By | October 23, 2015

Can a learning platform save lives? Actually, clinicians save lives. But they do it when they are living up to their full potential – a potential that a successful learning platform can help them achieve.

Picture this…

The air is thick in a brightly lit delivery room. There’s a feverish flurry of activity, which to you and me looks like a medical emergency. Physicians are swiftly attending to a distressed patient. Nurses are by their side, deftly assisting. They’re calmly speaking a common language and collectively processing the information as quickly as they receive it. “Beth,” an otherwise healthy 24-year old woman, is having an uncommonly difficult delivery. Without chaos and with their training kicking in, team members are estimating the blood loss and evaluating next steps. Taponade? B-Lynch suture? Their intuition and visible intensity says they’re on a trajectory to an adverse outcome, but they are proceeding with confidence.

This is what the Labor and Deliver team at NorthBay Medical Center in Fairfield, California, has been trained to do. According to Katie Lydon, director of Women’s and Children’s Services, the facility has relied on education and training to build a team confidence like they’ve never experienced before. And it’s working. Despite an unanticipated and life-threatening obstetrical hemorrhage, they saved the lives of Beth and her baby.

That’s precisely the reason why my company built Relias OB (formerly GNOSIS).

Rewind to 2009. NorthBay began working with APS to offer its nursing staff our online learning packages. Without a strong system of implementation, NorthBay leaders realized they were not taking full advantage of what they had before them.

Then, serendipity.

Katie Lydon, a staff nurse who benefitted from APS courses, moved into a leadership position. At the same time APS launched GNOSIS – an assessment-based learning platform with powerful analytics to help initiate change. It was at the AWHONN national convention in 2013 that Katie found GNOSIS. Now she was able to challenge status quo and make a deeper difference in patient safety.

Fast forward. With Katie’s recommendation and the financial support from the human resources department, GNOSIS became an integral part of NorthBay’s continuous improvement plan.

Because Katie believes that patient safety is built upon staff competency, she was driven to build a shared mental model. She recognized that GNOSIS was not like other continuing medical education models that just checked a box. According to Katie, GNOSIS is about changing behaviors, strengthening communication, and actually improving the care they provide patients on an ongoing basis.

Not surprisingly, in all OB courses NorthBay scored well above the national averages, but was still able to recognize where the team needed to focus its training, who needed to improve their skills, and in which areas of risk. It’s the analytics behind GNOSIS that helped NorthBay become more efficient and targeted in their efforts to improve patient care.

And at NorthBay, the results aren’t tied to the test, they are tied to the patients.

Investing in knowledge works. Katie reports that in the past four to six months NorthBay cared for three patients who would have had hysterectomies if NorthBay’s team hadn’t focused on patient safety. GNOSIS helped the team with identification and management of OB Hemorrhage.

Beth was one of those three patients and proved that shared knowledge among the entire team made a difference in quality of care – and in avoiding an adverse event.

Katie reminded me that if only a third of the staff participates in a program to improve proficiency, that means as a team you are failing two thirds of your patients. For a facility committed to quality, that’s unacceptable and that’s why they use GNOSIS. She also suggests that the implementation strategy is the key to success and recommends three components:

1. Set clear expectations

With GNOSIS for OB, NorthBay’s team set manageable deadlines for participation and completion of the modules, communicated them, and supported them by making sure staff had ample time to get it done. They chose a peer leader to organize and be a champion for the program and as a result they achieved nearly full staff engagement. In a team spirit, it became a collective effort to complete the program.

2. Build in flexibility

Some nurses were able to successfully manage their learning in between patient care. Other learners needed to be at home without distractions. Regardless of those variations in approach, there is standardization in the knowledge and judgment. Yes, her new nurses as well as her veterans were all benefitting because, following the assessment, the learning is personalized and can meet the content needs of each nurse. Plus, on average they save one hour and three minutes of time because they have “tested” out of the topics they already know.

3. Recognize success

NorthBay’s initial data presentation demonstrated the team’s strengths, with nurses scoring in the top quartile in the nation. While anecdotally these clinicians and their supervisors might have known they were top performers, GNOSIS quantified it. It also provided specific insight into areas that needed more work in order to move into a higher quartile. A cornerstone of the plan is to recognize and reward performance, which in turns builds pride, but also creates a positive environment in which employees want to be better for their patients.

Talking to Katie and hearing her experience was uplifting, especially for those of us who spend every day building the platform. But for the tens of thousands of clinicians who use GNOSIS, it’s highly validating. To know that the time they spend learning has measurable outcomes is not only inspiring but making a difference in patient care.

John Harrington

John co-founded APS in 1993 after completing his training as a board certified medical illustrator. He is one of fewer than two hundred board certified medical illustrators worldwide. He has acted as a courtroom expert witness in obstetrics, orthopedics, and neurology, and has been a contributing illustrator to a variety of texts along with publications including the New England Journal of Medicine, Boston Globe, Fortune Magazine, and Lawyer’s Alert. He has also presented at a range of continuing medical and legal education seminars and events throughout the country. John holds a Bachelor of Arts degree in Fine Arts from Boston University. Prior to founding APS, he was employed by Harvard Medical School. He is a Massachusetts Continuing Legal Education faculty member and a member of both the Association of Medical Illustrators and the Massachusetts Association of Trial Attorneys.

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