expediting a sustainable_approach_for_new_resident_emr_ver_9

Randy Graff

Sara Henning

Expediting a Sustainable Approach for New Resident EMR Access

Problem Background Goals

Timeline Training Lessons Learned

Challenges Overview

300 new housestaff from all over the world

Problems

Start July 2 – safe to see patients

Encounters with Patients

Underground work

New Service Provider

Great OpportunityTransform Educational

Process

TrainingBlitz

PlannedEducation

Training ServicesOffice

Productivity

Faculty Developme

ntEpic

Everything Else

PeopleSoft

SharePoint

GME Milestones

Training ServicesOffice

Productivity

Faculty Developme

ntEpic Everything

Else

PeopleSoft

SharePoint

GME Milestones

6 Physician Support/Trainers

2 Training Environment Builders

Physician Subject Matter Expert (ARNP)

Video Talent (Medical Student)

Web Development & Online Content

Community Manager – The Magic Bullet

UF&Shands

GME Office

New Innovations

Clinical Leadership IT Leadership

Epic Resident Champions

Program Directors

Program Coordinators

Credentialing OfficeIdentity

Management

Problem Background Goals

Timeline Training Lessons Learned

Challenges Overview

Gainesville, FL

1,688 Beds

929,000 Outpatient visits

12,000Employees

1,500 Faculty Physicians

6 Colleges

6 Centers and Institutes

6,000 Students

6,000 Students and Housestaff

19 Core Programs 45 Sub

Specialties

220 New Housestaff

680 Total

• ADT• ASAP• Cadence• EpiCare Ambulatory• EpiCare Inpatient (ClinDoc)•HIM•HOD•MyChart•OpTime• Prelude• Resolute PB• Stork•Willow

AnesthesiaBeaconRadiantResolute HB

Epic Modules

2011

• Register Housestaff• Identify Epic Champion• 4 HR “Coaching” session• Take assessment in

HeathScream• Work through first rotation• Gain access to production

Email

3 Websites

HealthStream

Classroom

Sakai

Spreadsheets

Initial In

patient Go Live

Problem Background Goal

Timeline Training Lessons Learned

Challenges Overview

Goal

Train new housestaff before July 2

Problem Background Goal

Timeline Training Lessons Learned

Challenges Overview

Training Materials

Epic Environment

Challenges

Switching Specialties

Challenges

Training Method

Challenges

Coordination

LMS Tools

Email Addresses

Challenges

Internationals

June 30 – July 2

Challenges

Do I have to do this?I’m retiring next year…

Do fellows have to take this training too?

Can we have our training right here?

I have been using Epic for five years. I am a Super User. Do I have to do this?

Problem Background Goal

Timeline Training Lessons Learned

Challenges Overview

Process

Trainers met with Epic Resident Champions (ERC)

[What do you do?]

Trainers created an outline

Vetted with ERC

Process

Trainers drafted training

Training Services Instructionally Designed

Training Services tested

Process

Trainers & ERC tested

Trainers Cross-Checked Specialties

FEB APR MAY JUN JULMAR

Develop Milestones (2/1)

Chief Resident Meeting (2/10)

Program Coordinator Meeting (2/28)

FEB

Resident Match Complete (3/15)

Resident Demographic in New Innovations (3/22)

MAR

UF IDs Created Sent to Sony (4/6)

UF data sent to Shands Identity Mgmt (4/6)

Resident Website & Form Updated (4/13)

Education Modules Due (4/26)

APR

Assessments Due (5/4)

Peer Review of Modules (5/11)

Program Coordinators Receive Shands Credentials (5/18)

MAY

Training Begins - Email all Incoming Housestaff (6/1)

In Class Training Handouts Due (6/8)

In Person Training Begins – OB (6/15)

Online Training Complete (6/22)

Housestaff Orientation/Training (6/25)

Email Incompletes to Prog. Coordinators (6/29)

JUN

In-Person Training Complete (7/3)

Evaluation of Process – Nurses (7/5 -7/13)

New Housestaff Training Complete (7/13)

JUL

External Communication

Internal Communication

Problem Background Goal

Timeline Training Lessons Learned

Challenges Overview

Online Training – ELearning in Sakai

Online Training – Medicine Learning Map

Each Learning Map contains:• Playground

Instructions• Assigned Patient

Information• Inpatient &

Outpatient Scenarios

• Proficiency Assessment

• Course Feedback

Psychiatry & Anesthesia Learning Map

Online Training – Scenario ExampleEach Scenario contains:• Learning Objectives• Patient Situation• Actions based on

Workflow• Screenshots & Video

Clips• Handouts for Review• Check Your Work• Important NotesEach Scenario also:• Included Collaboration

of Epic Champions

In-Person Help – Epic Study Halls

Online Help – Resources

Sakai

Citrix & Epic

Online Assessments

• 80% or better to pass. May use Epic Playground during Assessment

• Maximum of 2 attempts to successfully complete this assessment

• Failed assessments - required to meet one-on-one with an Epic trainer

• Not able to meet with patients until online and in-person training complete

Course Feedback

In-Person Training – Classroom

Psychiatry

Emergency

Radiology Internal Med

Open House Surgery

Peds Res

Family Med

OB & GYN

Ortho

Neuro Surg

June 15 – 29th

July 2nd & 3rd

Anesthesia

Peds Fellow

Ophtha

In-Person Training – OutlineInpatient Training (2 Hours)• Configuration in Production• Login & P-Sync• Resources• Order Sets & Smart Text

• Demo/Training• Charts & Results Review• Patient Summary• Graphing

In-Person Training – OutlineAmbulatory Training (2 Hours)• Overview of the Schedule (Care Teams,

Change Provider)• Overview of the Visit Navigator• Order Entry (medication, lab, radiology,

POCT, referral, preference list)• Progress Note (smartphrases, Notewriter)• Completing office visit encounter• Overview of the telephone encounter• Other encounters (orders only,

documentation only)

Problem Background Goal

Timeline Training Lessons Learned

Challenges Overview

Lessons Learned

New Innovations

Credentialing OfficeIdentity

Management

Doctor Numbers

GME Office

Add More Sub Specialties

Epic Training

In Patient Out Patient

Epic Training

Clear WorkflowsRich Scenarios

More Customized Videos

Test Out

Test Out

Proctored Tests

Thank You!

Sara Henningsara@ufl.edu

Randy Graffrgraff@ufl.edu

Questions?