An interview with Lee Ann Hanna, Director of Education, TriStar Centennial Medical Center (HCA), Nashville, Tennessee
Currently the Director of Education at TriStar Centennial Medical Center (HCA), Nashville, TN, Ms. Hanna has over thirty years experience in healthcare settings; sixteen years experience in neonatal, pediatric, and adult critical care; and fifteen years experience in knowledge management and quality improvement. She is a Certified Professional in Healthcare Quality and a National Association for Healthcare Quality (NAHQ) Fellow. Lee Ann regularly presents at nursing and quality education conferences on the local, state, regional, and national levels.
We recently spent some time speaking with Lee Ann about her insights, challenges; and opinions, gleaned from her years of clinical education in a large hospital setting. Here is an excerpt from that conversation:
HealthStream: You have had a long and varied career, on both sides of the educational fence. What, in your opinion, is the biggest change in Pharmaceutical/Medical Device (PMD) training over the last five or ten years?
Lee Ann Hanna: Devices and drugs have been around for a long time; we implement new and/or we convert to the next. The biggest change over the last five to ten years has been that it’s coming at a faster pace. Implementations may come rapidly; sometimes this is based on outcomes data, regulatory directives, availability of products, and/or contract negotiations. Organizations are continuously moving to highest quality and best price. It’s not a good thing or a bad thing. It’s a reality of our economic environment.
While that is the biggest change, there are other changes that affect PMD training. Hospitals must work at higher productivity standards. Seldom do you find hospitals that budget for PMD training. It is usually absorbed by the patient care units. Although some hospitals allow for training cost centers, when all is said and done, training costs still hit the bottom line.
There is a shortage of bedside nurses. This may be due to intermittent shortages related to call-outs, leaves, and turnover, or long term shortages related to supply and demand. Patient care units staff for patient care. Unless a PMD training program is moderate to big and requires extensive training, most of this training occurs during the same hours that bedside nurses are scheduled to deliver patient care. As patient care is the priority, this may lead to distractions and missed training opportunities. There is nothing more frustrating than to be asked to use a device or administer a drug without training. According to the rules and regulations of registered nurses in our state, nurses should not perform nursing techniques or procedures without proper education and practice.
There is also a shortage of clinical educators. This affects the organization’s ability to develop and implement PMD training programs. I am aware of hospitals that do not have clinical education departments or centralized clinical educators. While this work has been decentralized to patient care units, those nurses may not have the knowledge and experience to develop and implement effective and efficient training programs. They may also have to be flexed to patient care to meet staffing needs, which may cause delays and quality issues.
PMD companies face the same challenges as healthcare organizations. Their environment is moving at a rapid pace. Competition and resources are just as challenging for them. These companies must also work in a cost effective and efficient manner, especially when it comes to training. Some PMD companies consider training a value-added service. Some PMD companies will not sell a product unless staff members are educated and competent to use their products. The latter understand that proper use of their devices and drugs will lead to improved outcomes and higher quality. If you take care of quality, everything else falls into place.
HealthStream: How is PMD training more cost effective today than it used to be?
Lee Ann Hanna: In my opinion, online training, alone or paired with classroom activities, is more cost-effective than traditional standup training alone. Online training may be completed on demand by participants and saves resources (class room space, human resources, time, travel expenses, etc.) for both the hospital and the device and drug companies.
By using online training, we can assign it and track it. If a PMD company sponsors the online training it can be updated with changes (appearance, function, label use, discontinuation, etc.). The hospital does not need to rely on clinical educators to develop and review programs, a resource intensive task. I advocate online training for small changes and online training in conjunction with hands-on training for medium to large changes. We call this blended learning or problem-based learning. It is efficient and effective.