Utilizing Blended Learning to Improve Efficiencies

The Story of Pullman Regional HospitalPresented at the Dallas SUN Laerdal Conference

April 29, 2011by: Bernadette Berney, Director of Human Resources

Donna Haynes, MSN, RN, BC – Human Resources

ObjectivesAt the end of this session, learners will be able to:• Understand the alignment of blended learning with

organizational cultural traits.• Identify decision components for blended learning

solutions.• Review key elements of adult learners.• Discuss attributes that contribute to highly efficient and

highly effective blended learning programs.• List the outcomes from effective resuscitation training

programs.

Pullman Regional Hospital

• Located in Pullman, Washington• New Hospital December 2004• 25-Bed Critical Access Hospital• 400 Employees• 60 Medical Staff Providers• Home of Washington State University• Agricultural Region – Dry Land Farming

Pullman Regional Hospital• 2007 – 2010 Most Wired Small and Rural Hospitals –

Hospital and Health Network

• 2009 Summit Award Recipient – Press Ganey

• #1 in Overall Patients Satisfaction in Washington State – HCAHPS April 2009 to March 2010

• Affiliate clinical site for students

Organizational Cultural Traits• Personal Accountability – employees are

accountable for obtaining and maintaining their required certifications.• Choice – employees are given a choice as to

how they would like to attain their certifications.• Serving Others – a high level of customer

service is provided to the users of the BLS, ACLS, and PALS systems.

Organizational Cultural Traits• Flexibility – employees can do their learning

either at the hospital or off-site.• Transparent – the completion of the

modules is tracked on the HealthStream system.

• Consistency – the instruction is the same for each employee who takes the certification – it is not instructor dependent.

Organizational Cultural Traits• Personal Growth – employees have the

opportunity to obtain certifications that are and are not required for their positions.

• Inclusive – any employee of the hospital can take a certification course including employees in non-clinical roles.

• Progressive – the hospital provides the opportunity to obtain certifications using blended learning.

Organizational Practices• Staffing levels – by design – most areas of

the hospital have staffing levels that are above average.• No Mandatory Low Census – the hospital

does not low census any staff during periods of low patient volume.• Mandatory is a “four letter” word – it is

not a part of our organizational culture.

• What do we know about the learners?

Audience

• Is the organization ready and supportive of blended options?

Organization

• What issues unique to this context should be considered?

Context

• Are there any barriers to the technology-based delivery?

Infrastructure

• What do the learners need to be able to do?

Outcomes

The Adult Learner• Is autonomous and self-directed• Has accumulated a foundation of

experiences and knowledge• Is goal-oriented• Is relevancy oriented• Is practical• Needs to be shown respect

Consider Components of Best Practices in Implementing Simulation Education

• Contextual Learning (Kneebone) • Mastery Learning (Bloom)

• Deliberate Practice (Ericcson)

Our Approach• Partnered with HealthStream and Laerdal• Embraced an “anytime-anywhere”

approach• Knowledgeable of the programs and

manikins• Committed to a high level of customer-

service

HealthStream-Laerdal-AHA

• BLS• ACLS• PALS

Anytime-Anywhere

• IT Solutions• Access outside of the organization• Availability of the Skills Lab

IT Solutions• Updated the Adobe Flash

Players • Gave software download

administrative rights to targeted computers for PALS • Provide a high level of

customer service to assist the staff with individual computer challenges

Access Outside the Organization

Availability of the Skills Lab

• 24/7 access• Priority for

use

Knowledge of Programs and Manikins

• Know what makes the manikins thrive• Pearls that reinforce proper technique• What constitutes a repeat of the

simulation• Know where the resources are in the

programs

What Makes This Approach Efficient and Effective?

• Certification Tracking• Staff satisfaction scores• Decreased organizational costs• Increased confidence in competence

Certification Tracking

• Use payroll system tracks certification dates.• Staff call and ask for courses to be loaded.• HLC Administrator reviews expiration date.• BLS automatically loads every 2 years.• Certification tracked through annual

performance reviews.

Staff Satisfaction Scores• BLS – 227 total employees– Overall content of program – 90% appropriate/very appropriate– How likely are to you recommend this program to your

colleagues? – 64% somewhat likely/very likely• ACLS – 63 total employees– Overall content of program – 65% appropriate/very

appropriate– How likely are to you recommend this program to your

colleagues? – 56% somewhat likely/very likely

Staff Satisfaction Scores• PALS – 13 total employees– Overall content of program – 85% appropriate/very

appropriate– How likely are to you recommend this program to

your colleagues? – 77% somewhat likely/very likely

Staff Comments - Positive

• “Learning is easy at my own pace and review is also easy.”

• “I was pleased with the learning styles utilized within this program.”

Staff Comments - Positive

• “I liked doing this on the computer. It gave me time to think without pressure.”

• “I prefer self-directed study over classroom teaching. I can learn at my own pace and focus on the areas I need more knowledge.”

Staff Comments – Challenges• “I prefer a class setting with instructors so

that when I have questions, I have someone present to answer them.”

• “I am not very good at using computer simulated tools and would prefer a live class by far.”

Staff Comments – Challenges• “More time is spent trying to locate appropriate

actions/interventions in the program then actually reviewing or learning from it.”

• “I am little disappointed that I could not download or print the educational materials. I think they should come with the course either hard copy or the option to save them on a zip drive.”

Decrease Organizational Costs• Estimated Average Savings per Employee– BLS $117.00 per employee– ACLS $1,062.00 per employee

• Estimated Average Savings Total– BLS $26,559.00 for 227 employee– ACLS $66,906.00 for 63 employee

• Total Estimated Savings $93,465.00* over 3 + yrs *salary expense is using 2011 wages

Increased Confidence in Competence

• C.N.A. Story

• Nursing students

• First-time takers

• “Can’t pass unless you do it right”

Putting it All Together

• Blended learning should include the opportunities to:–Reflect–Apply–Build Team

Putting it All Together

• Mock Codes• Monthly Skill Focus• Continuing Education

QUESTIONS?

References• Bloom, B. (1987). The Mastery of Learning: notes from a

Benjamin Bloom lecture. Retrieved April 2, 2011 from: http://learn.midsouthcc.edu/learningObjects/masteryLearning/printout.pdf

• Kneebone, R (2005). Evaluating clinical simulations for learning procedural skills: A theory based approach. Academic Medicine, 80, 6, 549-553.

• Kolb, D. (2009). David Kolb on experiential learning. Retrieved April 2, 2011 from: http://www.infed.org/biblio/b-explrn.htm

• Merrill, M.D. (1994). Instructional design theory. Englewood Cliffs, N.J.: Educational Technology Publications.