technology and learning in the home health care...
TRANSCRIPT
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TechnologyandLearningintheHomeHealthCareSettingJUDITHARNESON,RN,MSPARTNERSHEALTHCAREATHOME
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AnIntroductiontoPartnersHealthCareatHome• Establishedin2000withmerger
of27VNAs
• 800+employees(~500clinicians,80homehealthaides)
• 4branchoffices
• Averagedailycensus 3,700
• Annualadmissions 27,000
• Visitsperyear 470,000
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PartnersHealthCare
Brigham&Women’s/FaulknerHospitals
MassachusettsGeneralHospital
NorthShoreMedicalCenter
Newton-WellesleyHealthCareSystem
PartnersContinuingCare
Brigham&Women’sHospital
Brigham&Women’sPhysiciansOrganization
FaulknerHospital
TheGeneralHospitalCorporation
MassachusettsGeneralPhysiciansOrganization
McLeanHospitalCorporation
TheMGHInstituteofHealthProfessions
MGHHealthServicesCorporation
NorthEndCommunityHealthCommittee
SalemHospitalNorthShoreChildren's
Hospital
UnionHospital
CharterProfessionalServicesCorporation
Newton-WellesleyHospital
NeWell MedicalDeliveryOrganization
NWHCharitableFoundation
SpauldingRehabilitationNetwork
• SpauldingRehabHospitalBoston
• SpauldingRehabHospitalCambridge
• SpauldingHospitalforContinuingMedicalCareCapeCod
• SpauldingNursingandTherapyCenterNorthEnd
• SpauldingNursingandTherapyCenterWestRoxbury
• SpauldingOutpatientCenters
PartnersHealthCareatHome
ClarkHouseatFoxHillVillage
DanaFarber/PartnersCancerCareTwoPhysiciansAppointed
byPartnersPartnersCommunityPhysician’s
Organization(PCPO)
Martha’sVineyardHospital
NantucketCottageHospital
CooleyDickinsonHospital
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StaffLearningChallengesinHomeCare
• Workforcedispersedduringtheworkday;fieldcliniciansmaygodayswithoutgoingtoanoffice
• Tightproductivityexpectationsforfieldstaff(patientvisits/day),andsomealsohaveextensivedriving
• Impromptutrainingsessionsareoftenimpossible
• Evenscheduledsessionsrequireadditionaldriving,decreasedproductivity
• Lessface-to-faceinteractionwithmanagersandco-workersthaninafacility• Lessinformalknowledgetransmission
• Lessopportunityfortransmissionofnorms&expectations
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TheHealthStreamLearningManagementSystem
LearningManagementSystems(LMS)permitremoteaccessviatheinternet,provideonlinelearningmodules,includetrackingandreportingfunctions
HealthStream istheLMSusedthroughoutthePartnersnetwork
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TheHealthStreamLearningManagementSystemHealthStream istheLMSusedthroughoutthePartnersnetwork
Libraryoflearningmodules
• Widevarietyoftopics(clinical,safety,compliance,administrative)
• Foravarietyofaudiences(nurses,therapists,aides,officestaff,allemployees)
• MajorityareHealthStream-authored
• Somecreatedbyothervendors
• Somecreatedin-housebyPartnersstaff
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UseofHealthStream inPartnersHealthCareatHome
Orientation
• Allnewemployeescomplete17standardmodulesduringtheirfirst90daysofemployment
• Fieldcliniciansalsocompleteanadditional16modulesnecessaryfortheirrole
AllNewEmployeesBackSafetyCorporateCompliance:AProactiveStanceCulturalCompetence:BackgroundandBenefitsCulturalCompetence:ProvidingCulturallyCompetentCareDiversityintheWorkplaceElectricalSafetyEmergencyPreparednessFireSafetyGeneralSafetyHandHygieneIdentifying&AssessingVictimsofChildAbuse&NeglectIdentifying&AssessingVictimsofDomesticAbuseIdentifying&AssessingVictimsofElderAbuse &NeglectInfectionControlSexualHarassmentintheWorkplaceWorkplaceViolencePHEHIPAA
NewCliniciansAdvanceDirectivesMedicalEthicsPatientRightsPersonalProtectiveEquipmentPreventingPatientFallsTuberculosisDrivingSafetyinHomeCareHomeCareBasicsHomeHealthCoveredServicesMedicationSafetyinHomeCareOASIS-C:RoombyRoomOASIS-C:BeyondtheBasicsRecipeforEffectiveDocumentationHomeCareofthePatientwithAdvancedHeartDisease:ManagementAdvancedPainManagementinHomeCareandHospice:AssessmentProfessionalBoundariesinHomeCare
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Tocompleteallofthesemodulesrequiresalotoftime(modulesaverageanhoureach).
• Modulescanbedoneathomebutareconsideredworktime.
• In-personorientationclassesmayendat2or3.
• Daysinfieldwithpreceptormayhavedown-timefornewemployee.
• ManagersmayscheduleblocksoftimefornewemployeetofinishHealthStream assignment.
Particularchallengesnotedforhomehealthaides
UseofHealthStreaminPartnersHealthCareatHome
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HealthStream maystillbeunder-utilizedforlearningoutsideoforientation,butuseisincreasing.
• Annualmandatorycompliancetraining
• Annual“ActiveShooter”video
• Updatesforcliniciansonimportantchangesmadetodocumentationsoftware
• Preparationforupcomingchangestoregulations
• Electiveorassignedlearningonclinicaltopics
UseofHealthStream inPartnersHealthCareatHome
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OnlineLearningModules,TraditionalandBeyond
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Instructionaldesignisarelativelynewbutmaturingfield.
Increasingattentiontotryingtomakee-learningeffective:
• Concrete
• Relevant
• Interactive
OnlineLearningModules,TraditionalandBeyond
“Gamification”
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WithfundsfromtheCommonwealthCorporation,wedevelopedpalliativecaremodulesin-houseforusethroughoutPartnersContinuingCare
• Concrete – usecases(fictional,butrealistic)topresentcontent
• Relevant – informationandcasesaredirectedatanaudiencewhoworkinthepost-acutecaresetting(homecare,SNFs,LTACs,andinpatientrehab)
• Interactive – Eachtopichasatleastoneuserinteraction
OnlineLearningModules,TraditionalandBeyond
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ACoupleofQuickSamples
http://zebr.as/2oiSTXw
http://zebr.as/2oqxzga“Preventing,Identifying,andManagingDelirium”
“WhatIsPalliativeCare”
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TechnologyandLearningOutsideoftheLMS
• Webinars
• Smartphones
• Videotransmissionoftalkstodifferentoffices
• Startbuttonresources
• PartnersHandbook
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InteractiveEducationalSessioninFourLocations
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Start-ButtonResourcesPHH-Specific
• PracticeGuidelines
• DocumentationGuidelines
• PoliciesandProcedures
• MiscellaneousResources
Partners-Wide
• PartnersHandbook
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UpToDateOnlinemedicalresource
Expertphysiciansineachfieldupdatearticlesregularlyasnewresearchcomesout.
Thereisalimited,freeversion,butPartnersHealthCareSystemhaspurchasedaccessforallofitsemployees.
Samplesituation:goingouttoadmitanewpatienttohomecare;referralpaperworklistsprimarydiagnosisashepatocellularcarcinoma
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ChangingCultureGettingthetechnologyinplaceisonlythebeginning.Otherpiecesoftheprocesscomeevenslowerandharder.
• Imaginingwhatitpossible,notjustassumingthatwe’llkeepdoingwhatwe’vealwaysdone
• Accommodatingnewlearningapproachesintheflowofourworkday,workweeks
• Makinglearnersawareofopportunities
• Shiftinglearnerhabitsforseekinginformation