There are nearly 140 million emergency departments visits each year. And unfortunately in those departments, there exists variation in the quality of care delivered to patients. Not surprisingly, as a result malpractice claims are high and the education and training to mitigate claims exposure is disparate to say the least.
Katie Hesse, director of emergency services for Dignity Health joined Lora Sparkman, vice president of clinical effectiveness at APS and Dr. Bill Binder, emergency medicine director at APS on a webinar to explain how Dignity Health is rolling out continuing medical education in the emergency departments at 37 system facilities.
The three clinical leaders offered their recommendations for implementing education in a results-oriented patient safety program focused on risk reduction.
1. Standardize education
“Variation is risk,” said Hesse. “And standardization whenever possible is the goal.” According to Hesse, traditionally E.D. clinicians found education through various channels, meaning nurses were learning different material at varying degrees of quality from different resources. And if there were an education option provided by the manager or education leader it was more like, “Here’s your pile of work to do for the year.” Often this lacked rigor and, more importantly, the tracking to make sure learners were completing the work and actually learning. She explained on the webinar how Relias (formerly GNOSIS) unifies the team and helps managers easily monitor the education investment.
2. Practice judgment
Hesse noted that the education courses she explored from other vendors lacked a focus on critical thinking. She stressed that more than just the clinical knowledge, the clinician needs to understand how to apply that knowledge, especially with atypical presentations and dynamic factors in the emergency department. Dr. Bill Binder, who developed the courses in GNOSIS, demonstrated how case-based scenarios from real life are described with various management decisions presented to the learner. Hesse added, “What we are finding is this making them act critically and use some judgement. I have not found that in any other nursing education that I have ever seen.”
3. Use data
“You can’t improve what you don’t measure,” said Sparkman when imploring the value of using data to make decisions. She also explained how assessment data is being used to benchmark proficiency in knowledge and judgment at the system level, the facility level, and the clinician level. GNOSIS data and analytics reveal actual areas of risk and allows Dignity Health to make more informed decisions about how to improve patient safety. For example, who needs additional education and in what practice areas do they need to focus their training? Said Hesse, “It was eye opening that we could have those kinds of visuals measure judgment and knowledge and critical thinking and get a report all at the same time.”