Making the transition to an electronic medical records system — whether from a paper-based system or an existing EMR — is an exciting development for an ASC. A good system brings about improvement in all areas of an ASC's operations, including patient safety, operating room efficiency, profitability and compliance. But implementing a system can also create stress among ASC staff. After all, many people are opposed to change of any sort, and when making the switch to an EMR, you're asking your team to learn a new, robust system.
Fortunately, there are many steps you can take before going live with a new EMR that will make this transition easier for your team, reduce disruptions in workflow and allow your ASC to maximize the benefits of the new system right off the bat.
Here are 10 steps that will help you simplify EMR training for your staff and physicians.
1. Clearly define workflow of every department. Your ASC's various departments will each use different components of the EMR to manage their specific responsibilities and drive their portion of your workflow. You will want to define those responsibilities and workflow, and identify how your new EMR addresses them, so your training can target education in these areas. Clear and straight-forward training, without an ambiguity of workflow, will help ensure your staff properly and efficiently uses the EMR.
2. Determine how departments interact. You will also need to understand how your different departments interact with one another during tasks that overlap between them. While you should assess your pre-op and OR individually, you must also, for example, determine how they interact through the EMR during patient handoff. Providing training for both departments on how the EMR addresses this task is critical for ensuring staff uses the EMR properly and therefore maintains a continuous workflow. This will also assist in identifying the potential for missing or duplicated charting.
3. Understand specific needs of every individual user. Drilling down even further, you should take the time to understand each individual staff member's responsibilities and how that translates to his or her responsibilities for using the EMR. When staff members undergo individual training, it is best to focus solely on what they will need to do on the system at go-live and nothing more (or less).With an EMR you will often have discrete data which is flowing in and out of each individual nursing record.
It is also important that users know where certain data is coming from, and where data they are entering may be flowing. For example, how to use the EMR to alert an anesthesia provider of a possible risk.
While workflow and staff responsibilities will undoubtedly evolve and change over time, it's best to focus on what staff needs to know now rather than what they may need to know in the future. Keep training simple and streamlined.
4. Appoint strong superusers. "Super users" are the go-to contacts for your EMR vendor and ASC staff prior to, during and after the system's integration. These are individuals who become experts in use of the system, and are capable of training others including surgeons, anesthesia staff, per diem nursing staff and new staff who may not be on-site during training provided by the vendor. Super users are also tasked with addressing, whenever possible, staff member questions about the system following go-live.
You will likely want to identify one super user per department, from pre-op and recovery, at least one OR nurse, an anesthesiologist, a surgeon representative and a business office staff member. It is critical that superusers are committed to serving in this role, and have the support of the ASC's leadership to receive the training necessary for them to truly become superusers. For new facilities, it is wise to have more than one superuser due to the possibility of turnover.
5. Allocate necessary time for training. It is essential for staff to have plenty of time to receive training on a new EMR. Good training cannot be accomplished properly in half an hour. ASCs must carve out time for staff members to undergo training while making sure to balance this against the amount of time spent tackling their typical daily responsibilities.
If you have staff members working a 10-hour day and expect them to stay in the ASC for several hours of training, this training is not likely to be highly effective. Many facilities will bring in per diem staff in order to allow staff to receive training during the workday while avoiding a need to scale back on the caseload on days when training occurs.
6. Determine location and setup for training. Training on a new system requires more than just time; it requires access to computers with the EMR installed on them. Your ASC will need to determine where training will occur and how this environment will be set up. We recommend, if possible, establishing a training environment in a central area of the ASC that has some form of separation from other areas of the ASC critical to workflow.
This training environment would optimally connect to a test server that essentially runs a demonstration version of the EMR on a few computers so multiple team members can train together at once. This space would be used not only for training prior to go-live, but, if possible, should remain operational year round for training staff on new responsibilities, testing new functions and features added by the vendor and training new hires.
A test server is also a valuable tool for post-go-live training. It is very helpful for trying out features of new releases prior to having them in your live environment, training new hires and adding departments at a later go-live date. If you are considering using any interfaces, a test environment is also helpful for sending and receiving sample data.
7. Set aside time for practice. While blocking out time during the week for training is essential, ASCs should also make sure staff members have time to practice what they learn during training, preferably using a test server. This practice will help staff members get a good feel for using the system without a trainer looking over their shoulder and holding their hands.
Practice also presents an opportunity for staff members to identify any areas in need of additional training. Once again, if practice is expected to occur during the workday, ASCs will want to make sure they take steps to maintain proper staffing levels.
8. Keep physician training brief. Many physicians resist undergoing training on a new EMR, so it is best to keep their training time as short as possible. It is often best to try to schedule just one or a few quick training sessions rather than longer sessions.
To help keep training sessions as brief as possible, ASCs should...
9. … Adequately prepare for physician training. When you have a physician's attention, use it wisely. To maximize the time you have to train physicians on use of the EMR, make sure the system is already set up for them prior to beginning their training. Enter in their specific discharge instructions, orders and any operative note templates they may use in the system. Show them this personalized information and provide a quick walkthrough on how they will use the system on a daily basis (and hopefully convince them how easy it is). Ask if they have any updates to request.
10. Make sure your leaders are cheerleaders. The transition to a new system is more likely to succeed when an ASC's leaders, including physicians, the administrator and director of nursing, are strong cheerleaders for the project. When leaders express excitement about the new system, remain positive during the EMR's integration (especially in the face of the occasional bump in the road) and show their support for staff to undergo the necessary training and practice to maximize the benefits of the EMR, it can go a long way for ensuring a smooth transition and successful go-live.
Ed Daihl is CEO of Surgical Information Systems (www.sisfirst.com) and its subsidiary, AmkaiSolutions (www.amkai.com). Mr. Daihl has dedicated the past 20 years to successfully building software and technology services companies, and turning them into world-class solution providers. A proven leader, he is tasked with leading SIS to the forefront of the surgery and anesthesia healthcare IT industry. SIS' mission is to help hospitals and ambulatory surgery centers successfully manage their perioperative operations anywhere surgery is performed, allowing them to deliver safe, efficient, cost-effective care.
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