Imparting knowledge about a new electronic patient record (EPR) via a training and education programme is one of the most critical, if not the most important, elements of a digital system implementation.
Clinical solutions – irrespective of their functionality and usability – are only as good as the people who use them. If staff aren’t adequately supported in understanding the objectives of rolling out the solution and empowered to use it effectively (for them, their patients, and the organisation as a whole), then the programme is at risk of falling at the first hurdle.
However, there isn’t a ‘one-size-fits-all’ approach to getting education about a new system right. This is particularly true in the NHS, where organisations are at varying levels of digital maturity and the level of change with an EPR implementation ranges from minimal to significant. Additional factors such as COVID Elective Recovery, staff shortages, and resourcing demands since the EU departure also play a factor.
The expectations on what is being delivered by the training and education programme can often have varying definitions for different individuals, which can lead to misunderstandings and omissions when it comes to establishing a strategy for training before, during, and after the go-live. EPR system training doesn’t replace clinical expertise and understanding, but with users at all levels of digital engagement, ensuring the right balance in content creation and delivery is essential.
With the NHS England directive for trusts to have a core level of digital maturity and, specifically, an electronic patient record (EPR) by March 2025, the number of system go-lives in the near future requires key preparation today. Throughout any system implementation, the right education programme is vitally important from the outset.
Below are a few key considerations for success.
An evolution, not a big bang
Whilst there tends to be a significant focus on workforce training ahead of a go-live (which is undoubtedly important), it shouldn’t be at the expense of longer-term plans to support staff. There is a need for refresher and optimisation sessions, as well as the re-running of previous content as people shift roles and departments. The EPR will now be a key system for the majority of staff, so developing or redeveloping the staff induction process to include this content should be a key part of any overall strategy. To maximise the full functionality and productivity of clinical systems (optimisation stage), there will also need to be new lessons post-go-live. By setting out a clear roadmap from the beginning, these distinct phases can be resourced effectively and the necessary budget ringfenced.
Identify and recruit the right people
The role of the content creation team (principal trainers, training developers) is one of the most difficult in an EPR implementation and beyond. There is a fine balancing act between the technical system understanding, workflow knowledge, and learning skills. In addition, peer trainers, clinical champions and superusers can support in delivering the best results when it comes to initial training. Having them involved in content creation and deploying it amongst staff is fundamental, however, with them balancing the role with their day job, it’s important to have a strategy that creates the capacity for them to be involved from the beginning.
Deliver training scenarios as though real-life
Certain content is better suited to particular formats, ideally using the system used day-to-day. Nurses who will be using mobile devices to input clinical observations, vitals, and potential recording on the Medication Administration Record (MAR) should train on those devices rather than computer screens. Classrooms require considerable technical setup and equipment, but they are a key component of the learning package, one that is easy to overlook and shortcut.
Design for the Ebbinghaus Forgetting Curve
If we learn something new but then make no attempt to relearn or use that information, we remember less and less of it as time goes by. Without reviewing or reinforcing our learning, our ability to retain the information plummets. However, it's easier to remember things that have meaning, so EPR training content needs to be meaningful and engaging to aid users in remembering. Why not develop your curriculum with "spaced learning" in mind? For example, providing after-class exercises and a playground for users to practice in will allow them to create their own spaced learning approach of reviewing and refreshing what they have learned since their original training dates.
Getting the timing right – planning for training should always be from the beginning of a digitisation programme. However, there is a proven period for execution. Delivering the courses six to eight weeks before going live is the best window of opportunity in terms of maximising retention of knowledge and application in practical terms. Although it should be said that it also generates a resourcing squeeze in terms of releasing staff for training over a short time span just prior to a go-live. There is a balancing act of training effectiveness and training completion that can only be developed by collaborating with operational teams and working in a flexible manner.
Precision but flexibility – there are a lot of components to preparing and executing a training and education programme, so precision is key. However, with success being defined by how the recipients respond and use the information, it can’t be too prescriptive. There must be enough scope to react to feedback and refine according to the needs of people. Reactive lesson content allows the classroom delivery to be flexible to the engagement and questions of staff – it will take more effort to create content in this manner, but the improvements during the delivery phase will ensure value for that time.
Cyclical feedback loop – it isn’t an end, but rather an evolving programme of work that supports the success of the digital programme. Therefore, the right feedback channels need to be baked in from the outset, but with the scope to be refined and enhanced as staff get to grips with the solution and ask questions, provide suggestions, or air frustrations.
Measuring success – how success is defined should not just focus on the total number of people trained. Instead, it needs to consider metrics for the quality of the education programme and validation with end users to demonstrate that it has been fit for purpose. There should also be considerations for how it meets the overarching objectives of the change management programme and different phases of the EPR implementation. To achieve this, activity and performance data must be captured and analysed.
Mastering an EPR is like mastering a language. However, unlike most languages, EPRs keep evolving. To ensure your staff are speaking fluently, training is not a one-time endeavour but a continuous strategy that evolves with new system features, new regulatory requirements, and the needs of the patient population.
By implementing these suggestions, you’re not just equipping your team with the skills they need today; you’re preparing them for the challenges and innovations of tomorrow.
If you would like to find out how Nordic can help with your training needs, please get in touch.