Information technology only works if staff is adequately trained

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Keeping record
Keeping record
No question, information technology can go a long way toward streamlining business processes, enhancing data accuracy and, ultimately, improving overall operations and resident care.

The caveat? Even the best solutions won't be worth their salt unless staff members are adequately trained to use them and management adopts a comprehensive strategy for success. 

Although those might seem like rather obvious points, experts stress that many long-term care operators aren't practicing due diligence to ensure that staff are even remotely prepared to receive the newly adopted solutions.

“It's the employees who really make any program successful,” notes Aric Agmon, president and CEO of long-term care IT software developer Answers on Demand Inc., Fort Lauderdale, FL. “The question is, how can we invest in people? How do we find time in a busy day to provide a relaxed environment, the supportive tools and the encouragement to help employees go beyond the familiar routines and expand their understanding of the potential benefits of technology?”

The answers to those questions are both varied and complex. However, IT experts and long-term care operators in the know assured that successful outcomes can be attained through careful planning, realistic expectations and an ongoing commitment to staff and the software suite itself.

Assuming that a facility has carefully evaluated available solutions and has chosen the best one for its needs – and has garnered the necessary staff buy-in – the next step is establishing a detailed implementation plan.

Setting the stage

“It's very important to set expectations early in the process by defining exactly what is to be implemented, how it is to be accomplished, and by whom,” says Marie Pipes, director of implementation services, CareVoyant Inc., Schaumburg, IL. A strong project plan, she explains, details step- by-step the precise actions both the vendor and healthcare provider are responsible for, which individuals must take ownership of each specific task, and outlines what the sequence of events and overall time frame of the project. 

Defining, and perhaps refining current processes, either manual or computer-based, also is essential. Sources agreed that the better an organization can define and document its critical processes, the better chance it has at improving them through information technology. 

Put simply: “Computerization or automation of poor processes simply gives a facility faster poor processes,” emphasizes JoAnne Marceau, marketing director of SureQuest Systems Inc., a Dallas-based dietary software and services provider. 

One nurse and clinical solutions engineer further underscored that point, noting that a facility that blindly moves all current paper processes to an electronic environment may not reap the benefits of efficiencies in the new environment.

“Focus on the outcomes wanted rather than the specific processes, and this may lead to some significant gains in efficiency for the organization,” suggests Shelly Schulz, RN, of Momentum Healthware Inc., Nashville, TN.

Of course, training is another key piece to the software implementation puzzle, and this goes beyond just teaching staff how to use the technology at hand. Although many long-term care employees are somewhat computer-savvy, observers point out it's a mistake to assume they'll be able to hit the ground running when new IT solutions are introduced.

Operators also must recognize that even experienced and highly knowledgeable staff may have little or no computer experience and might require basic computer training to build their skills and confidence prior to going live with computer-based technology.

“An assessment of current computer skills will provide some guidance on where to start. Basic computer skills are essential for most of the new technology available. If you have staff members with little or no keyboard experience or those who have not worked with a mouse, these skills will need to be taught prior to learning the new software,” Schulz says. 

Vendor training

Often, the degree of training or customer service a vendor provides can be negotiated in the contract. If appropriate, vendor payments may also be tied directly to the vendor's ability to meet service and implementation benchmarks, according to James Brennan, FACHE, managing director of VirtualCDO, a corporate development and governance service provider in Great River, NY. 

Either way, it's up to the long-term care customer to understand the extent and limitations of the vendor training, and if necessary, take additional steps to boost computer skills in less tech-savvy staff.

“You may need to send [some staff] to a basic computer class in advance to get him or her up to speed before the software training begins,” says Julie Natzke, marketing and communications manager, MDI Achieve Inc., St. Louis. 

When the Church of God Home Inc. in Carlisle, PA, began actively embracing IT solutions, it became clear to the continuing care retirement community's administrator that a comprehensive training plan was in order. 

“When I came here five-and-a-half years ago, there was very little technology in place,” notes Carson Ritchie. “I had quite a few people on staff who didn't even know how to turn a computer on, let alone operate software.” 

To bring the organization beyond the IT infancy stage, Ritchie set up an in-house training room – led by his executive assistant – where employees were “patiently taught” basic computer skills prior to being exposed to new software technology. 

“We worked with them as long as necessary to bring them to the next level of functionality,” he says, adding that even the chaplain received basic computer training and was taught how to send and receive e-mail. 

Allowing – and even encouraging – staff to have fun with various computer-based tools is another good strategy, assures Douglas Fullaway, president and COO of Vigilan Inc., a Wilsonville, OR-based software provider geared toward assisted living.

“[Have them] go online and get an e-mail account, use the calendar, use the tutorials that come with these tools. And, yes, play some games,” he says. “Having fun will make [staff] more productive because they'll get familiar with the computer, the mouse, printing things, saving things, [and so on].”

Implementing success

Prior to going live with newly adopted technology, employees must be given adequate time to familiarize themselves with the tool. And they must have a firm grasp of their managers' expectations regarding its implementation.

Ideally, training should take place on a live, fully configured system that is virtually identical to real resident data with which staff will be expected to work.

Patience is imperative during the solution training phase and early implementation phase. If long-term care leaders want to have the best chance for success, they need to give the solution – and staff – ample time to gain proper footing. 

“It's important to understand that widespread, high-level implementation won't happen overnight. In fact, it can be about a four-month process,” says Stephen Pacicco, president and CEO, SigmaCare, eHealth Solutions, a New York-based electronic medical record solutions provider. “Even the most intuitive, easy-to-use software is secondary to good education and training, and this requires ongoing management support to drive good results.”

During the early implementation phase, over-staffing might be necessary in order to allow employees 
to focus on training. The reason being is if staff members' everyday responsibilities stand in the way of learning, it becomes easier not to use the software. 

“Bringing in part-time help that allows for thorough set-up of the software and the initial stages [of implementation] promotes success,” confirms Marceau. 

Motivating staff to develop and maintain new skill sets can also drive success. Aside from demonstrating how the new software program will simplify employees' daily tasks, facilities also might want to consider modest post-training and post-implementation pay increases.

“The return on investment of a properly operated department will usually more than offset the higher labor cost,” Marceau explains.

Choose a champion

Identifying a project leader early on can garner positive results by giving staff a reliable place to turn if they have questions or encounter any problems with the technology during the implementation process. 

“Find people who are comfortable with the product and technology and then identify champions who are willing and eager to embrace the technology and help others [do the same],” says Jim Quasey, president of Vocollect Healthcare Systems Inc. Based in Pittsburgh, Vocollect provides voice-assisted care solutions for the long-term care industry. 

And don't neglect third-shifters. For optimal success, every shift should have the same level of training and support, with vendors providing “a substantial amount of training on the front end and equal parts of technical support on the back end,” says Jack York, co-founder and president of It's Never 2 Late, Centennial, CO. 

The same degree of due diligence is required when facilities are ready to go live. At this point, managers and their vendor partners already should have outlined expectations for various timelines and implementation phases. Depending upon the extent of the project, facilities should expect “operational transformation” to occur within approximately six months – not immediately. (Especially when implementing an EMR or equally detail-driven solution, Pacicco says.)

Ideally, IT solutions vendors should be working in tandem to ensure that their systems are properly integrated and aren't requiring staff to duplicate entries and take other time-consuming steps that limit the tools' effectiveness.

“Vendors seem to do a good job of setting up their own systems, but where the ball is dropped is how all these systems come together,” says Peter Fugaro, president of Prymak, a technology consulting firm in Greensboro, NC. “Systems should communicate with other systems. If staff has to re-enter the same information over and over, the benefits are quickly lost.”

Facilities should also prepare for ongoing staff training, particularly because of high turnover rates in the long-term care environment. “The brain trust leaves when the trained employee leaves and the new person is not sufficiently trained” – contributing to underutilization of the application and a wasted investment, according to Marceau.

Ongoing implementation assessments are also in order. The Church of God Home fosters long-term communication with its software vendors to ensure their solutions are being used optimally, Ritchie points out. 

“The software itself can be terrific, but if an organization isn't aware of all it can do ... they may just move from one software solution to another. And I'm sure we can all agree that there's no value in that, Ritchie says.” 


Tips for IT implementation success

1.    Establish measurable business goals

2.    Get facility executive support upfront

3.    Assign a program manager to be accountable for driving results

4.    Minimize software customization, which can be expensive

5.    Invest in training

6.    Phase-in the rollout

7.     Measure and track outcomes

8.    Align business goals and information technology operations

9.    Actively involve end-users in system implementation and problem resolution

10.  Consider using trained, experienced consultants to keep the project on track