held? Who has completed training and can be activated in the system? It is imperative to dedicate at least one full time LMS administrator or coordinator to these ongoing Epic needs. Depending on the organization’s size, this may require up to four full-time resources.
The number of Epic trainers needed will vary according to the organization’s size and hiring volume. Depending on the application and the hiring schedule, your principal trainer may be able to handle all training without the support of additional resources. However, I recommend having at least one credentialed trainer available for backup—to cover vacations, assist in remedial training, etc. Consider cross-training to make trainers versatile in related apps. Maintain expertise amongst your trainers by limiting cross-training to three areas of focus.
The example below includes enough trainers to cover the needs of a two hospital system and surrounding clinics in the same geographical location.
CT1 – SBO, HB/PB
CT2 – ClinDoc, Stork, Orders
CT3 – ClinDoc, Beaker, Orders
CT4 – Ambulatory, HOD, Cadence
CT5 – Ambulatory, HOD, Cadence
CT6 – Radiant, Cupid
CT7 – Beacon, Willow
CT8 – ASAP, OpTime, ANA
CT9 – HIM, GC
CT10 – HIM, GC
PT1 – GC, Cadence
PT2 – Ambulatory, HOD
PT3 – ClinDoc, Stork
PT4 – Orders, ASAP, Beaker
PT5 – OpTime, ANA
PT6 – Radiant, Cupid
PT7 – Beacon, Willow
PT8 – HIM, HB, PB, SBO
Creating partnerships throughout your organization, along with a steady, recurring training schedule, is the key to running an efficient, low-budget training team. With exceptional, easily accessible training materials and operational preceptors, training can be efficient, low-cost, and have employees in their positions with minimal classroom time.
About Chris Cooley
Chris Cooley is a Subject Matter Expert for the Training Point division of Pivot Point Consulting, a Vaco Company. Previously, she worked as a full-time training manager, with 15 EMR implementations under her belt. With a combined knowledge of adult learning principles, technical writing, project management and the healthcare world, Chris is known for her creative solutions.