When Holy Cross Hospital hired Mary Lou Alonso to bring their computer education system into the 21st century, its leaders probably never imagined that their healing establishment would be overrun by COWs. Yet that’s exactly what happened when Alonso created an e-learning program featuring Computers-on-Wheels, or COWs, to drive compliance and patient safety training.
“Most of the time when you buy off-the-shelf education, you have to modify it to meet your policies and procedures,” said Alonso, director of clinical education and training, Holy Cross Hospital. “You can’t just buy something, put a video in and go, ‘OK, that’s the end of that.’ You still have to modify the education. Then you’ve got to track who’s completed the in-service or the education, and that was my challenge.”
Learning also had to be convenient for nurses and other clinical staff, such as pharmacy and respiratory personnel, to participate in while taking care of patients. Limited resources were a formidable obstacle, and Alonso’s first big move was to revamp Holy Cross’ existing method of distributing regulatory learning via paper newsletters.
“Usually they sent this newsletter to a print place, and it would have all the updates for annual education in regards to Joint Commission (Joint Commission on Accreditation of Healthcare Organizations) and other regulatory requirements. Joint Commission doesn’t care how you get the information to them, as long as all your associates do the education and you track that they’ve done it,” Alonso said. “Then everyone read the newsletter. They had to do some questions and then make sure that this little slip of paper went to their manager. The manager had to make sure that little slip of paper went to the learning center. I said, ‘Why are we doing all of that?’ It cost $10,000 just to produce this thing. With that amount of money, we bought COWs, computers-on-wheels. We put computers on wheels and strategically located them in nursing lounges, and then we started writing an e-learning platform.”
First Alonso and fellow subject-matter expert and clinical nurse educator Naomi Mora experimented with PowerPoint presentations on the Hospital’s intranet, which participating staff enjoyed. That success gave them the courage to search out and implement ePath Learning’s Web-based Integrated Learning Management System (iLMS), a more robust e-learning platform where they could create content, track it and distribute it with appealing multimedia elements. This did not take long to deploy. The project began in June 2004. “We’re in the process of having it interface with our LMS, which is Lawson, which has all the biographical data of our associates so that it eventually will keep track of when people terminate, when people come on. It puts them right into the e-learning system,” Alonso said.
The iLMS allows Alonso to upload education very quickly. “In the medical field things get changed constantly. A policy gets changed. Within one-week turnaround, you’ve got the policy, you can put it as a PDF, put a few questions to it and then say to your associates, ‘You have to read this and take the questions.’ Before when the policy would come out, managers would have to tell their staff at a staff meeting where they may have only gotten six people to attend. Now communication is better,” Alonso said. “When something gets changed, everyone can get those changes.”
Alonso said the COW system is efficient and also enables self-study. “If we videotape a speaker, they can check out the video from our library, go online and take a test and get continuing education credits for that. If I have courses on campus, people can register for those courses on campus. The instructor who’s teaching a course can easily go in the system and see who’s self-registered for courses rather than people having to call the learning center, leave a message, say ‘I want to go to this class,’ and find out that it’s full. The new system will tell them the class is full and put them on a wait list.”
Holy Cross University, the hospital’s online learning center, measures the success of programs like COWs through evaluations. “Anything that’s over 10 or 15 minutes, we’re measuring that. We also do a yearly association survey that they fill out saying ‘Are we meeting their needs, do they like the way our education is being presented?’ We do that once a year. That was always in place, measuring our associate satisfaction, but measuring education here is fairly new,” Alonso said.
There have been a few challenges to getting the COW program off the ground, such as the staff’s fear of using the computers. “I think the biggest challenge today is you may say, ‘This is the greatest thing since sliced bread,’ but many organizations still have computers that are old and they can’t do what we’d like them to do. So we’re upgrading some things,” Alonso said. “The other big challenge is that people are frightened of computers. They use computers all the time. They go to the ATM machine, but if they don’t have a computer in their home, they think they’re illiterate. We’re in a little bit of a hurdle trying to get people comfortable doing that though people are more computer literate than they give themselves credit for.”
Overall response to the COW program has been positive. “Let’s put it this way,” Alonso laughed. “Can anybody give us grant money so we can buy more COWs? We’re in the process right now of upgrading a computer room we have with old computers. We’re getting a grant from the Diabetes Center to put new computers up there so people can use that as another satellite learning center. They like the COWs so much I wish I could put a COW in every unit, but right now we strictly have it for nursing. I need about another 20 COWs.”
“The first time we used the COWs, they were not connected to the Internet because they weren’t wireless,” Alonso said. “Now we’ve bought wireless cards, and they have a little tail on them because there’s a little antenna that’s sticking up. These COWs, a few of them have tails and a few of them don’t. We have to tell them, if they can’t get online, ‘Did you look to see if it had a tail?’”