Technology and Learning in the Home Health Care...
Transcript of Technology and Learning in the Home Health Care...
TechnologyandLearningintheHomeHealthCareSettingJUDITHARNESON,RN,MSPARTNERSHEALTHCAREATHOME
AnIntroductiontoPartnersHealthCareatHome• Establishedin2000withmerger
of27VNAs
• 800+employees(~500clinicians,80homehealthaides)
• 4branchoffices
• Averagedailycensus 3,700
• Annualadmissions 27,000
• Visitsperyear 470,000
PartnersHealthCare
Brigham&Women’s/FaulknerHospitals
MassachusettsGeneralHospital
NorthShoreMedicalCenter
Newton-WellesleyHealthCareSystem
PartnersContinuingCare
Brigham&Women’sHospital
Brigham&Women’sPhysiciansOrganization
FaulknerHospital
TheGeneralHospitalCorporation
MassachusettsGeneralPhysiciansOrganization
McLeanHospitalCorporation
TheMGHInstituteofHealthProfessions
MGHHealthServicesCorporation
NorthEndCommunityHealthCommittee
SalemHospitalNorthShoreChildren's
Hospital
UnionHospital
CharterProfessionalServicesCorporation
Newton-WellesleyHospital
NeWell MedicalDeliveryOrganization
NWHCharitableFoundation
SpauldingRehabilitationNetwork
• SpauldingRehabHospitalBoston
• SpauldingRehabHospitalCambridge
• SpauldingHospitalforContinuingMedicalCareCapeCod
• SpauldingNursingandTherapyCenterNorthEnd
• SpauldingNursingandTherapyCenterWestRoxbury
• SpauldingOutpatientCenters
PartnersHealthCareatHome
ClarkHouseatFoxHillVillage
DanaFarber/PartnersCancerCareTwoPhysiciansAppointed
byPartnersPartnersCommunityPhysician’s
Organization(PCPO)
Martha’sVineyardHospital
NantucketCottageHospital
CooleyDickinsonHospital
StaffLearningChallengesinHomeCare
• Workforcedispersedduringtheworkday;fieldcliniciansmaygodayswithoutgoingtoanoffice
• Tightproductivityexpectationsforfieldstaff(patientvisits/day),andsomealsohaveextensivedriving
• Impromptutrainingsessionsareoftenimpossible
• Evenscheduledsessionsrequireadditionaldriving,decreasedproductivity
• Lessface-to-faceinteractionwithmanagersandco-workersthaninafacility• Lessinformalknowledgetransmission
• Lessopportunityfortransmissionofnorms&expectations
TheHealthStreamLearningManagementSystem
LearningManagementSystems(LMS)permitremoteaccessviatheinternet,provideonlinelearningmodules,includetrackingandreportingfunctions
HealthStream istheLMSusedthroughoutthePartnersnetwork
TheHealthStreamLearningManagementSystemHealthStream istheLMSusedthroughoutthePartnersnetwork
Libraryoflearningmodules
• Widevarietyoftopics(clinical,safety,compliance,administrative)
• Foravarietyofaudiences(nurses,therapists,aides,officestaff,allemployees)
• MajorityareHealthStream-authored
• Somecreatedbyothervendors
• Somecreatedin-housebyPartnersstaff
UseofHealthStream inPartnersHealthCareatHome
Orientation
• Allnewemployeescomplete17standardmodulesduringtheirfirst90daysofemployment
• Fieldcliniciansalsocompleteanadditional16modulesnecessaryfortheirrole
AllNewEmployeesBackSafetyCorporateCompliance:AProactiveStanceCulturalCompetence:BackgroundandBenefitsCulturalCompetence:ProvidingCulturallyCompetentCareDiversityintheWorkplaceElectricalSafetyEmergencyPreparednessFireSafetyGeneralSafetyHandHygieneIdentifying&AssessingVictimsofChildAbuse&NeglectIdentifying&AssessingVictimsofDomesticAbuseIdentifying&AssessingVictimsofElderAbuse &NeglectInfectionControlSexualHarassmentintheWorkplaceWorkplaceViolencePHEHIPAA
NewCliniciansAdvanceDirectivesMedicalEthicsPatientRightsPersonalProtectiveEquipmentPreventingPatientFallsTuberculosisDrivingSafetyinHomeCareHomeCareBasicsHomeHealthCoveredServicesMedicationSafetyinHomeCareOASIS-C:RoombyRoomOASIS-C:BeyondtheBasicsRecipeforEffectiveDocumentationHomeCareofthePatientwithAdvancedHeartDisease:ManagementAdvancedPainManagementinHomeCareandHospice:AssessmentProfessionalBoundariesinHomeCare
Tocompleteallofthesemodulesrequiresalotoftime(modulesaverageanhoureach).
• Modulescanbedoneathomebutareconsideredworktime.
• In-personorientationclassesmayendat2or3.
• Daysinfieldwithpreceptormayhavedown-timefornewemployee.
• ManagersmayscheduleblocksoftimefornewemployeetofinishHealthStream assignment.
Particularchallengesnotedforhomehealthaides
UseofHealthStreaminPartnersHealthCareatHome
HealthStream maystillbeunder-utilizedforlearningoutsideoforientation,butuseisincreasing.
• Annualmandatorycompliancetraining
• Annual“ActiveShooter”video
• Updatesforcliniciansonimportantchangesmadetodocumentationsoftware
• Preparationforupcomingchangestoregulations
• Electiveorassignedlearningonclinicaltopics
UseofHealthStream inPartnersHealthCareatHome
OnlineLearningModules,TraditionalandBeyond
Instructionaldesignisarelativelynewbutmaturingfield.
Increasingattentiontotryingtomakee-learningeffective:
• Concrete
• Relevant
• Interactive
OnlineLearningModules,TraditionalandBeyond
“Gamification”
WithfundsfromtheCommonwealthCorporation,wedevelopedpalliativecaremodulesin-houseforusethroughoutPartnersContinuingCare
• Concrete – usecases(fictional,butrealistic)topresentcontent
• Relevant – informationandcasesaredirectedatanaudiencewhoworkinthepost-acutecaresetting(homecare,SNFs,LTACs,andinpatientrehab)
• Interactive – Eachtopichasatleastoneuserinteraction
OnlineLearningModules,TraditionalandBeyond
ACoupleofQuickSamples
http://zebr.as/2oiSTXw
http://zebr.as/2oqxzga“Preventing,Identifying,andManagingDelirium”
“WhatIsPalliativeCare”
TechnologyandLearningOutsideoftheLMS
• Webinars
• Smartphones
• Videotransmissionoftalkstodifferentoffices
• Startbuttonresources
• PartnersHandbook
InteractiveEducationalSessioninFourLocations
Start-ButtonResourcesPHH-Specific
• PracticeGuidelines
• DocumentationGuidelines
• PoliciesandProcedures
• MiscellaneousResources
Partners-Wide
• PartnersHandbook
UpToDateOnlinemedicalresource
Expertphysiciansineachfieldupdatearticlesregularlyasnewresearchcomesout.
Thereisalimited,freeversion,butPartnersHealthCareSystemhaspurchasedaccessforallofitsemployees.
Samplesituation:goingouttoadmitanewpatienttohomecare;referralpaperworklistsprimarydiagnosisashepatocellularcarcinoma
ChangingCultureGettingthetechnologyinplaceisonlythebeginning.Otherpiecesoftheprocesscomeevenslowerandharder.
• Imaginingwhatitpossible,notjustassumingthatwe’llkeepdoingwhatwe’vealwaysdone
• Accommodatingnewlearningapproachesintheflowofourworkday,workweeks
• Makinglearnersawareofopportunities
• Shiftinglearnerhabitsforseekinginformation