AET/515 Transitioning to Electronic Medical Records

This 8 week training course focuses on hospital transition process from paper inpatient notes to electronic notes, using electronic medical records. Staff taking this course will learn the key drivers and barriers that affect the implementation process of the EMR (time and location). Learners will learn the best practices and approaches to take to have a smooth transition. Change the Instructional Plan Template title to reflect your personal plan.

*5 professional development hours.*

Breeanna Duncan

Part I Agenda: Analysis and Design of

Instruction

Needs Assessment slide 3-4

Instructional Goal slide 5 Performance-Based Objectives slide 6 Summative Assessment & Learning Outcomes slide 7

Learner Characteristics slide 8

Learning Context slide 9
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Needs Assessment
1. What is the learning problem or opportunity? Hospital staff continuously make mistakes inputting and interpreting notes in patient records. This results in patient care complications. 2. What is currently available? Currently staff uses a handwritten technique to input patient notes. The jargon used is not universal or consistent between staff. Staff also delays the input of data in patient charts, which impacts patient care. 3. What should be available? There should be a universal language and systematic method used by all staff members to input patient notes into patient files to ensure patients are Instructional Plan Template care. receiving proper

Needs Assessment
4. Explain the gap analysis between what is available and what should be available. There is a gap in the translation of the medial records to patient care. This gap can result in treatment errors and even fatalities
5. What is your recommended solution for filling the gap? Hospital s need to transition to and staff need to learn how to use Electronic Medical Records to avoid errors in patient files.

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Instructional Goal
What should the learners be able to do after successfully completing this instructional plan? After completing this training course hospitals will be able to implement a smooth transition to EMR system. Hospital staff will be able to use the new system through the electronic tablets to record and interpret patient notes, using the universal language.

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Performance-Based Objectives
Using the EMR Enablement Solutions, hospital staff will convert one new patient paper record into the electronic format with 99% accuracy.

Using the EMR tablet staff will add additional notes to an existing patient file with 98% accuracy

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Summative Assessment & Learning Outcomes

At the end of the training the staff will demonstrate the skills acquired in the training course by using a mock EMR site. Staff will be required to log into the mock site and complete the three functions:
Inputting new patient records Updating existing patient records Accessing patient history

*At the completion of the activities on the mock site staff will be given a certification in EMR process.*
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Learner Characteristics
The trainings are geared toward hospital staff: nurses, doctors, and other medical personnel, both men and women. Ages range from 25 to 50, with a variety of educational and professional experiences in the field Some may also have previous experience using ERM so only a review of the benefits and challenges of EMR will ne needed. Manuals will be given to staff to use through the course with the online tutorial and virtual hospital setting.

Implications: This group of learners already

have knowledge and application of patient records so no pre-requisite skills in this area will need to be trained. The first part of the course will need to include a review of the basic computer functions to refresh learners on how to use the resource.
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Learning Context
The instructional setting will be in web-based online format. The training will be in the form of an online tutorial with interactive functions and audio and can be accessed on a personal and home computer Explanation: Understanding that learners will be on the computer either at home or work for 8 weeks allows the ability to identify limitations and barriers faced in this environment that may hinder the staffs learning capability. Also it has an impact on the amount information covered in each weekly session.
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PART II Agenda: Development and

Implementation of Instruction

Delivery Modality slide 11 Instructional Strategies slide 12 Plan for Implementation slide 13-16 Instructional Resources slide 17 Formative Assessment slide 18

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Delivery Modality
Web-based tutorial Hospital staff will have access and log into a the online web-based tutorial to learn the EMR details and to complete the required trainings. This online tutorial will be accessible through hospital and remote computers
The training course can be done on the staffs own time and during work hours. The environment needs to be asynchronous because not all staff can be off the floor and on the training at the same time. This type of environment will also accommodate the work schedules of the hospital staff The first part of the training will consist of a video session that will be held for staff to get a background of why EMR transition is taking place. This video sets the foundation for the online training materials that will be delivered through the tutorial.

Asynchronous learning

Video taped instruction

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Instructional Strategies

Self directed learningscaffolding instruction will be part of the web tutorial. By progressing through the tutorial each section will build off of what the staff already knows and they will be able to find their own way of putting the pieces together, with the structure provided.

Scavenger hunt-The exploratory instruction will be the first strategy used to help staff learn tools and helpful resources used in tutorial. This strategy enables the staff to get more details regarding EMR while getting used to navigating the web-based tutorial.

Practice exercises in tutorial will be used to help students apply skills learned. This strategy will be used at the end of each section of material covered, therefore exercises will be given at students own pace. Students will be given scenarios in the tutorials and will be able to interact and apply techniques used to demonstrate proficiency in each section.

Multi-media/simulationsThis strategy will be used all throughout the tutorial, to allow students the opportunity to experience the real life application of EMR and get exposure to the transition process. Students will need to use critical and evaluative thinking to work through the simulation. This experiential strategy will be used to keep the staff engaged while going through the tutorial
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Plan for Implementation

Week 1(1 hour)
Hospital staff will attend a 1 hour orientation session where they will watch a video and gain exposure of the web based training that is getting ready to take place. The video is 30 minutes and will introduce and provide insight on the transition process to electronic medical records and give history of the affects it has on hospitals During last 30 minutes the web-based tutorial will be explained and previewed in the orientation to allow for Q&A, before providing the software packages to the staff.

Week 2(20mins)

Scavenger Hunt Hospital staff will use scavenger hunt interactive sheet available through the tutorial to navigate the functions and tools that will be used throughout the training course

Week 3(30mins)

Enablement Solutions Students will review concepts of Enablement Solutions and role it plays in the transition process to electronic medical records At the end of this tutorial section the students will take a 4 question quiz on the key factors with system. At the completion of the quiz, the staff member will receive a green checkmark on the left side of the screen indicating he or she met the proficiency on the section.

Week 4(30mins)

Inputting patient Records Staff will use the Enablement Solutions systems to enter paper patient information into an electronic format. Interactive Simulation will be available throughout this section At the end of this section of the tutorial staff will print out job aid and input data on practice sheet. Green checkmark will be added to left side of screen to indicate proficiency in this area Instructional Plan Template 13

Plan for Implementation

Week 5(30mins)
Updating existing patient records using Electronic Tablet Staff will use their EMR tablet to add new patient information into an existing electronic record. To complete this proficiency staff will have to update a patient record with information provided in the scenarios. Once all scenarios are complete staff will receive a green checkmark in this section.

Week 6(20mins)

Accessing patient history Staff will use both the Electronic Tablet and the workstation computers to access patient history information. Concepts from Week 3 (Enablement Solutions) will also come into play in this weeks learning objectives. Once students are able to access patient records both ways, green checkmarks will be indicated.

Week 7(35mins) Week 8(1hr15min)

Proficiency Review Enablement solutions Transition Process Patient Records-Inputting, Updating and Accessing History Preview of Mock EMR site

Mock EMR Site for Certificate of completion of training Students will use the mock EMR site to apply skills student obtained through the tutorial A scenario sheet will be provided for staff to follow All parts of Mock Site will need to be completed in order to be award a certificate of completion Instructional Plan Template

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Plan for Implementation

Week 2:
Week 1: -Weekly email reminder of objective will be sent out to all staff members by Director Staff -All staff must complete Scavenger Hunt, found in booklet -Can be done on staffs own time -Must complete Section before moving to week 3 objectives -No penalty for Late Assignment
Week 3:
-Weekly email reminder of objective sent out to all staff members by Director Staff -All staff are required to use Enablement Solutions Software provided through Tutorial links -Must complete Section before moving to week 4 objectives No penalty for completing objective late

-Mandatory training for all staff

-2 Trainings will be held during this week -EMR tutorial Booklet and Software provided

Week 4: -Weekly email reminder of objectives sent out to all staff members by Director Staff -All staff will use the Interactive Simulation -Must Complete Section before moving to week 5 objectives No penalty for completing objective late

Week 5: -Weekly email reminder of objectives sent out to all staff members by Director Staff -Nurses and Doctor Staff will use Electronic Tablets -Admin Staff will use workstations -Must Complete Section before moving to week 6 objectives
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-No penalty for completing objectives late

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Plan for Implementation

Week 6: Weekly email reminder of objectives sent out to all staff members by Director Staff Email reminder of Deadline to Completion and Percentage completed will be sent Nurses and Doctor Staff will use Electronic Tablets Admin Staff will use workstations Must complete Week 6 before moving to week 7 No Penalty for completing objectives late

Week 7:
Email reminder sent to staff about final week to complete objectives Director and staff meet with staff for preparation for mock site. All objectives must be complete this week
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Week 8:
Probation penalty imposed to staff who have not completed weekly objectives Mock Certification of Completion Collected by Director/Supervisors
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Instructional Resources
EMR Transition Manual Mock EMR site directions Job Aid for Enablement Solutions system Certification of completion

Electronic Tablet
used to review, input, and edit patient record information

Computer
Adobe flash player Internet MS office Software

Job Aid for Proficiency review

Mock patient data forms

To use in week 4 and week 5

Video Player
To play orientation video

Frequently Asked Questions sheet

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Formative Assessment
Q&A sessions: Held by Director/Supervisor staff after first meeting to gather feedback and check in on staff prior to getting started

Checkpoint /Quizzes: performed at end of the weekly objectives.

Observations: Management staff will observe and gather feedback from employee progress in completing the weekly tutorial objectives. Information will be relayed at the end of week 7

Student Record Keeping: The tutorial has green checkmarks in stalled, therefore students are able to track their own progress and proficiencies with objectives

Problem Solving Simulations/Scenarios: Staff will be able to demonstrate applicability of knowledge obtained and thought processes use. These scenarios throughout the tutorial can be used to gauge what information is being retained.
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PART III Agenda: Evaluation of Instruction

Evaluation Strategies slide 20 Outcome Review slide 21-22 Recommendations slide 23 References slide 24

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Evaluation Strategies

Performance Based Assessments

Surveys
http://www.surveymon key.com/s/8MPG7NY

Follow-up with Management Staff

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Outcome Review
Exemplary Proficient Fair Unacceptable

Electronic Tablets
Use of Staff was able to Electronic Tablet use tablet with no issues Staff used tablet with few errors Staff had moderate accuracy using tablet Staff could not use tablet

Competency in Transition Process

Knowledge of EMR Transition Process Staff were very knowledgeable / knew full details could train others Staff knew EMR transition process to perform duties Staff had some knowledge of EMR transition process Staff had no knowledge of EMR Transition process

Inputting New Patient Record

Process of Staff were able documenting to input new new patient info patient data with no errors Staff were able Staff were able to input new to input new patient data with patient data with Instructional Plan few errors Template some errors Staff were able to input new patient data with multiple 21 errors

Outcome Review
Exemplary Proficient Fair Unacceptable Updating Existing Patient Records and Accessing Patient History Process of updating and accessing patient history/record Staff was able to access and update patient history record without errors Staff was able to access and update patient history record few errors Staff was able to access and update patient history record some errors Staff was able to access and update patient history record with multiple errors

Mock EMR Site Navigation Movement on Site Staff had no trouble moving completing activities on Mock Site Staff moved through activities on Mock Site with little difficulty Staff moved through activities on Mock Site with some difficulty Staff moved through activities on Mock Site with much difficulty

Tutorial Completion Status of Tutorial Completion Staff completed 100% of the tutorial Staff completed Staff Completed 85%-99% of the 75%-84% of the Tutorial Plan Template tutorial Instructional Staff completed 074% of the tutorial
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Recommendations
Pre-assessment may need to be to determine level of knowledge with EMR transition process to eliminate the use of the video, which appeared to be not needed.

Installation of deadlines for each weekly objective to ensure all staff members complete training and certification process on time

Live demonstration of Mock site during week 7 review period to ensure staff doesnt have difficulty navigating site.
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References
Chao, T., Saj, T., & Tessier, F. (2006, Fall ). Establishing a quality review for online courses. Educause Quarterly, Retrieved from http://net.educause.edu/ir/library/pdf/eqm0635.pdf

Duncan, B. (2012). EMR training survey. Saskatoon Public Schools. Retrieved from http://www.surveymonkey.com/s/8MPG7NY

Evaluating Student Learning. (n.d.). Retrieved from http://www.temple.edu/provost/aaa/other_accrediting/documents/measurementapproaches.pdf

National Campaign for Public School Improvement. (2010). What Should Parents Know About . Retrieved from http://http://www.projectappleseed.org/assesment.html

Illinois Online Network and the Board of Trustees . (2010). Instructional Strategies for Online Courses. Retrieved from http://www.ion.uillinois.edu/resources/tutorials/pedagogy/instructionalstrategies.asp#LECTURE
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References
Iron Mountain. (2011). A smooth transition to an effective electronic medical records system. Retrieved from http://www.ironmountain.com/Knowledge-Center/Reference-Library/View-by-DocumentType/General-Articles/A/A-Smooth-Transition-to-an-Effective-Electronic-Medical-Records-System.aspx

Roundedcube Inc. (2002-2012). Elsevier: Electronic medical record. Retrieved from http://www.roundedcube.com/OurWork/CaseStudies/ElsevierEMR

Supporting Self-Directed Learning. (2010). Retrieved from http://instructionaldesignfusions.wordpress.com/2010/09/10/supporting-self-directed-learning/

Saskatoon Public Schools. (2010). Simulations. Retrieved from http://olc.spsd.sk.ca/de/pd/instr/strats/simul/index.html

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