Making the right investments in learning often means understanding where an organization’s weaknesses lie. At Tuomey Healthcare System in Sumter, S.C., Administrative Director for Organizational Development Michael Frisina realizes that to create the type of development offerings that will have an impact, he has to overcome issues that plague hospitals everywhere.
“We need to understand the most appropriate way to train people, identify what their needs are, do needs-based assessment and then find alternative ways to deliver training in a way that can ensure an appropriate outcome,” Frisina said. “There’s an old saying, ‘To know and not to do is not to know.’ I certainly don’t want to waste a lot of energy and a lot of money investing in training, not knowing if it’s doing any good.
“If we had something good happen to our mortality data, showing that mortality rates were going down, we couldn’t link that to training that we’d done on reducing medication errors or education that we’d put in place on different techniques or process changes related to medication errors.”
Frisina said part of this disconnect is because hospitals and the health care system in general are very slow to change. But he also said he is optimistic about chances burgeoning across the health care spectrum.
For instance, he successfully persuaded Tuomey leadership to move to a formal structure of organizational development for managing change, quality, education, and staff and leader development within the organization and formalizing learning delivery methods.
He said the hospital used the “see one, do one, teach one” medical model for learning without really investigating other options.
Frisina said Tuomey now is at the beginning of a journey, during which he investigates ways to create and deliver development opportunities that will allow the organization’s 1,600 employees to care for patients first, as is required, but also to enjoy uninterrupted learning that ultimately will benefit patients and the overall organization.
“The whole concept of investing in human capital is still new,” Frisina said. “Hospitals are now trying to leverage an opportunity for revenue growth against a reduction in cost because they’re cut to the bone — they can’t go any leaner. That’s what’s driven us and consequently, we’re behind in our understanding of the best way to bring education and training into the organization. One way is to develop our own core asset of instructors within the facility. I’m trying to create a set of core instructors in-house, and we have people with the talent to do that. They just have to be trained appropriately.”
Frisina actively promotes learning solutions that meet some of the challenges inherent to the hospital environment.
“When you’ve got people in patient care in an ICU and emergency room or a basic nursing floor — particularly in clinical specialty areas — the work doesn’t slow down to get people out of the workplace and into a training environment,” Frisina said. “Patients always come first. If you start something, folks are getting paged, or someone’s actually coming down and pulling them out and back into patient care. Consequently, we try to do a lot of large-group-oriented learning activity and schedule it at variable times during the day and multiple times through the course of a week to rotate people through. We do competency fairs, where you’ll have multiple round-robin stations with various core competencies, and folks move through those and do hands-on demonstrations to retain competency.”
Despite the often unusual learning situations that occur, Tuomey has very rigorous training standards, and metrics data is gathered on multiple levels.
“We use measurement standards that are benchmarked across the country, so they’re not arbitrary to us,” Frisina said. “We’ll do chart audits on returns to the operating room within 24 hours. We’ll measure post-operative infection rates. We have core measures and patient outcome indicators that we use to discern how well the people are training, performing and functioning.
“We have an improving organizational performance team that will institute a process-change initiative and go in and look for a special cause that’s red, meaning bad. We’ll trend that, benchmark against national data. Then we’ll try to turn that into a common cause and institute a process change where we revert back to special cause, only now it’s a special-cause blue rather than red, meaning it’s now producing a favorable outcome.”
– Kellye Whitney, firstname.lastname@example.org