“That is a training issue.”

July 19, 2026

Anyone who works with technology development knows that there will be a time when someone will say, “That is a training issue”. This statement often comes after someone asks, “how will the user know how to do <insert workflow step>?”

Sometimes the technical steps are not necessarily intuitive to the user’s anticipation of what to do next. This is a mismatch in the user experience. When this occurs, the user has (at best) confusion in trying to identify the next step. The confusion can lead to extreme frustration that halts progress toward completing the next step in the process (and lost time). 

Example: Pop Up Window Advertisements

Consider when you see a pop-up window to save you 10% on your first order for any given advertisement. You may or may not be interested in the welcome discount. If not, it can be quite difficult to find the “X” on the screen to exit the offer. You look around all four corners and sometimes need to locate the very faint area where you can exit out. If not found, you could exit the screen or put in your email to just get to what you wanted to see. (Of note, this is likely by design to obtain your email address  ). 

The lack of visibility of the “X” is a user experience or more specifically, a usability design issue. Sure, one could say it is a training issue and tell each person they need to look VERY CAREFULLY each time they accidentally find themselves with a discount offer. However, this becomes the user’s issue rather than the system design issue that removes this extra step. This usability design issue turns into a training issue. The usability shifts from the responsibility of the system designers to that of the individual to “learn” how to “workaround” the intended design.

Healthcare Training Issues

Now, let us look at healthcare. Healthcare is dependent upon clinical and administrative information systems to manage the individual and population level care. However, most clinicians are not formally educated on the foundations of informatics and/or information system design. Therefore, there is an inherent concern and perhaps intimidation faced where there is concern about whether they are charting the right way. 

Some clinicians will over chart while others will struggle to know what exactly needs to be charted and may unintentionally miss something. The extremes here are a result of a culture, especially in nursing, of “if it is not documented, it is not done”. However, when it becomes hard to know where to go next or how to enter some data correctly, you see the (largely unintentional) risk of error.  Add to this baseline, a handful of “training issues” and we have just added more stress to an already  stressed and fatigued workforce. 

Of course there are some aspects that do require training. However, for a moment think about how many times you have turned to watch a video or training session to use your new smart phone. Much of what you need to be able to do with your smart phone or device can be figured out without a training session.

We should be striving for this type of user experience with healthcare technology.  The need for formal training sessions should be minimal or very brief. Instead, the design of the systems should be such that the user is able to follow what the next step is through an intuitive human computer interaction experience. 

There is an abundance of qualitative and quantitative data to show that nurses, doctors, and healthcare professionals in general are working against the clock each day. There are never enough minutes to go around for everything that needs to get done in that shift. To add more things to what is expected of them will only increase the burden felt rather than create relief.

Healthcare cannot be delivered without the use of technology. However, we must consider that we have a workforce already spread thin. Instead of putting more responsibility through “training issues”, why not create a sense of ease and/or intuitive flow for them to experience each day? 

~ Dr. Kelley

We have the ability to make change.

August 19, 2018    |   , , ,

Tonight I spoke to a group of graduate nursing students at Northeastern University about how to look at daily problems as opportunities to form impactful solutions.

Too often we just accept that ‘this is just the way that it is’ and keep battling the challenges that really don’t make sense when you have a moment to stop and think about them.

So what do you do? Well let’s think about the linen cart.

Tonight I asked the group how many had experienced a situation where there was never enough linen on the cart to change the bed or bathe the patient or get a new onesie or johnny for the patient. The vast majority raised their hands.

So why is it that we all experience this but yet it remains an issue? I think part of it is that we aren’t speaking up to ask why and help to solve the problem. I think we also haven’t necessarily been trained to recognize these issues as solvable problems. Instead, we view them as individual workarounds. Yet, it wastes valuable time that could be spent caring for the patient instead of running after linen on another unit. There is no reason why this needs to continue.

The same is true with many different workarounds that nurses, health care professionals, patients and families face each day in the health care delivery process. Tonight I encouraged the group to think about what bothers them or affects their ability to provide the best care and see how it could be solved.

If we don’t start to take on some of these issues within our profession, we will continue to workaround them. We have the ability to make change, we simply need to begin and/or continue to take action.

 

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Post originally appeared on LinkedIn on November 7th, 2017

Health Tech Venture Network Female Entrepreneurship Conference: Recap

August 19, 2018    |   , , ,

A nice recap of the HealthTech Venture Network Female Entrepreneurship Conference on October 7th in Seaport Boston.

“To hear the other women’s stories and to hear how similar, not necessarily the specifics are, but just the accounts of the day-to-day… I felt like I was in the right place. And there are so many times you feel like you’re not in the right place. So that was really rewarding for me.” – Tiffany Kelley of Nightingale Apps

 

 

Nightingale’s Innovative Nurse (October): Dr. Shanina Knighton PhD RN

August 19, 2018    |   , , , , ,

Meet Dr. Shanina Knighton:
The Entrepreneur in Patient Hand Hygiene

ShaninaKnighton

Describe your initial interest in patient hand hygiene? 

As a student nurse during my clinical rotations I would often hear about the importance of healthcare worker hand hygiene, but with flu outbreaks such as Swine and H1N1 being an issue at the time I wondered why patients did not practice hand hygiene. I asked my clinical instructor who said, “Our hands being clean matters more than patients.” I disagreed and wanted to theoretically understand how a population that comes to hospital settings because of illness could not be a risk to contaminating others.

What was the problem that you saw which was not being addressed? 

Throughout my years as a nursing student and now as a nurse, I repeatedly observed patients’ deficient hand hygiene practices. I would provide them with resources which they could not and would not use because of being sick, weak, bedbound or forgetful. I would watch them struggle to use the wall dispensers, sinks, hand sanitizer bottles and wipes.

As a nurse, I knew the burden and frustration of not being able to assist patients with hand hygiene every time they blew their nose, used their urinals, touched their wounds, or simply just wanted to clean their hands. Without many studies to support my phenomena, I created a patient-smart hand sanitation dispenser that affixes to the patient’s bedrail, reminds the patient when and how to clean their hands and advocates for the patient by telling others coming near to clean their hands. I remember pitching my product in front of a group of investors for an innovation startup fund and being rejected by a guy with no nursing background that said, “You seem nice…but only healthcare workers cause infections.”

What was a turning point for you in your efforts to support patients with hand hygiene? 

My expertise and years of experience was overshadowed by someone that never practiced as a clinician. That day changed my life. I said, “If entrepreneurs, inventors, investors, healthcare leaders whom have never practiced heavily influence products and services used by patients and nurses WITHOUT nurses, something is wrong.” Furthermore, I noticed that there was not much research or policies out there to support my claim that patients carry pathogens on their hands and have poor hand hygiene practice.

How did your entrepreneurial journey begin? 

I remember walking into Frances Payne Bolton School of nursing and saying, “I am an entrepreneur and infection control leader and I want to study patient hand hygiene because our patients need usable products.” I will never forget the words of Dr. Jaclene Zauszniewski, “Well study it then, let me tell you about out PhD Program.” Entrepreneurship launched my nursing career in research and research enhances the depth of innovation, collaboration and impact that I am and will be as an entrepreneur and researcher.

Project Entrepreneur via Rent the Runway

August 19, 2018    |   , , , ,

For any early stage entrepreneurs, this is a great opportunity to consider. I loved my time in the program two years ago.

Take a moment to watch this video: #BeInspired: Jenny Fleiss, Co-Founder of Rent the Runway

Post originally appeared on Dr. Tiffany Kelley RN on October 27th, 2017